Evaluation of the 5th National Program on Maternal, Child and reproductive Health / Монголын Анагаах Ухаан

Background@#As a result of the previous programmes implemented by the Government of Mongolia, maternal mortality and under-five mortality rates had declined fourfold from 1990 levels to 2015 The Millennium Development Goals (50.0), shifting from a country with a high maternal mortality rate to a country with a moderate maternal mortality rate [6, 7, 8, 9]. However, as maternal and child mortality have not been steadily declining, regional disparities in care have not been eliminated, unmet needs for family planning have increased, contraception use has reduced, abortions and repeat abortions have not decreased. The quality of antenatal care is low; the continuing challenges have led to the development and implementation of the 5^th National Programme. As the programme was finished in 2016-2020, assessing its impact on Mongolia is significant. @*Objective@#Evaluating the objectives of the National on Maternal, Child and Reproductive Health Programme, the implementation of planned activities, whether the intended results have been achieved according to the criteria was to determine future needs and the main areas of focus. @*Materials and Methods@#Quantitative and qualitative methods were used to analyse the information required for the assessment. The activities of the programme implementation plan were evaluated in the form of activities implemented in 2016-2020 and time spent on implementation, which implemented, who was involved, the budget spent, the type and the number of beneficiaries, and the reasons for nonimplementation. @*Results@#A total of 28 indicators of the National Program was 76.8 percent. In 2016, by the time the programme was launched, the under-five mortality rate was 20.8 per 1000 live births. However, the goal to reach 15 in 2021 was achieved to reach 12.7 by successfully implementing the programme. The program aimed to reduce the maternal mortality rate from 48.6 per 100000 live births to 25 per 100000 live births in 2021, but has not yet been achieved, reaching 30.2 in 2020 and 43 in the first five months of 2021. Initially, the program implementation plan included cooperation with more than 600 organisations, such as 9 ministries, 14 government organizations, 21 provinces, health centers, and maternity hospitals. However, an excessive number of organizations and an unnecessary amount of planned work made it impossible to identify the beneficiaries in addition to the Government of Mongolia, donors such as UNFPA, UNICEF, and WHO made a significant contribution to the implementation of the programme by providing financial and technical assistance. As of 2017-2021, no funds had been found to implement the National Programme on how much has been spent on information, publicity, and advocacy measures. According to the interviews with the programme implementers, a lack of leadership, lack of proper planning, turnover in the civil servants, and the ongoing pandemic had resulted in the lack of a transparent annual implementation plan, the insufficient time and resources for next year’s planning and implementation of the planned work, and the lack of budget resources. @*Conclusion@#As the total of 28 indicators of the National Programme was 76.8 percent, it has been evaluated as having achieved specific results.

Comparison of pre training and post training knowledge of hypertension among medical officers of Narmada district of Gujarat, India

Background: Hypertension is a major risk factor contributing to cardiovascular and cerebrovascular diseases and death. Medical officers play an important role in Indian public health care system. The objective of this study was to evaluate the impact of training program on knowledge about hypertension among medical officers working in government health centres in Gujarat, India.Methods: A one day training program was conducted for medical officers of various Primary Health Centres (PHCs) and Community Health Centres (CHCs) in Narmada district of Gujarat. This training focussed on screening, diagnosis and management of hypertension, essential and secondary hypertension, lifestyle modifications, various anti-hypertensive drugs and practical aspects of examining a patient with hypertension. Impact of the training program was evaluated by a questionnaire consisting of 10 questions which was used as a pre-test and a post-test.Results: A total of 30 medical officers (18 male and 12 female) attended the training. The mean age of participants was 37.4 years and average clinical experience was 11 years. The pre-test mean score of participants was 4.52 and post-test mean score was 8.44. This improvement in the post-test mean score was found to be statistically significant. On comparison of questions answered incorrectly in pre-test and post-test, we found that there was a significant reduction in the number of questions answered incorrectly in the post-test.Conclusion: There was a significant improvement in the knowledge of medical officers regarding screening, diagnosis and management of hypertension as a result of their training.

Acceptance of immunization by caregivers of children attending a tertiary health facility in Northwestern Nigeria

Introduction: Immunization against childhood diseases is well received in most developed countries; also, countries in the Caribbean and Latin America have attained over 90% immunization coverage unlike the most sub-Saharan African countries, such as Nigeria, which have a dismally low coverage. Our objective is, therefore, to determine the acceptance and willingness to complete immunization of children by caregivers seen in our health facility. Materials and Methods: This study was cross sectional involving caregivers attending the pediatric outpatient clinic of Aminu Kano Teaching Hospital, Kano, Nigeria, during the month of December 2017. This was questionnaire based and was administered by the researchers and trained assistants. It contained 20 questions consisting of both open- and close-ended questions. Results: All respondents were aware of the childhood immunization program and were willing to accept all vaccines for their children. They all believed that immunization was beneficial to their children; 126 (79.7%) respondents could correctly state the advantages of childhood immunization. However, only 18 (11.4%) of the respondents could correctly list the names of the childhood vaccines in the National Programme of Immunization. About 33.5% of respondents reported six visits as the total number of visits for childhood immunization; higher proportion of health workers and those with tertiary educational qualification could correctly list the names of the vaccines given to their children, and these observations were statistically significant (Chi-squared test = 27.786, df = 1, P = 0.000; Fisher's exact test = 12.421, P = 0.004). Conclusion: This study showed that most respondents were willing to accept and complete the immunization schedule; however, there was a significant knowledge gap, especially in listing the names of the vaccines and the expected number of immunization visits.

Grupo de cessação de tabagismo na atenção primária à saúde: experiência de uma unidade de saúde de Porto Alegre/RS / Smoking cessation group in primary health care: experience at a health unit in Porto Alegre, RS

Objetivo: avaliar a frequência e tempo de cessação de tabaco em usuários que realizaram o Grupo de Cessação de Tabagismo em uma Unidade de Saúde de Porto Alegre/RS. Métodos: um estudo transversal, quantitativo, analítico, por meio da aplicação de um questionário com ex-participantes dos Grupos de Cessação de Tabagismo, realizados entre 2011-2014 da Unidade de Saúde SESC, Porto Alegre/RS. A entrevista foi composta por duas partes: a primeira com dados pessoais e socioeconômicos (sexo, idade, idade no momento do grupo, quantas pessoas moram na mesma casa, a renda total da casa), e a segunda sobre a cessação do tabagismo (se parou de fumar com o grupo, se voltou a fumar, se participou dos 4 encontros do grupo, pontos positivos e negativos do grupo). Resultados: trinta e oito pacientes foram entrevistados, 52,6% deles pararam de fumar com a ajuda do Grupo de Cessação, destes 50% seguem sem fumar e 100% deles participaram dos 4 encontros preconizados pelo INCA, essencial na cessação (p=0,001). Dos demais que não pararam de fumar (47,4%), apenas 33,3% participaram dos 4 encontros, 60,5% da amostra total usaram algum tipo de medicamento e a diferença entre o índice de Fagerström entre o grupo que parou de fumar e o que não parou não foi significativo. Dos pontos positivos do Grupo, a troca de experiências entre os membros foi o mais relevante, enquanto, no tocante ao ponto negativo, a curta duração do grupo e a falta de um grupo de manutenção tiveram destaque. Conclusões: o Grupo de Cessação de Tabagismo da Unidade SESC, na forma como está estruturado tem auxiliado os pacientes na cessação, uma vez que mais da metade dos participantes pararam de fumar. A participação nos 4 encontros do Grupo mostrou ser mais eficaz que o uso dos medicamentos. Algumas modificações podem ser feitas, para que cada vez mais os usuários consigam alcançar o objetivo esperado, sendo o Grupo de Manutenção uma estratégia possível, para aumentar o tempo de cessação, auxiliando na recaída.

Objective: evaluate the frequency and duration of tobacco cessation among users who took part in the Smoking Cessation Group at a Health Unit in Porto Alegre, RS. Methods: a cross-sectional, quantitative, analytical study that administered a questionnaire to past participants of Smoking Cessation Groups conducted between 2011-2014 at the SESC Health Unit, Porto Alegre, RS. The interview was composed of two parts: the first with personal and socioeconomic data (gender, age, age at the time of the group, number of people living in the same household, the total income of the household), and the second on smoking cessation (did they stop smoking with the group, did they go back to smoking, did they participate in the four meetings of the group, positive and negative points about the group). Results: thirty-eight patients were interviewed, 52.6% of them stopped smoking with the help of the cessation group, of these 50% continue not smoking and 100% of them participated in the four meetings recommended by the Brazilian National Cancer Institute (INCA), essential in cessation (p=0.001). Among the others who did not quit smoking (47.4%), only 33.3% participated in the four meetings. Among the total sample, 60.5% used some type of medication, and the difference in the Fagerström index between the group that stopped smoking and the group that did not stop was not significant. Among the positive points about the group, the exchange of experiences among members was the most relevant, while among the negatives the short duration of the group and the lack of a maintenance group stood out. Conclusions: we conclude that the Smoking Cessation Group of the SESC unit, in the way it is structured, has helped patients with cessation, since more than half of the participants stopped smoking. Participation in the 4 group meetings has proved more effective than the use of drugs. Some modifications can be made so that more and more users could reach the expected goal, with the Maintenance Group being a possible strategy to increase the duration of abstinence, helping against relapse.