• ISSN 2399-1623

Volume 2

Social accountability in maternal health services in Baglung district, Nepal: a qualitative study

31 December 2018
J Glob Health Rep 2018; 2: e2018041

Despite there being many state and non-governmental organisation (NGO) health programs, Nepal still has a high maternal mortality ratio of 258. Previous research has indicated that social accountability mechanisms can improve maternal health. However, the functioning of these mechanisms has not yet been explored in Nepal. Social accountability mechanisms can be identified and analysed through the information, dialogue & negotiation model.

The quality of care in family planning services: an assessment of family welfare centres in Gujranwala, Pakistan

29 November 2018
J Glob Health Rep 2018; 2: e2018027

To assess the quality of provision, the present study assessed ten core needs of clients attending family planning services including information, access, choice, safety, privacy, confidentiality, dignity, comfort and continuity of care as well as the opinion of clients on the service provision.

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Non-adherence among women enrolled in a contraceptive vaginal ring use study in Kisumu, Kenya, 2014-2015

29 November 2018
J Glob Health Rep 2018; 2: e2018032

Given future potential use of vaginal rings to prevent HIV infection, we examined the association of contraceptive vaginal ring (CVR) non-adherence with user dissatisfaction, tolerability, demographic, and behavioral factors.

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Planned social network change and modern contraceptive use in a rural Ethiopian community

29 November 2018
J Glob Health Rep 2018; 2: e2018034

Over the last decade, Ethiopia has substantially increased uptake of modern contraception and experienced a decline in total fertility, coinciding with implementation of the national Health Extension Programme (HEP), involving an extensive deployment of health extension workers (HEWs), and a health development army (HDA) of volunteer families. The dynamics of such change are important. This multi-method qualitative study was conducted in a rural community in Oromia, Ethiopia, as part of a larger effort to understand the influence of social networks on modern contraceptive use.

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Assessment of knowledge and usage of HIV post exposure prophylaxis among healthcare workers in a regional hospital in Ghana

13 November 2018
J Glob Health Rep 2018; 2: e2018028

Post exposure prophylaxis remains the single most important means of decreasing HIV infection upon occupational exposure. It offers over 80% protection against HIV sero-conversion when initiated within 72 hours of exposure and if the treatment regimen followed diligently for 28 days. This study assessed the level of knowledge and usage of post exposure prophylaxis among healthcare workers in the Eastern Regional Hospital, Koforidua, Ghana where HIV prevalence is high.

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Improving care for people with asthma: building capacity across a European network of primary care organisations – the IPCRG’s Teach the Teacher Programme

03 November 2018
J Glob Health Rep 2018; 2: e2018026

The International Primary Care Respiratory Group (IPCRG) is a global network of organisations committed to improving assessment/treatment of chronic respiratory disease (CRD) in primary care. As a charity IPCRG supports improvements in health systems within member countries by disseminating research evidence and offering evidence-based resources, such as the U-BIOPRED (Unbiased BIOmarkers in PREDiction of respiratory disease outcomes) research into different phenotypes of asthma and IPCRGs desktop helper - which is short practical guidance distilled from the evidence on structured asthma review – termed “SIMPLES”.

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A narrative review of protocols for the management of respiratory illness on short-term medical missions (STMMs) in Latin America and the Caribbean

01 November 2018
J Glob Health Rep 2018; 2: e2018035

Respiratory illnesses are prevalent on short-term medical missions (STMMs) in Latin America and the Caribbean, and commonly include upper respiratory infections, asthma, and allergic rhinitis. There have been no previous attempts to describe protocols that international volunteer clinicians use in managing these patients. The purpose of this study was to collect North American clinical protocols used by sending organizations in their volunteer operations in Latin America and the Caribbean, summarize the most common pharmacologic and non-pharmacologic management strategies, and compare these to published international practice recommendations.

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Pilot peer health education for noncommunicable disease prevention in Bangladesh, Ethiopia, and Palau

26 October 2018
J Glob Health Rep 2018; 2: e2018039

Noncommunicable diseases (NCDs) are growing health threats in developing countries. We previously conducted epidemiological and qualitative ethnographic studies on NCD risk factors in Bangladesh, Ethiopia, and Palau, and found that NCD risk factors were significantly prevalent. Although people had some knowledge of NCDs, they had no clue to change their daily risky behaviour, revealing urgent needs for developing appropriate health education programs. Peer health education is a strategy widely applied in developing countries for infectious disease control and maternal and child health, and known to be effective to change behaviour. This article aims to describe the experience of developing peer health education modules and evaluating the trials.

Characteristics of men who have sex with men and transgender women in Myanmar who test frequently for HIV

25 October 2018
J Glob Health Rep 2018; 2: e2018040

HIV prevalence among men who have sex with men (MSM) and transgender women (TW) in Myanmar is increasing and less than half report having a HIV test in the past 12 months. The promotion of regular testing among this group has been identified as a key priority of the national HIV response, yet there remains limited information on HIV testing patterns and frequency among MSM and TW.

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Analysis of quality assurance in the hospital sector of the People’s Republic of China

22 October 2018
J Glob Health Rep 2018; 2: e2018038

Quality assurance of medical treatment in hospitals has become increasingly important in the People’s Republic of China in recent years. Health sector reforms have mainly focused on cost reduction, leading to undesirable developments in the quality of medical treatment. One serious problem concerns aggression towards medical personnel in cases where treatment has proven unsuccessful. This article reviews the general situation of hospitals, the payment of doctors, the legal situation, and finally the organisation of medical quality management in the People’s Republic of China. The study is based on a literature research in English and Chinese, which in particular includes recent literature from 2015 onwards. In addition, laws, draft laws and legal research are systematically processed. As such, the People’s Republic of China has already established a system of DRGs and quality management for hospitals, but it faces many practical problems. Especially data quality has to be improved. Organisationally, further control functions have to be implemented and regular supervision is missing. Experiments with pay-for-performance systems have shown that this seems to be a way to improve medical treatment. Ultimately, the reform of the pay structure for hospital doctors must be addressed first, before further measures in terms of quality assurance can be pursued effectively. This might be the main topic for further research to be done.

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A review of organizational arrangements in microfinance and health programs

02 October 2018
J Glob Health Rep 2018; 2: e2018024

Combining health programs with microfinance is gaining more recognition as a pathway for improving health and increasing access to health services among the poor, especially women living in low-income countries. Recently published reviews have summarized the changes in health behaviors and health outcomes due to the effective layering of health interventions with microfinance initiatives. However, a large gap remains in defining and understanding the organizational strategies for implementing effective health programs and services that improve the health and social well-being of women and their families.

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The global health impact of a multidisciplinary medical service trip: lessons from Belize

02 October 2018
J Glob Health Rep 2018; 2: e2018029

The Rush University Belize Immersion Experience (RUBIE) aims to engage healthcare professionals in a multidisciplinary team to build a home for a deserving Belizean family. A complimentary purpose of this program is for team members to achieve cultural immersion and a broader understanding of healthcare disparities in Belize.

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From images to voices: a photo analysis of medical and social support needs of people living with HIV/AIDS in Tanzania

02 October 2018
J Glob Health Rep 2018; 2: e2018031

Tanzania is one of the countries hardest hit by HIV/AIDS in Sub-Saharan Africa. Since early 1980s, different levels of community interventions have been designed to provide care and address challenges faced by people living with HIV/AIDS (PLWHA). These efforts are of little value, however, if they lack the opinion of PLWHA on their needs. We used photographs taken and selected by PLWHA to identify perceived needs and challenges related to daily living with the disease.

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A cross sectional study on the occupational airborne exposure and the prevalence of self-reported asthma, and respiratory symptoms amongst workers in selected factories in Nairobi, Kenya

02 October 2018
J Glob Health Rep 2018; 2: e2018033

Inhalation of airborne particulate matter of less than ten microns diameter (PM10) in workplaces causes a variety of respiratory ailments and symptoms. This cross-sectional study was conducted on factory production workers (N=388) to investigate the association between occupational airborne exposure to PM10 and the prevalence of asthma and respiratory symptoms amongst factory workers in selected Nairobi factories.

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Hand Therapy Assessments for Use with International Technicians (HTAIT)

02 October 2018
J Glob Health Rep 2018; 2: e2018036

Hand Therapy Assessments for Use with International Technicians (HTAIT) is a simple, easy to use needs assessment intended to help identify current knowledge as well as areas for growth in the rehabilitation of the hand and upper extremity. The target population includes hand therapists and non-profit organizations preparing to travel internationally. This tool can be administered to international technicians, nurses, or healthcare staff at a host institution that have been identified as participants of the learning opportunity. The HTAIT consists of four assessment modules that can be used together or independently depending on purpose of the trip: Basic Upper Extremity Anatomy, Wound Care & Scar Remodeling, Orthotic Principles and Rehabilitation. The scoring rubric and grid allow the instructor to use the score(s) in identifying the technician’s most likely learning level. The results of the HTAIT allow for tailored training, demonstration, and learning opportunities by assisting the visiting therapist or organization in determining the level of competency in a host therapy technician. Targeted learning opportunities lead to a more effective experience for both the visiting and host practitioners, while increasing the likelihood of long-term carryover of occupational therapy principles.

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Health facility readiness and facility-based birth in Haiti: a maximum likelihood approach to linking household and facility data

08 September 2018
J Glob Health Rep 2018; 2: e2018023

Haiti has one of the world’s highest maternal mortality ratios. Comprehensive obstetric services could prevent many of these deaths, though most births in Haiti occur outside health facilities. Demand-side factors like a mother’s socioeconomic status are understood to affect her access or choice to deliver in a health facility. However, analyses of the role of supply-side factors like health facility readiness have been constrained by limited data and methodological challenges. We sought to address these challenges and determine whether Haiti could increase rates of facility-based birth by improving facility readiness to provide delivery services.

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Eastern European Roma: ethnic discrimination in the public healthcare system

07 September 2018
J Glob Health Rep 2018; 2: e2018025

The term "human rights" describes the inherent, equal, and irrevocable freedoms of the individual, and includes access to the basic necessities of life, freedom of expression, right to justice, and state of peace. Among these rights is access to quality healthcare and medical treatment for chronic and acute illness. In Eastern Europe, the Roma minority experience limitations to the provision of quality medical care as a result of cultural, ethnic, and racial stigma. Such discrimination results from historic sociocultural and economic seclusion across the entire European Romani diaspora, and leads to higher disease incidence and mortality amongst members of this ethnic group. This paper examines some of the barriers Roma face in Eastern European healthcare systems and provides considerations for future social changes to allow all citizens and patients access to equal treatment.

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Hardcore smoking among daily smokers in male and female adults in 27 countries: a secondary data analysis of Global Adult Tobacco Surveys (2008-2014)

03 September 2018
J Glob Health Rep 2018; 2: e2018019

Hardcore smokers (HCS) who do not want to quit make it more difficult for tobacco control efforts to further reduce smoking prevalence. We aimed to quantify the burden of HCS among daily smoking adult males and females in 27 countries.

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Factors associated with psychological distress among members of HIV discordant couples in western Kenya: the role of adverse childhood experiences

24 August 2018
J Glob Health Rep 2018; 2: e2018018

The relationship between measures of psychological distress and factors such as adverse childhood experiences (ACE) and HIV infection have not been well studied among members of HIV discordant couples living in Kenya.

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Identifying distinctions between undergraduate and graduate global health programs

24 August 2018
J Glob Health Rep 2018; 2: e2018022

The field of global health has traditionally been taught at the graduate level, but there are a small number of undergraduate level global health programs in the U.S. The development of undergraduate global health programs poses important questions for program administrators in terms of developing competencies and navigating overlap between undergraduate and graduate programs. Specifically, which competencies should undergraduate students be expected to master and how do these intersect with those of graduate programs?

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School violence, perceptions of safety and school attendance: results from a crosssectional study in Rwanda and Uganda

30 July 2018
J Glob Health Rep 2018; 2: e2018020

Adolescents displaced by conflict face a number of risks, and access to education has potential to have multiple protective aspects in humanitarian settings. Yet, the impact of violence experienced at school by adolescents in humanitarian contexts is poorly understood, especially in terms of impacts on educational outcomes.

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What is needed to realize universal “health” coverage? The meaning of health revisited

30 July 2018
J Glob Health Rep 2018; 2: e2018021

Health has been a long-term target of the World Health Organization (WHO) and United Nations (UN), where the meaning of health is sometimes restricted to longevity without diseases. However, health is perceived differently by the wider population, and thus should be reconsidered to realize the Universal Health Coverage (UHC), which is one of the most important targets of the Sustainable Development Goals (SDGs). Based on health from the perspective of medical anthropology and historical changes since ancient China and global diversity, we propose a comprehensive framework for health impairments and how to tackle them. This framework may contribute to understanding health and realizing UHC in its true sense.

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Randomized controlled trial evaluating the utility of urine HPV DNA for cervical cancer screening in a Pacific Island population

06 July 2018
J Glob Health Rep 2018; 2: e2018016

Non-invasive, self-collection sampling methods for human papillomavirus (HPV) DNA detection have the potential to address logistical and cultural barriers to Pap screening, particularly in under resourced settings such as Yap state in the Federated States of Micronesia – a population with low levels of screening and high incidence of cervical cancer.

Elimination of soil-transmitted helminthiasis infection in Bangladesh: knowledge, attitudes, and practices regarding mass drug administration

21 June 2018
J Glob Health Rep 2018; 2: e2018017

Despite several cycles of Mass Drug Administration (MDA), however, the prevalence of Soil-transmitted helminthiasis (STH) remains high in Bangladesh. A clear understanding of local knowledge, attitudes, and practices (KAP) related to the acceptance and utilization of MDA is critical for effective implementation of this intervention.

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Driving a greater understanding of non-communicable diseases in Africa through collaborative research: the experience of the GSK Africa NCD Open Lab.

16 June 2018
J Glob Health Rep 2018; 2: e2018012

The majority of premature deaths from non-communicable diseases (NCDs) occur in low-income countries. However, clinical research in these patient populations is generally lacking. Thus, many treatment paradigms for NCDs are either absent or extrapolated from populations with different genetics, health needs, and socio-economic circumstances. The objective of the study was to evaluate the outcomes from the first call for proposals from the GSK Africa NCD Open Lab.

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How the global health community will need to shift to tackle the Sustainable Development Goals

16 June 2018
J Glob Health Rep 2018; 2: e2018015

The global health goals for the 2030 Agenda for Sustainable Development is bold and ambitious. Achieving the health targets requires complete departure from the healthcare delivery standards set to meet Millennium Development Goals (MDGs). The existing health systems, particularly in low-income countries and some middle-income countries are frail and a nationally-led overhaul is needed. Nations should operate in partnership with key actors including the community. Further, innovation and high-quality evidence should drive policy decisions, clinical or public health practice and further investment in health. Only through bolstered health systems, robust partnerships and innovative healthcare delivery, lofty targets in the health Sustainable Development Goals be met.

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Testing the efficacy of the Lucky Iron Fish<sup>&#x00AE;</sup> in reversing iron deficiency anemia in rural, impoverished regions of Guatemala

24 May 2018
J Glob Health Rep 2018; 2: e2018014

According to the World Health Organization (WHO), the most common nutrient-related cause of anemia is a lack of dietary iron (iron deficiency anemia, IDA). In regions of the world where populations are at greatest risk for IDA, barriers make screening and subsequent treatment challenging. Thus, IDA remains one of the most common, yet treatable, nutrition-related health problems in developing countries. A new approach to IDA remediation, called Lucky Iron Fish<sup>&#x00AE;</sup> (LIF) (Lucky Iron Fish, Guelph, Canada), overcomes many of these challenges. When placed into a pot of boiling, acidified water for 10 minutes, the LIF releases iron into the cooking water. Subsequently, the food absorbs the iron from the iron-enriched water, increasing the overall iron content of the meal. The purpose of this 52-week longitudinal study, conducted in rural, underserved regions of Guatemala, was to determine whether or not iron status improved after 12 months of using a LIF for meal preparation.

Lest we forget, primary health care in Sub-Saharan Africa is nurse led. Is this reflected in the current health systems strengthening undertakings and initiatives?

08 May 2018
J Glob Health Rep 2018; 2: e2018009

Primary health care (PHC) in most African countries is nurse led. In South Africa, PHC has a unique history where efforts to provide holistic health care to rural communities began in the early 1940s. There are initiatives to ensure that doctors including General Practitioners (GPs) get to public clinics in South Africa-great initiatives but bearing in mind the current doctor patient ratios and the difficulties to get doctors into rural areas, until we get there, nurses will be and are providing most of PHC services.

Vision-related quality of life and access to eye care among recently resettled Syrian refugees in Philadelphia

01 May 2018
J Glob Health Rep 2018; 2: e2018013

Eye health is a major contributor to quality of life and remains a significant global health concern. Syrian refugees are at increased risk for worsening eye care due to the rapid loss of healthcare infrastructure. No studies to date have explored the visual needs and vision-related quality of life in refugee groups.

Competency for public health policy analysis: a case study of Pakistan.

19 April 2018
J Glob Health Rep 2018; 2: e2018011

…health policies and systems are themselves social and political constructions, it is important to acknowledge the particular value of social science perspectives in the field (1). Public policy analysis is very complex in Pakistan. In a developing country like Pakistan, Public policy regarding health, law and order, international relations and economic policies require more research. Many accountability factors are responsible for policy failures, like: no clear policy goals, political commitment, policy leadership, governance system, centralization, unavailability of resources, and influence of donor’s policies. Pakistan’s current policy document, the National Health Policy (2016-2025), is determined to reform the health sector in accordance with Health for All (HFA) (2).

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Association of Apolipoprotein L-1 polymorphisms with blood pressure in three multi-ethnic African studies

05 April 2018
J Glob Health Rep 2018; 2: e2018005

Genetic variants in the Apolipoprotein L1 (APOL1) gene greatly increase risk for chronic kidney disease in African Americans. We hypothesized that the APOL1 renal risk alleles would be associated with higher blood pressure in Africans.

Prevalence of adverse birth outcomes and disparity of unmarried women in South Korea: a systematic review

04 April 2018
J Glob Health Rep 2018; 2: e2018008

In this study, we aim to analyze the association between different types of cohabitation status and obstetric outcomes of preterm births (PTB), low birthweight (LBW), small for gestational age (SGA) and achieve a manifestation of social marginalization among varied marital status of women in South Korea.

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Supporting strong families and capable communities through cross-national research

04 April 2018
J Glob Health Rep 2018; 2: e2018010

Mental and behavioral ill-health are growing global problems and while there are promising evidence-based approaches aimed at reducing their impact, availability of services varies greatly, not only across nations, but also between urban, regional, and remote locations. Rural areas face accessibility and acceptability challenges related to mental health services that are similar to barriers experienced in developing countries. Initiatives to address mental health challenges in under-served rural areas can inform global mental health strategies.

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Predicting US state teenage birth rates using search engine query data on pregnancy termination and prevention.

01 April 2018
J Glob Health Rep 2018; 2: e2018001

Search engine query data (SEQD) include the information collected by search engine companies about search terms used, geographical location, and the date of the search. With an increasing need for data to monitor emerging global health risks, as well as evaluate the effectiveness of various interventions, SEQD provide important proxy, descriptive data. SEQD in health research are just beginning to be explored, most famously to predict influenza outbreaks. Most subsequent research has similarly focused on communicable diseases, although there is some limited use in other areas of public health.

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Freshwater access in high salinity regions: impacts and adaptation insights from the Ganges River Delta

01 April 2018
J Glob Health Rep 2018; 2: e2018007

Salinity, exacerbated by global environmental change and other phenomena, is a major challenge affecting densely populated river deltas around the world. One critical consequence of salinity is its effect on access to freshwater, crucial for drinking, hygiene, and other livelihood activities. To gain insight on the impacts and adaptation responses triggered by rising salinity, we conducted a multi-method study based in the Ganges river delta, in the region of southwest coastal Bangladesh.

The ethical implications of culture: challenges in the care of female sex workers in India

29 March 2018
J Glob Health Rep 2018; 2: e2018002

Cultural traditions are among the few instances in which ethical boundaries can be significantly shifted. The way in which we may judge a situation in the United States may likely have different social connotations in another setting which force us to reconsider our judgments. But what about traditions which are so viscerally disheartening that they demand universal change? Among those that have garnered such considerations include female genital mutilation, common in parts of Africa, Asia, and the Middle East. Less publicized but equally worthy of serious thought is cultural sex work, found in many parts of India.

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Do community level interventions work in the same way on incidence and longitudinal prevalence of diarrhoea among under five children in rural and urban slum settings? Insights from Stop Diarrhoea Initiative in India

29 March 2018
J Glob Health Rep 2018; 2: e2018003

Childhood diarrhoea is one of the leading causes of under-five morbidity and mortality globally including India. The National Family Health Survey in India shows that prevalence of diarrhoea among under 5 children has increased from 9.0% in 2005-06 to 9.2% in 2015-16 reflecting no impact on prevalence in a decade. As the burden of diarrhoea is influenced by health behaviors and set of risk factors prevailing in an environment where people live in, the authors in this study attempted to understand how community based interventions on prevention, control and treatment of diarrhoea work in rural areas and urban slums differently.

Progress towards health systems strengthening in Myanmar.

29 March 2018
J Glob Health Rep 2018; 2: e2018006

The Union of Myanmar is in transition from an isolated military regime to a new “democratic” government intent on engaging with the international community. However, decades of underinvestment in health care have resulted in an undeveloped and fragile health care system with poor health outcomes in maternal health, child health, communicable diseases and traffic related incidents. Although morbidity and mortality have improved over the last decade, they still remain the highest in the South East Asia, reflecting the unmet health needs of the Myanmar population. Large health disparities between indigenous rural and urban populations are significant since 70% of the population reside in rural areas.

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