rural

Perceptions of Adolescent Mothers on Feeding and Nutrition of their Children aged 0-3 Years in Rural Bangladesh

Published on: 16th June, 2023

Proper feeding practices at an early age are the key to improving a child’s overall health and achieving developmental milestones. In Bangladesh, a large portion of rural girls become mothers before the age of 18. Past records show that most interventions are designed to improve infant and young child feeding practices targeting older mothers. That is why, this study has been designed with an aim to explore the perceptions and practices of infant and young children feeding among rural Bangladeshi mothers aged <19 years old. Data was collected through in-depth interviews and group discussions with a total of 40 adolescent mothers who have children aged 0-3 years. Data has revealed that the majority of the mothers hold very limited knowledge of nutrition and child nutrition but those who are educationally a bit ahead hold a little better knowledge. Participants are aware of breastfeeding but they all misinterpret the term ‘exclusive breastfeeding’ with other liquid food. It has also emerged that most of the mothers know the ideal timing of starting complementary feeding but very few of them actually understand what to feed children. In spite of having misconceptions and superstation rural adolescent mothers practice responsive feeding instead of force-feeding. No gender discrimination has been found regarding child feeding. The findings of the study pinpointed that mothers are unable to practice proper infant and child feeding due to a lack of knowledge and limited affordability. Educating girls & young mothers and improving financial security could be an effective way to promote improved infant feeding practices.
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Water Purification Using Ceramic Pots Water Filter

Published on: 19th July, 2023

In this study, ceramic pot filters are made from clay and burn-out materials (sawdust) that give pore sizes capable of capturing contaminants. Manufacturing specifications were selected to achieve some results. Clay and sawdust are mixed in a 50% volume ratio each and sawdust was subjected to hot water extraction to give a treated sample. Filters produced comprised of untreated, treated, and a mixture of treated and untreated sawdust samples, some of which were dipped in a solution of silver nanoparticles while others were not dipped (treated undipped, treated dipped, mixed dipped, mixed undipped, untreated undipped, untreated dipped). The effectiveness of the produced filters for the removal of contaminants such as dissolved solids, turbidity, and metals was tested using water collected from the Ikeji Arakeji River in Osun, Nigeria. The results showed the filter with treated sawdust undipped in a solution of silver nano gave the best result in the removal of the contaminants. Also, the filter with the mixtures of treated and untreated sawdust gave a better result compared to the standard. While the standard gave a better result than the untreated undipped ceramic filter pot. In conclusion, with proper cleaning and maintenance of the filters, they can effectively provide treated water suitable for drinking to rural people affected by polluted water sources.
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Quality of Antenatal Care and its Determinants in the Urban-Rural Environment of Kamina, Democratic Republic of the Congo

Published on: 28th July, 2023

Introduction: Every woman should receive quality antenatal care during pregnancy wherever she lives. We carried out this research with the objective of evaluating the quality of antenatal consultations (ANC) in terms of periodicity, screening, and prophylaxis interventions during antenatal consultations in Kamina and to identify the determinants associated with inadequate ANC. Material and methods: This was a descriptive and analytical cross-sectional study carried out in 6 health facilities in Kamina over a period of 17 months with 476 women who had given birth having attended antenatal consultations at least once. A scoring grid of periodicity standards, screening, and prophylactic interventions with a score of 40 was used to qualify the ANC as adequate. Logistic regression was performed to identify the determinants of inadequate ANC. Results: 40.3% of mothers had reached at least 4 antenatal visits (3.4±1.36); 21.2% had started the ANC no later than 16 weeks for an average age of 22.8 weeks ± 6.19. Overall, 72.5% of pregnant women had benefited from ANC qualified as inadequate. After adjustment, the determinants of inadequate ANC were multigestity (aOR=1.86[1.08-3.19]), low level of education of the mother (aOR=3.93; 95% CI=[2, 08-7.42]), and attendance at a first-level health facility (aOR=3.22; 95% CI=[2.06-5.05]. Conclusion: In the majority of cases, the ANC received by pregnant women in Kamina is inadequate. The determinants thus identified should serve the actors to direct the means to improve the quality of antenatal care in Kamina.
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Case Report of a Child with Beta Thalassemia Major in a Tribal Region of India

Published on: 8th September, 2023

Introduction: Thalassemia is an inherited blood disorder of haemoglobin (Hb) synthesis, which affects different regions around the world. India has the largest number of children with beta-thalassemia major in the world, particularly in the tribal population. Heterozygous conditions are milder and even go unreported than the condition of homozygous where regular blood transfusion is required.Case report: This report focuses on a case of major beta-thalassemia in a child, whose parents are beta thalassemia minor to intermediate conditions, and who was treated by blood transfusion once a month. However, Thalassemia may be cured by allogeneic hematopoietic stem cell transplantation, although not everyone is a good candidate. Genetic counselling, prenatal diagnosis, and selective termination of affected fetuses are effective ways to control thalassemia.Discussion and conclusion: The paper reports a unique case of Thalassemia in rural India. The blood disorder while commonly presented in a juvenile whose parents were Thalassemia positive resulted in the termination of a fetus diagnosed with it. It archives the story of the parents who are now in the process of planning future offspring while mitigating disease risk. The case leads the way for effective management and containment of hereditary genetic disorders through carrier detection while planning alliances and offspring.
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Relationship between the Level of Spirituality and Blood Pressure Control among Adult Hypertensive Patients in a Southwestern Community in Nigeria

Published on: 19th September, 2023

Background: Spirituality has been strongly associated with good blood pressure control as it forms a strong coping mechanism in hypertensive patients. This hospital-based cross-sectional study was done to determine the relationship between spirituality and blood pressure control among adult hypertensive patients in rural Southwestern Nigeria to achieve good blood pressure control.Method: The selection was done by systematic random sampling technique. Socio-demographic and clinical information were obtained through semi-structured interviewer-administered questionnaires. The level of spirituality was assessed using the Spiritual Perspective Scale. Data were analysed using the Statistical Package for Social Sciences version 20.0. Statistical significance was set at p ≤ 0.05.Results: The mean age of the respondents was 61.1 ± 11.1 years. More than half (52.6%) had a high level of spirituality and more than two-thirds (67.1%) of respondents had controlled blood pressure. Respondents with a high level of spirituality were 4.76 times more likely to have good blood pressure control {p < 0.001, 95% CI (1.05-14.99)} than those with a low level of spirituality. Conclusion: Proper understanding and effective utilization of this relationship will assist health professionals and researchers in the appropriate integration of this concept into patients’ holistic care with the aim of achieving better blood pressure control among hypertensive patients.
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Emerging One Health Preparedness to Combat National Burden of Diseases in Pakistan: A Comprehensive Insight

Published on: 23rd November, 2023

In order to integrate and enhance the health of people, animals, and the environment, a multidisciplinary “One Health” concept has been coined. However, developing countries have frequently lagged in embracing this innovative vision. Pakistan’s ecology, human health, and animal health have all been severely jeopardized due to a lack of resources. Human health is significantly impacted by the spread and comeback of zoonotic illnesses, especially for people who live in rural regions and frequently interact with domestic or wild animals. More than 75% of zoonotic diseases were transmitted contiguously from animals to humans or indirectly through interactions among agents or vectors (including both humans and other animals). This review article gives critical insights into the most common zoonotic diseases found in Pakistan in addition to underlining the importance of the “One Health” philosophy in the management of these illnesses. Interdisciplinary research efforts are required given the current circumstances in order to politicize sustainable solutions for decreasing the disease burden in human and animal populations simultaneously.
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Determinants of Rural Women's Participation in Agricultural Cooperatives in Burundi: The Case of the TWITEZIMBERE and REKATUJANE Rice Cooperatives in the GIHANGA Commune

Published on: 13th February, 2024

This article shows the driving factors of rural women's participation in the TWITEZIMBERE and REKATUJANE rice cooperatives in the GIHANGA commune. These factors are related to the preservation of traditional culture in Burundi in general and in rural areas in particular, where women are in the majority. To achieve this, the research methodology used is both qualitative (individual interviews and documentary research) and quantitative (questionnaire administered to respondents). The results of this research show that traditional culture has forced rural women to stay at home to care for children and perform various household chores. This situation of isolation leads to a lack of information about the benefits of rice-growing cooperatives and the value they can bring to their members. It is also observed that rural women lack the will to adopt the new rice farming practices in Cooperatives. This situation of lack of will to adopt new behavior has hindered the massive participation of rural women in rice cooperatives. Finally, the article emphasizes that the illiteracy of these rural women and the lack of external technical and financial support are considered other important factors that constituted the barriers to their massive participation in rice cooperatives. To deal with this series of problems, the researcher has discovered strategies that can encourage rural women to participate massively in rice cooperatives, in particular, to become members of rice cooperatives that help their members to make them known and receive external technical and financial support, for example, incentives from the government. For this, the Government must therefore help them by providing multifaceted support including local and foreign technical and financial partners. Similarly, cooperative leaders might seek out various donors for their agricultural cooperative associations.
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Strengthening Healthcare Delivery in the Democratic Republic of Congo through Adequate Nursing Workforce

Published on: 19th February, 2024

The Democratic Republic of Congo (DRC) grapples with a critical shortage of nurses, exacerbating disparities in healthcare access and outcomes. This mini-review examines the factors impacting the nursing workforce in the DRC and presents potential solutions to strengthen it. Decades-long regional conflicts have endangered the nursing workforce, resulting in an imbalanced distribution that disproportionately favors urban areas over rural regions. Inadequate healthcare funding, compounded by mismanagement, has led to resource scarcity and inequitable distribution, further hampering nursing efforts. Additionally, stagnant policy reforms and ineffective advocacy have hindered improvements in nurse employment, wages, education, and working conditions. Infrastructure deficiencies and medical supply shortages have also contributed to reduced incentives for nursing professionals. Therefore, we undertook a mini-review aimed at offering a succinct and targeted overview of nursing care in the DRC. This involved analyzing available literature and data concerning the nursing workforce with a particular focus on the DRC. We believe that addressing these interlinked challenges necessitates comprehensive strategies that prioritize establishing regional stability, responsibly allocating and increasing healthcare funding, incentivizing nurse recruitment and retention through policy adjustments, enhancing healthcare infrastructure and nursing education, and fostering both local and global collaboration. Investing in nursing is paramount for transforming healthcare delivery in the DRC, particularly considering nurses' pivotal roles in delivering preventive, therapeutic, and palliative care services. Strengthening nursing capacity and addressing systemic challenges are essential steps toward mitigating healthcare disparities and enhancing population health, aligning with the objectives outlined in the United Nations Sustainable Development Goals.
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Preparation of Healthy Cookies from Germinated Flour Blends of Finger Millet and Pearl Millet Sweetened with Jaggery

Published on: 2nd April, 2024

Millets are physiologically and therapeutically healthy with high nutritious value and are in rising demand in emerging markets like India, China, Africa, and other developing countries including the Western world. Germinated Millets have high digestibility and are used as healthy food for children’s growth and development. Climate change resilience technology, high nutritional value, and the announcement of the year 2023 as “International Millet Year” have made it very popular. Bakery items based on Millet, particularly cookies, are becoming more popular in both urban and rural areas. Jaggery is raw sugar prepared from sugarcane juice and is considered superior to white sugar. It offers numerous nutritional and therapeutic benefits, including anti-carcinogenic with antitoxic actions. Hence, this study aimed to prepare healthy food items with germinated finger and pearl Millets for better nutritional quality that are attracting the attention of health-conscious people on a worldwide scale. Cookies made from blends of germinated wheat flour (GWF), germinated finger millet flour (GFMF), and germinated pearl millet flour (GPMF) were examined for their physicochemical qualities, in vitro digestibility, antioxidant activity, and overall acceptability by consumers. In vitro protein digestibility (62.24-82.34%), starch digestibility (47.48-62.41%), total phenolic content (11.45–49.12 mg GAE/100 g), and antioxidant activities significantly increased as the proportion of GFMF and GPMF flour increased in the cookie samples, whereas total starch, dietary fiber, carbohydrate, and phytic acid decreased. The physical qualities of the cookies were also improved by the addition of GFMF and GPMF flours. Cookies with acceptable sensory properties, including taste, aroma, appearance, mouthfeel, crispiness, and overall acceptability, were produced by blending 60% GWF, 20% GFMF, and 20% GPMF (T2). This study demonstrated that GFMF and GPMF flour blends may be used as functional ingredients to create superior goods.
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Examining the Effects of High Poverty and Unemployment on Rural Urban Migration in Nigeria and its Consequences on Urban Resources and Rural Decline

Published on: 2nd April, 2024

This study examines the intricate interplay among poverty, unemployment, education, and rural-urban migration in Nigeria, employing both quantitative and qualitative analyses. Quantitative data were analyzed using SPSS software, computing descriptive and inferential statistics such as regression analysis. Quantitative findings reveal income inequality, with many individuals earning below average. Education emerges as a key determinant of economic opportunities, with higher education associated with better outcomes. Moreover, poverty and unemployment exhibit a strong positive correlation with adverse outcomes, emphasizing the need for targeted interventions. Qualitative insights delve into the motivations behind rural-urban migration, shedding light on the economic drivers compelling individuals to seek opportunities in urban areas. Participants’ narratives uncover the challenges faced by migrants, from housing to accessing essential services. Additionally, the role of remittances in sustaining sending communities is highlighted, underscoring their significance. This study underscores the multidimensionality of poverty, unemployment, and migration and emphasizes the need for holistic, evidence-based approaches to promote inclusive development. Recommendations include investments in education, job creation, social safety nets, income inequality reduction, and support for migrant integration. These measures can contribute to equitable economic growth and improved well-being in Nigeria.
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The Impact of Telerehabilitation on Physical Therapy Services in Rural Communities

Published on: 3rd May, 2024

Telerehabilitation is a transformative approach to physical therapy, revolutionizing the accessibility of healthcare in rural communities through the strategic use of Telecommunications technology. This novel approach has the potential to significantly enhance the efficacy of healthcare delivery, particularly considering the critical challenges posed by geographical isolation and resource scarcity. This paper explores the multifaceted benefits of Telerehabilitation, including increased access to care and reduced costs, alongside the challenges of technological barriers and privacy considerations. It provides a comprehensive overview of Telerehabilitation’s impact on rural healthcare, emphasizing its capacity to optimize patient outcomes and proposing strategies for effective implementation. The findings of this study suggest that the use of technology to deliver telecare is a key means of delivering equitable healthcare to underserved populations, a promising way to improve access to rural physiotherapy services address the challenge of telehealth resources, and promote the long-term sustainability of rural Telerehabilitation practices.
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Prospective Community-based Study of Still Births in Remote Villages with Low Resources

Published on: 13th June, 2024

Background: Stillbirth (SB), either because of intrauterine or intrapartum fetal death, is amongst the most devastating pregnancy complications, hardest to predict, real challenge for health systems. India probably accounts for the highest SB numbers in the world.Objectives: A community-based prospective study was carried out to know the burden, and causes of SBs in rural women of remote region.Material methods: After approval of the ethics committee of the Institute in Maharashtra for broader research, which was service-oriented, the present study was conducted in 100 villages around the village with health facilities. These villages were included keeping in mind future services. After obtaining the consent of women, information was prospectively recorded on their predesigned tool (which was for broader work), by asking women and seeing their records of antenatal and intranatal care on a regular basis. The study subjects were selected after obtaining information from nurse midwives, Accredited Social Health Activists (ASHAs), and Aaganwadi workers. As the plan was to serve, there was excellent cooperation. The tool was made for broader work. Villages were visited 5 days a week. Study was community-based in villages in remote, hilly region with various local issues so any information the women gave conclusion and was in the record was used.Results: A total of 3905 births occurred over two years, 3635 (93%) term, and 270 (7%) preterm. Amongst 3635 term births, 3474 (95.6%) were live births, 161 (4.4%) SBs, amongst 270 preterm births, 239 (88.5%) were live births, 31 (11.5%) SBs. Of 192 SBs, 48 (7.2%) SBs were amongst 2690 women with anaemia, (16 (2.4%) SBs amongst women with very severe anaemia, 12 (1.8%) SBs were amongst 667 women with severe anaemia, 12 (1.8%) SBs were amongst 664 women with moderate anaemia, 8 (1.2%) SBs were amongst 680 women with mild anaemia). Overall of 192 (4.9%) SBs, 31 (18.1%) SBs were among 517 women with hypertensive disorders of pregnancy (HDsP) 8 (4.4%) SBs amongst 280 women with moderate HDsP, 12 (6.9%) SBs amongst 175 women with severe HDsP, 11 (6.8%) SBs in 62 women with eclampsia. Overall of 192 SBs, 6 (3.1%) babies had weight < 1 kg, 8 (4.1%) of ≥ 1 to < 1.5 kg, 50 (26.0%) ≥ 1.5 to < 2 kg, 64 (33.3%) ≥ 2 to < 2.5 kg, 64 (33.3%) 2.5 kg and more, obviously fewer babies more deaths in birth weight less than 1. 5 kg, more so less than 1 kg.Conclusion: Overall SBs were in women with disorders but 4.5% SBs did occur in women with no disorder. SBs were significantly higher amongst babies weighing less than 1 kg, beyond this weight, numbers were similar.
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Improving Cardiac Rehabilitation Referral Rates in Patients with Coronary Heart Disease from Diverse Communities Using an Electronic Order System

Published on: 29th June, 2024

Introduction: Despite the benefits of Cardiac Rehabilitation (CR), local and national CR referral and participation rates remain low when compared to established cardiovascular therapies, especially amongst racial/ethnic groups. Objectives: This study investigated the effects of the implementation of a CR program and electronic order set (EOS) in a large health system on CR referral and participation rates among a diverse group of patients with Coronary Heart Disease (CHD). Methods: A total of 360 patients from UCSD Health who presented with ACS were prospectively evaluated during initial hospitalization and 6- and 12-weeks post-discharge. The multivariable logistic regression model assessed referral and participation rates by week 1 and -12 post-discharge, adjusting for gender, age, race, ethnicity, geography, and referring physician subspecialty. Results: UCSD CR program implementation led referral rates to increase at week 1 (Pre- 38.6% and Post-54.9%, p = 0.003) and week-12 (Pre- 54.1% and Post- 59.8%, p = 0.386). Post-CR referrals were more likely at week-1 (OR: 1.93, 95% CI 1.27-2.95) and week-12 (OR: 1.26, 95% CI 0.79-2.00). EOS implementation increased referral rates at week-1 (Pre- 40.3% and Post- 58.7%, p < 0.001) and week-12 (Pre- 54.9% and Post- 60.4%, p = 0.394) with referrals more likely at week-1 (OR: 2.1, 95% CI 1.35-3.29) and week-12 (OR: 1.25, 95% CI 0.795-1.98). Participation in CR following EOS was more likely at both week-1 and week-12. Multivariable analysis revealed disparities in referral based on race, geographic location, and referring physician subspecialty. Conclusion: A CR program and EOS implementation were shown to increase referral rates with long-term potential for increasing referral and participation rates. Condensed abstract: This prospective study investigated the implementation of a Cardiac Rehabilitation (CR) program and Electronic Order Set (EOS) within the same health system on CR referral and participation rates. 360 patients with ACS were evaluated over 12 weeks. UCSD CR program and EOS implementation led referral rates to increase at week-1 and -12. CR participation was more likely to increase at week-1 and -12 following EOS. Multivariable analysis revealed disparities in referrals disproportionally affecting racial and ethnic minority groups and rural communities. CR and EOS implementation may increase CR referral rates for diverse patients with CHD.
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Pattern of Eye Disease in Nenwe Rural Eye Clinic, Nigeria: A Seven Year Review

Published on: 8th July, 2024

Background: The establishment of eye clinics in the form of rural outreach centers as a means of educating and providing eye care to rural residents was made necessary by the lack of eye care services in rural areas within Nigeria and the need to increase the cataract surgical rate among ophthalmologists in training. Understanding patterns of eye diseases in rural areas and eye health-seeking behaviors is crucial to achieving the goals of Vision 2020 especially for aspiring ophthalmologists.Aim and objectives: To examine the types of eye conditions observed at Nenwe, a rural outreach post of a tertiary hospital, and to evaluate their distribution.Methodology: A retrospective analysis of all patients who were seen at the community eye clinic during seven years was carried out. Records of patients at the Nenwe outreach eye clinic dating from November 2016 to August 2023 were examined, yielding information on patients examined during the period of study.Results: Glaucoma was the most common eye condition to be diagnosed. Cataracts were the second most common eye condition accounting for 20.8%. Other common eye illnesses were refractive error (9%), pterygium (7%), and allergic eye disease (6%) with 129, 101, and 95 cases, respectively. Retinal detachment (51 cases), prebyopia (47 cases), corneal lesion (58 cases), and dry eye condition (47 cases) were less common.Conclusion: The results show the burden of eye disorders in the Nenwe rural community and the importance of community-based eye care services.
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Causes of Coronary Angioplasty Denial in Patients Diagnosed with Significant Coronary Artery Disease in East Afghanistan

Published on: 30th October, 2024

Coronary Artery Disease (CAD) is a leading cause of mortality worldwide, with coronary angioplasty being a crucial intervention for patients with significant disease. This study aimed to identify and analyze the causes of coronary angioplasty denial in patients with significant coronary artery disease in Afghanistan, focusing on demographic, socioeconomic, and clinical factors.A case-control study was conducted with a sample size of 213 patients diagnosed with significant CAD at tertiary care center in Afghanistan. The case group consisted of 106 patients who were denied angioplasty, and the control group included 107 patients who underwent the procedure. Data were collected on demographic characteristics, comorbidities, education, residence, functional status, income, and the reasons for angioplasty denial. Descriptive statistics and comparative analyses were performed to assess the factors associated with denial.The primary reasons for angioplasty denial were financial constraints (45.3%, p < 0.001), limited hospital facilities (15.1%, p = 0.045), patient refusal (23.6%, p < 0.001), and physician preference for conservative management (12.3%, p = 0.091). Denial rates were higher among patients who were older, had multiple comorbidities, were from rural areas, and had lower education and income levels. Illiteracy and cultural beliefs contributed significantly to patient refusal, while inadequate healthcare infrastructure disproportionately affected rural populations.Financial and infrastructural barriers are the leading causes of coronary angioplasty denial in Afghanistan, exacerbating disparities in healthcare access, particularly among low-income and rural patients. Addressing these issues through policy reforms, improved healthcare infrastructure, and targeted public health education is essential to reducing CAD-related morbidity and mortality in the country.
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