Community Health Equity Research & Policy

Epidural analgesia is widely used as an effective method of pain relief in labor. This study was therefore designed to investigate the awareness and level of utilization of obstetric analgesia in labour among pregnant women in Wesley Guild Hospital Ilesha, Nigeria. The descriptive study involving 110 pregnant women revealed that about half (41.8%) of the respondents had poor knowledge score, 37.3% had fair knowledge, while 20.9% had good knowledge score on obstetric epidural analgesia. Only 10.9% of the respondents had used epidural analgesia and 83.3% were satisfied with the use. There was a significant relationship between knowledge of respondents and the use of obstetric epidural analgesia. Moderate awareness, poor knowledge and low level of utilization of obstetric epidural analgesia were documented. There is a need for adequate awareness programs to enhance the knowledge of epidural analgesia and its utilization among pregnant women in order to reduce the excruciating labour pain.

Background: Spiritual Well-Being (SWB) is an important aspect of health. Since soldiers, as members of community, are faced with numerous spiritual, psychological, and physical problems, belief in spirituality can play an important role in explaining their purpose in life (PIL). Therefore, this study aimed to evaluate SWB, PIL, and the relationship between these two concepts in conscripts. In this cross-sectional study, 301 soldiers were selected by available sampling method from one of the military barracks in Iran 2019. Data were collected using the demographic, SWB, and PIL questionnaires. The results showed that SWB of the soldiers were at the high level (100.6 ± 12.30) and their PIL were at the moderate level (112.92 ± 13.70). Furthermore, a direct and intermediate relationship was observed between the soldiers' SWB and PIL (P <0.001, r = 0.50). Based on the findings, increased SWB enhanced PIL in soldiers and vice versa. To increase generalizability of the data, studies over a larger statistical population are recommended in different cultures. Findings of this study can also identify the interventional strategies to increase the soldiers' purpose in life.

A study of environmental attributes of HIV/AIDS affected households in Ijesa region, Nigeria (N = 297). Data from both primary and secondary sources were used to establish the relationship between socio-economic and environmental characteristics at different rural community zones; namely traditional core, post traditional and contemporary. There were more female HIV/AIDS patients, located in traditional core zones (78.1%) with high house density, living in shared apartments where residents shared sleeping and bath/toilet rooms. Thus, rape was significantly associated with the design and habitation density of households. In addition, widowhood, young age, informal education, menial jobs and unemployment of patients did not correlate with most environmental variables related to HIV/AIDS in contemporary zone compared with traditional zone. However, wealth status and quality education in relation to good housing environment and decent house density were significant in contemporary zone respectively. The study concluded that policies on HIV/AIDS prevalence at rural community level should focus more on high density areas having poor socio-economic and environmental characteristics.

This cross-sectional study was conducted in 2019 on 204 postmenopausal women aged 45–55 years who referred to Yazd health centers to determine the predictors in initiating and sustaining nutritional behaviors to deal with menopausal symptoms based on the multi-theory model (MTM). The participants were required to complete the demographic information questionnaire and a researcher-made questionnaire over the effective nutritional behaviors in menopause based on the MTM. The data were summarized and analyzed using SPSS 18 and AMOS23 by running descriptive indicators and path analysis. Behavioral confidence (β = 0.61, P < 0.001) had a higher predictive power in initiating a nutritional behavior compared to the changes in the physical environment (β  = 0.13, P < 0.05) and participatory dialogue (β = 0. 10, p < 0.05). Among the behavior-related constructs, only emotional transformation (β = 0.78, P < 0.001) could predict the behavioral sustaining. A positive and significant association was observed between nutritional behavior sustaining and quality of life (β = −0.41, P < 0.001). The MTM is an appropriate model for predicting the initiation and sustaining of the nutritional behaviors in dealing with menopause. The behavioral confidence, changes in physical environment, and participatory dialogue constructs played a significant role in predicting the initiation of behavior. The emotional transformation construct was also an important predictor in maintaining nutritional behaviors to deal with menopausal symptoms. So, future researchers are recommended to conduct MTM-based investigations according to the predictive constructs among menopausal women.

Introduction: Over consumption of salt adversely affects health and is associated with some diseases. Salt over consumption has been reported to be higher in Asian countries including Iran. This research aimed to identify the facilitative factors of reduced salt consumption among 20–65 year-old women to develop effective educational interventions. Methods: This research used qualitative content analysis. We included 42 (31 women aged 20–65 years residing in Hamidia, Yazd and 11 healthcare providers) using Purposeful sampling method. Data were collected through focal group discussions (three groups of 6) and in-depth semi-structured individual interviews with 24 Participants. Data analysis was done using Graneheim and Lundman’s approach. Results: Motivators and facilitators were extracted. The former consisted of sub-categories: physical fitness and healthcare, obtaining others’ approval, family cooperation and support, internal motivators, contextual motivators and healthcare staff support. Sub-categories of the latter were gaining more information from different instructions, willingness to acquire self-protection skills and nutritional advice. These factors affected to reduce the salt intake among women. Conclusion: In the light of the qualitative results of motivating and facilitating factors, it is essential to enhance internal motivators and increase access to information via different communicative channels in community including schools, medical care providers and public associations. It is also necessary to pave the way for more family and medical staff support, provide appropriate educational and advertising programs, raise women’s awareness and change their attitude and behavior with this concern.

In most cultures of the world, infertility is seen as a disaster and is associated with a myriad of emotional and psychological problems for women. Using Complementary and alternative medicine (CAM) can help treat infertility. The present qualitative study aimed to explore women’s attempts related to CAM use in infertility causes and diagnosis. This qualitative study has been carried out through a purposive sampling technique on 78 women living in Neyshabur, Iran. An individual interview and focus group discussions (FGDs) was used to collect data. Purposive sampling was used based on the objective of the study and the characteristics of a population. The data collection was discontinued when saturation occurred, and no new themes or information were explored in the data. Data analysis was performed by content analysis and Atlas T software. This study revealed medical diagnosis and traditional medicine, custom activity, medicine causes, and nutrition issues influence women’s view pints and attempt towards infertility and CAM use. Results suggested that infertility should be understood not only in biomedical terms but in light of cultural beliefs and the contingent need for culturally-appropriate supportive CAM. The application of CAM along with medical medicine is an essential element in assisting couples in infertility causes.

Inappropriate healthcare waste management (HCWM) may lead to health hazards through the release of toxic and infectious agents into the environment. This study aimed to assess the appropriateness of a Health Action Model (HAM) operationalized in a training intervention to promote behavioral intent towards HCWM practice among hospital staff. This was a quasi-experimental intervention study of 128 hospital staff attending a training intervention in Sabzevar Hospital, Iran. Four training intervention was carried out using potential constructs of the HAM model to compare the quality of HCWM process and behavioral intent of hospital staff before and after a training session. A questionnaire based on HAM and multiple statistical analyses were used to assess the effectiveness of the training intervention. The average age of the eligible participants was 35.05 ± 9.4 years. A majority of the participant was married (88%), nursing staff (54%) and possessed a bachelor’s degree (66%) or diploma (18%). After the intervention, a significant change (p < 0.05) was observed in the intervention group compared to the control group in staff knowledge, attitude, self-efficacy, belief, and motivation. Further, our result showed a significant improvement from 53.6 ± 24.3 to 83.6 ± 11.5 in the behavioral intention toward HCWM practice. This work provides evidence of the effectiveness of the HAM as a guide in which the potential determinates that influence an individual’s behavioral intention toward medical waste practice were identified and described. This model help promote behavioral intention at a variety of target audiences and setting in waste management practice.

Coverage of HIV testing services (HTS) is generally low among men who have sex with men (MSM) and transgender women (hijra) in Bangladesh, thus impeding the national goal of attaining the 90-90-90 target. In this context, this article delineates HTS uptake barriers among these populations. This qualitative study entailed 30 in-depth interviews, six focus groups and seven key-informant interviews with purposively selected MSM and hijra, alongside service providers. Participants cited individual and interpersonal barriers such as low risk perception and misconceptions about HIV testing, programmatic barriers such as knowledge gaps among peer service providers, as well as community and structural barriers such as the criminalization and stigmatization of male-to-male sex. Considering these contexts, it is essential for stakeholders to improve the HTS modality using multipronged approaches to address the multifaceted barriers of HTS uptake.

This study investigated maternal care utilization in Primary Healthcare Centers (PHCs) in four rural communities in Ughelli North LGA, Delta State, Nigeria. The study is a cross-sectional household survey that used a structured questionnaire to elicit information from 398 women within the reproductive ages. The data were analyzed with descriptive and multivariate statistical methods. The data revealed that 67.1% of currently pregnant women utilized ANC in PHCs, 55.7% of women who reported recent birth delivered in PHCs and 30.9% delivered outside health institutions. The odds for delivery care utilization in PHCs were significantly lower for women who reported at least secondary education [aOR: 0.50; 95% CI: 0.22   – 1.16] and those on the highest income bracket N(15,000–99,000) [aOR: 0.08; 95% CI: 0.00 – 0.82]. Poor quality of care accounts for the highest proportion of the reasons why some women refrained from utilizing maternal care in PHCs despite proximity. Delta State government should put in place measures to upgrade PHCs in the rural part of the State.

The ongoing COVID-19 pandemic has necessitated providing populations with simple and relevant, actionable informational messages for them to be informed on individual and community level measures to combat the pandemic. Distilling guidance from various sources into simple actionable message themes in a short time frame should be the hallmark of any rapid health promotion campaign. We developed and disseminated actionable Information, Education and Communication (IEC) messages on prevention and control during the ongoing COVID-19 pandemic by selecting five key message themes of prevention. A modified Delphi technique was used for the development process which was peer reviewed after consensus was generated. An online training model using specifically developed YouTube videos and Zoom Meetings was utilized to train Master Trainers and the further hierarchy reaching out to 6989 Community Resource Persons at the peripheral echelons. Conservatively the population reached out has been estimated to be more than 6 million (across 1.2 million households), over a two week period in April 2020. The implementing agency has created 300 videos in around 22 languages based on the 5 Key Messages, which are available online for universal access. A rapid IEC campaign that can be developed, designed and rolled out in a short span is required for emergency situations such as the ongoing pandemic. NGOs play an important role in reaching out relevant messages to the community, filling in the gaps by virtue of their relative systemic agility.