HIFA-Zambia: Health Care for Allhttps://hifaforums.org/hifa-zambia<p>This is an open discussion forum and was launched on 5th May 2011.</p> 2f714ad7-fc66-4161-9a73-8b92209074b6https://hifaforums.org/_/hBNAJ6SndiscussionCollaborating to reduce the burden of group B strep diseaseDear HIFA-Zambia colleagues, <br /> <br />Wishing you all a happy, healthy New Year! <br /> <br />Interested in group B strep (GBS) as a researcher, healthcare professional, or health advocate working to improve the health of Zambians? <br /> <br />1. Become a member of GBS Research Connect at https://www.gbsresearchconnect.org to collaborate with other members to better understand GBS and how it can affect the health of populations at all stages of life in all parts of the world. Membership is free and includes access to special events, forums, blogs, mentor and mentee opportunities, and more! <br /> <br />2. Register at https://members.gbsresearchconnect.org/Events for our exciting member-exclusive webinar “Collaborating to Close GBS Data Gaps | Part I: Use of Genomics” being held on the 18th of January, 9AM EST / 2PM GMT to learn how our speakers are closing GBS data gaps in their communities and worldwide. <br /> • Dr Dorota Jamrozy, Sanger Institute, will be presenting on results from the JUNO project <br /> • Dr Luria Leslie Founou, CEDBCAM-RI, will be presenting on GBS in non-pregnant populations <br /> • Dr Laura Oliveira, Universidade Federal do Rio de Janeiro, will be presenting on GBS from a One Health perspective <br /> <br />Looking forward to all we can accomplish to reduce the burden of GBS disease in 2024! <br /> <br />Marti Perhach <br /> <br />HIFA profile: Marti Perhach is CEO/Cofounder of Group B Strep International, United States. Professional interests: Group B strep disease research and prevention, prenatal infection, One Health. Email address: marti.perhach AT gbs-intl.org <br /> <br /> <br />Thu, 04 Jan 2024 19:15:32 Zgroupbstrepinternational@gmail.com224418b0-0ff2-4a6e-b3fa-c03bcabd458ehttps://hifaforums.org/_/m69hskpndiscussionPrevalence, perceptions and factors associated with menthol cigarette smoking: findings from the ITC Kenya and Zambia SurveysDear HIFA and HIFA-Zambia colleagues, <br /> <br />NextGenU.org is supporting HIFA in 2023 and 2024 to explore issues around information and learning needs in relation to tobacco, alcohol and opiates. <br /> <br />I would like to share this new paper from Tobacco Control that highlights the false belief that menthol cigarettes are less harmful than other cigarettes. <br /> <br />CITATION: Prevalence, perceptions and factors associated with menthol cigarette smoking: findings from the ITC Kenya and Zambia Surveys. <br />Tobacco Control. 32(6):709-714, 2023 11. <br />Authors: Kaai SC; Fong GT; Ong&#39;ang&#39;o JR; Goma F; Meng G; Craig LV; Ikamari L; Quah ACK; Elton-Marshall T <br />https://tobaccocontrol.bmj.com/content/32/6/709.abstract <br /> <br />ABSTRACT <br /> <br />Abstract <br />Background Menthol masks the harshness of cigarette smoke, promotes youth smoking and encourages health-concerned smokers who incorrectly believe that menthols are less harmful to smoke menthols. This study of smokers in Kenya and Zambia is the first study in Africa to examine menthol use, smokers’ beliefs about its harmfulness and the factors associated with menthols. <br /> <br />Methods Data were from the International Tobacco Control (ITC) Kenya Wave 2 (2018) and Zambia Wave 2 Survey (2014), involving nationally representative samples of smokers. This study focuses on 1246 adult smokers (644 in Kenya, 602 in Zambia) who reported smoking a usual brand of cigarettes (menthol or non-menthol). <br /> <br />Results Overall, menthol use was significantly higher among smokers in Zambia than in Kenya (48.0% vs 19.0%), females (45.6% vs 31.2% males), non-daily smokers (43.8% vs 30.0% daily) and those who exclusively smoked factory-made (FM) cigarettes (43.0% vs 15.2%). The erroneous belief that menthols are less harmful was more likely among smokers in Zambia than in Kenya (53.4% vs 29.3%) and among female smokers (38.5% vs 28.2%). In Kenya, menthol smoking was associated with being female (adjusted odds ratios (AOR)=3.07; p=0.03), worrying about future health (AOR=2.28; p=0.02) and disagreeing with the statement that smoking was calming (AOR=2.05; p=0.04). In Zambia, menthol use was associated with being female (AOR=3.91; p=0.002), completing primary school (AOR=2.14; p=0.03), being a non-daily smoker (AOR=2.29; p=0.03), exclusively using FM cigarettes (AOR=14.7; p&lt;0.001), having a past quit attempt (AOR=1.54; p=0.02), believing that menthols are less harmful (AOR=3.80; p&lt;0.001) and choosing menthols because they believed it was less harmful (AOR=3.52; p&lt;0.001). <br /> <br />Conclusions Menthols are highly prevalent among females in both countries. There is a need in African countries to combat the myth that menthols are less harmful and to ban menthol and other flavourings. <br /> <br />HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org <br />Mon, 01 Jan 2024 16:16:20 ZNeil Pakenham-Walshc4d76e05-ff7c-4ae4-be07-3b6e2c81871dhttps://hifaforums.org/_/aSRGgcz3discussionFW: SAVE THE DATE: African Alliance for Maternal Mental Health Webinar and Annual General Meeting, 29 November 2023From: African Alliance &lt;africanalliancemmh@gmail.com&gt; <br />Sent: Thursday, November 2, 2023 10:06 AM <br />Subject: SAVE THE DATE: African Alliance for Maternal Mental Health Webinar and Annual General Meeting, 29 November 2023 <br /> <br />Greetings from the African Alliance for Maternal Mental Health (AAMMH)! <br /> <br />AAMMH (www.aammh.org) is an umbrella organization supporting the formation of alliances of organizations in Africa to promote the mental well-being of mothers. The challenges that can affect the mental well-being of mother and baby in Africa are cross-cutting and so require a multi-disciplinary approach. That is why AAMMH encourages organizations in fields of maternal and child health, nutrition, gender-based violence, women’s rights and other sectors to come together in the form of alliances to raise awareness of country specific challenges in advancing good maternal mental health. <br /> <br />You are invited to AAMMH’s webinar in collaboration with MAMI Global Network titled, &quot;Opportunities and challenges arising from the integration of maternal mental health into a Maternal and Child Health (MCH) service in Ethiopia&quot; by Dr Mubarek Abera, Jimma University, Ethiopia. <br /> <br />This webinar will be followed by the Annual General Meeting of AAMMH. This will be an important opportunity to learn about the work of AAMMH and network with organizations working in African countries to promote good maternal mental health. <br /> <br />The 1.5 hour event will take place on Zoom starting at 1pm CAT/ 12pm WAT/ 2pm EAT/ 11 am GMT <br /> <br />Please register for these events through this link : https://www.eventbrite.com/e/maternal-mental-health-webinar-and-annual-general-meeting-tickets-749865436707?aff=oddtdtcreator <br />Kindly invite other people and organizations within your network from your country. <br /> <br />Kind regards, <br />Dalitso Ndaferankhande <br />Executive Director <br />African Alliance for Maternal Mental Health <br />Cell: +265 98 224 8938 <br /> <br />MSc Global Mental Health, University of Glasgow <br />Chevening Scholar 2020 <br />Fri, 24 Nov 2023 13:42:36 Zclare.l.taylor@kcl.ac.uk9d4dc993-ad1a-438d-83ea-a12d07212df9https://hifaforums.org/_/pcAEVoMtdiscussionKnowledge, attitudes and practices related to Taenia solium taeniosis and cysticercosis in Zambia (2)Interesting. Thank you for sharing this Neil. An old friend (retired nurse) of my late mum (nurse) developed adult onset seizes and luckily, she had a CT scan brain done and a diagnosis of neurocysticercosis was made (had to come from Luanshya on the Copperbelt to Lusaka for this) by a neurosurgeon, and after 3 months of treatment, is back to normal. <br /> <br />We need more of such case studies shared so that public health preventive measures can be intensified. <br /> <br />I am about to launch a health podcast and hope to have an episode on this one as the general public get shocked on how worms can find themselves in their brain! Will share details of the podcast by the end of this month of November. <br /> <br />Regards, <br />Wezi <br /> <br />HIFA-Zambia profile: Wezi P. M. Sunkutu is a medical doctor (GP) with over 5yrs exposure in the rural parts of the country at both clinical and administrative level. http://www.wezisunkutu.flp.com/home.jsf drwezisunkutu AT gmail.comThu, 09 Nov 2023 07:46:45 ZWezi Sunkutuf47f5dc6-280e-404c-9a39-7c72d4af73ebhttps://hifaforums.org/_/6aCfHwJmdiscussionGBS Research Connect has launched!Greetings, HIFA-Zambia colleagues! <br /> <br />Group B Strep International is pleased to announce that GBS Research Connect is here! Join to connect with fellow researchers, healthcare professionals, and health advocates to further group B strep (GBS) research and disease prevention for both babies and adults in our communities and worldwide. <br /> <br />Individual memberships are free and include access to events, the ability to join forums, collaborate, upload GBS-related research and case studies, become a mentor or mentee, and more! <br /> <br />To join, please apply at https://members.gbsresearchconnect.org/apply or visit https://www.gbsresearchconnect.org/ to learn more. We look forward to collaborating with you! <br /> <br />Best! <br /> <br />Marti <br /> <br />(Ms.) Marti Perhach <br />CEO/Cofounder <br />Group B Strep International <br />+1 909 620-7214 <br />marti.perhach@gbs-intl.org &lt;mailto:marti.perhach@gbs-intl.org&gt; <br />groupbstrepinternational@gmail.com &lt;mailto:groupbstrepinternational@gmail.com&gt; <br />www.groupbstrepinternational.org &lt;http://www.groupbstrepinternational.org/&gt; <br />Facebook &lt;https://www.facebook.com/GroupBStrepInternational&gt; | Twitter &lt;https://twitter.com/GroupBStrep&gt; | Instagram &lt;https://www.instagram.com/groupbstrep&gt; | <br />LinkedIn &lt;https://www.linkedin.com/company/group-b-strep-international&gt; <br /> <br /> <br />Promoting awareness and prevention <br />of group B strep disease in babies <br />before birth through early infancy <br /> <br />Thu, 09 Nov 2023 07:40:24 Zgroupbstrepinternational@gmail.com30b7fc00-b90c-4bc5-8741-c19186a7a0c1https://hifaforums.org/_/410b9ksjdiscussionKnowledge, attitudes and practices related to Taenia solium taeniosis and cysticercosis in ZambiaDear HIFA-Zambia colleagues, <br /> <br />Below are the citation and author summary of a new paper in PLOS Neglected Tropical Diseases. Full text: https://doi.org/10.1371/journal.pntd.0011375 <br /> <br />CITATION: Community knowledge, attitudes and practices related to Taenia solium taeniosis and cysticercosis in Zambia <br />Gideon Zulu et al. <br />PLOS NTDs. Published: August 10, 2023 <br /> <br />AUTHOR SUMMARY <br />Taenia solium taeniosis / cysticercosis (TSTC) is endemic in Zambia. We aimed at assessing knowledge, attitudes and practices (KAP) related to TSTC and epilepsy in a community setting in Chiparamba area of Chipata district of the Eastern Province of Zambia. Understanding KAP is important in designing and implementing public health interventions for control and eradication of TSTC in a community. We found generally poor KAP related to TSTC among the community in our study area. This lack of knowledge about TSTC infections can lead to behaviours that facilitate the transmission and maintenance of T. solium infections and could hinder efforts to control the most preventable cause of epilepsy in the sub-Saharan African region. More efforts to improve KAP using a One Health approach for the control and elimination of TSTC are therefore required in Zambia. <br /> <br />Best wishes, Neil <br /> <br />HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.orgThu, 02 Nov 2023 11:52:59 ZNeil Pakenham-Walshf9f7bf2b-5b79-451d-a36b-a99480eb156chttps://hifaforums.org/_/mx5psjv8discussionHIFA-Zambia members: Can you spare a few seconds or minutes to support our global survey?Dear HIFA-Zambia members, <br /> <br />Re: Global survey on Universal access to reliable healthcare information, in official relations with the World Health Organization <br /> <br />There are just a few days left before our online survey closes! The survey closes on October 15th <br /> <br />Please act now: <br /> <br />IF YOU HAVE A FEW SECONDS <br />Please retweet: https://twitter.com/hifa_org/status/1711260704458637314 <br /> <br />IF YOU HAVE A FEW MINUTES <br />1. Have you completed the survey yourself? Please do: www.hifa.org/survey2023 <br />2. Have you emailed the survey to your colleagues? Please forward this message to them and invite them to complete the survey also: www.hifa.org/survey2023 <br />3. Have you told your contacts about the survey? Below is an email you can use/adapt <br /> <br />+++ <br />Universal access to reliable healthcare information: Your voice will help shape the future of healthcare worldwide <br /> <br />Dear [Name], <br /> <br />Lack of timely access to reliable healthcare information results in countless deaths and avoidable suffering every day. Reliable information saves lives. Misinformation destroys lives. <br /> <br />Healthcare Information For All (HIFA.org) is leading a global survey on how to accelerate progress towards universal access to reliable healthcare information, in official relations with the World Health Organization. The survey is available in ten languages. <br /> <br />We invite everyone to complete the survey: patients, health workers, publishers, library and information professionals, policymakers, knowledge brokers, researchers, the general public… The findings will help inform action by WHO, HIFA and partners towards universal access to reliable healthcare information. The survey is open until 30 Septemebr and takes 5 minutes to complete. Please complete the survey now and forward this URL widely to your contacts! www.hifa.org/survey2023 <br /> <br />[Sign off] <br />+++ <br /> <br />I attach a graphic you can add to your emails or social media posts. <br /> <br />With thanks, Neil <br /> <br />HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org <br /> <br /> <br /> <br /> <br /> <br /> <br />Mon, 09 Oct 2023 08:00:24 ZNeil Pakenham-Walsh88401775-de72-46b5-9a14-e13aafd67742https://hifaforums.org/_/d23pc0x4discussionCommunity knowledge, attitudes and practices related to Taenia solium taeniosis and cysticercosis in ZambiaCitation, abstract and comment from me below. <br /> <br />CITATION: Community knowledge, attitudes and practices related to Taenia solium taeniosis and cysticercosis in Zambia. <br />PLoS Neglected Tropical Diseases [electronic resource]. 17(8):e0011375, 2023 Aug. <br />Zulu G et al. <br />https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0011375 <br /> <br />Abstract <br />BACKGROUND: Several studies on Taenia solium taeniosis / cysticercosis (TSTC) have been conducted in Zambia. However, none has assessed community knowledge, attitudes and practices related to TSTC and epilepsy. <br /> <br />METHODS: A community-based cross-sectional study was conducted between November and December 2022. The design consisted of a questionnaire-based survey conducted in each of the 25 purposely selected villages in Chiparamba Rural Health Centre (RHC) catchment area in Chipata district of the Eastern Province. <br /> <br />RESULTS: A total of 588 participants comprising 259 (44%) males and 329 (56%) females with median age of 42 years (range 17 to 92 years) were interviewed. Awareness of the signs and symptoms of taeniosis and human cysticercosis (HCC), including transmission and prevention measures was very low. Whilst the majority had heard about epilepsy, they were not able to link HCC to epilepsy. Most participants were aware of cysticerci in pigs (PCC) including its predilection sites but were not aware of mode of transmission and prevention measures... <br /> <br />CONCLUSION: The study shows overall poor knowledge, attitudes and practices related to TSTC among the community of Chiparamba RHC in Chipata district of the Eastern Province of Zambia. This poses a serious challenge for control and elimination of T. solium infections and thus efforts to improve knowledge, attitudes and practices should be made using a One Health approach for the control and elimination of TSTC. Educational programs about TSTC transmission, signs and symptoms, prevention, management and control need to be scaled up in the study area and Zambia as a whole. <br /> <br />HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org <br /> <br />COMMENT (NPW): The authors note that &#39;Only 40% (141) of those who had heard about tapeworm infection were knowledgeable about the signs and symptoms of taeniosis&#39;. This sounds quite a good percentage to me, although it is not clear how &#39;knowledgeable&#39; is defined. As a general comment, there are many research studies that measure knowledge about different diseases, but there is little if any standardisation of levels of knowledge, so authors&#39; use of words such as &#39;only&#39; and &#39;poor&#39; is hard to interpret. Such studies are generally not associated with an intervention to measure knowledge before and after, so it is not clear what are the best interventions to improve knowledge (and practice). <br /> <br />HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.orgMon, 11 Sep 2023 07:31:32 ZNeil Pakenham-Walsh235ee331-11a5-49c2-a54e-7598ea18b4abhttps://hifaforums.org/_/55y689k0discussionAttitudes towards the WHO Surgical Safety ChecklistDear HIFA and HIFA-Zambia colleagues, <br /> <br />The surgical safety checklist (SSC) has been shown to be highly effective but this study from Zambia suggests that some senior surgeons have negative attitudes towards it, so that it is not always implemented. The full text suggests many contributing factors, including lack of staffing and perceived time burden of completing the check. Would HIFA-Zambia members like to comment, and do wider HIFA members have experience in other countries? <br /> <br />CITATION: Munthali, J.; Pittalis, C.; Bijlmakers, L.; Kachimba, J.; Cheelo, M.; Brugha, R.; Gajewski, J. <br />Barriers and enablers to utilisation of the WHO surgical safety checklist at the university teaching hospital in Lusaka, Zambia: a qualitative study. <br />BMC Health Services Research; 2022. 22(894):(09 July 2022). <br />https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-022-08257-y <br /> <br />ABSTRACT <br />Background: Surgical perioperative deaths and major complications are important contributors to preventable morbidity, globally and in sub-Saharan Africa. The surgical safety checklist (SSC) was developed by WHO to reduce surgical deaths and complications, by utilising a team approach and a series of steps to ensure the safe transit of a patient through the surgical operation. This study explored barriers and enablers to the utilisation of the Checklist at the University Teaching Hospital (UTH) in Lusaka, Zambia. <br /> <br />Methods: A qualitative case study was conducted involving members of surgical teams (doctors, anaesthesia providers, nurses and support staff) from the UTH surgical departments. <br /> <br />Results: Analysis revealed variability in implementation of the SSC by surgical teams, which stemmed from lack of senior surgeon ownership of the initiative, when the SSC was introduced at UTH 5 years earlier. Low utilisation was also linked to factors such as: negative attitudes towards it, the hierarchical structure of surgical teams, lack of support for the SSC among senior surgeons and poor teamwork. Further determinants included: lack of training opportunities, lack of leadership and erratic availability of resources. Interviewees proposed the following strategies for improving SSC utilisation: periodic training, refresher courses, monitoring of use, local adaptation, mobilising the support of senior surgeons and improvement in functionality of the surgical teams. <br /> <br />Conclusion: The SSC has the potential to benefit patients; however, its utilisation at the UTH has been patchy, at best. Its full benefits will only be achieved if senior surgeons are committed and managers allocate resources to its implementation. The study points more broadly to the factors that influence or obstruct the introduction and effective implementation of new quality of care initiatives. <br /> <br />HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org <br />Mon, 11 Sep 2023 07:09:12 ZNeil Pakenham-Walsh02740c37-861f-4968-b7f6-762a479c2603https://hifaforums.org/_/b6dtsznxdiscussionWHO Bulletin: CHWs and rectal artesunate for severe malariaDear CHIFA and HIFA-Zambia colleagues, <br /> <br />A new paper in the WHO Bulletin finds that &#39;rectal artesunate administered by community health volunteers can be an effective intervention for severe malaria among young children&#39;. <br /> <br />CITATION: Rectal artesunate for severe malaria, implementation research, Zambia <br />Cathy Green et al. <br />WHO Bulletin 2023 <br />https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10225942/ <br /> <br />ABSTRACT <br />Objective: To determine whether the positive results of a single-district pilot project focused on rectal artesunate administration at the community level in Zambia could be replicated on a larger scale. <br /> <br />Methods: In partnership with government, in 10 rural districts during 2018–2021 we: (i) trained community health volunteers to administer rectal artesunate to children with suspected severe malaria and refer them to a health facility; (ii) supported communities to establish emergency transport, food banks and emergency savings to reduce referral delays; (iii) ensured adequate drug supplies; (iv) trained health workers to treat severe malaria with injectable artesunate; and (v) monitored severe malaria cases and associated deaths via surveys, health facility data and a community monitoring system. <br /> <br />Results: Intervention communities accessed quality-assured rectal artesunate from trained community health volunteers, and follow-on treatment for severe malaria from health workers. Based on formal data from the health management information system, reported deaths from severe malaria reduced significantly from 3.1% (22/699; 95% confidence interval, CI: 2.0–4.2) to 0.5% (2/365; 95% CI: 0.0–1.1) in two demonstration districts, and from 6.2% (14/225; 95% CI: 3.6–8.8) to 0.6% (2/321; 95% CI: 0.0–1.3) in eight scale-up districts. <br /> <br />Conclusion: Despite the effects of the coronavirus disease, our results confirmed that pre-referral rectal artesunate administered by community health volunteers can be an effective intervention for severe malaria among young children. Our results strengthen the case for wider expansion of the pre-referral treatment in Zambia and elsewhere when combined with supporting interventions. <br /> <br />Join CHIFA (child health and rights): http://www.hifa.org/joinchifa <br />Join HIFA-Zambia: http://www.hifa.org/join/join-hifa-zambia <br /> <br />HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.orgSun, 04 Jun 2023 06:42:28 ZNeil Pakenham-Walsh35135876-decf-4db4-9719-b8e5b345f821https://hifaforums.org/_/z7qmm6mvdiscussionComprehensive sexuality education linked to SRH services reduces early and unintended pregnancies in ZambiaDear HIFA and HIFA-Zambia colleagues, <br /> <br />The cumulative evidence is overwhelming. And yet many countries restrict comprehensive sexuality education. Citation, abstract and comment from me below. <br /> <br />CITATION: Comprehensive sexuality education linked to sexual and reproductive health services reduces early and unintended pregnancies among in-school adolescent girls in Zambia <br />Michael T. Mbizvo, Kondwani Kasonda, Nelly-Claire Muntalima, Joseph G. Rosen, Sophie Inambwae, Edith S. Namukonda, Ronald Mungoni, Natasha Okpara, Chifundo Phiri, Nachela Chelwa &amp; Chabu Kangale <br />BMC Public Health volume 23, Article number: 348 (2023) <br /> <br />Abstract <br />Background: Advancing the health of adolescents, particularly their sexual and reproductive health, including HIV prevention and care, is a development imperative. A critical part for improving their wellbeing and economic development is the social status accorded to adolescent girls and young women (AGYW). However, AGYW in many countries including Zambia, encounter health challenges that stem from gender inequalities, lack of empowerment, inaccurate knowledge on sexuality, and poor access to sexual and reproductive health (SRH) services and information. Addressing the knowledge gaps through comprehensive sexuality education (CSE) and improving access to SRH services and appropriate information, should reduce school attrition from early and unintended pregnancies (EUP) and enhance realization of their full potential. <br /> <br />Methods: The aim was to reduce EUP and improve SRH outcomes among AGYW in Zambia through provision of CSE linked to receptive SRH services. A 3-Arm randomized control study collected cross-sectional data at baseline, midline and Endline. Schools where CSE was being routinely provided were randomized into a non-intervention arm (arm1), an intervention arm in which information on available SRH services was provided in schools by health workers to complement CSE, (arm 2), and arm 3 in which pupils receiving CSE were also encouraged or supported to access pre-sensitized, receptive SRH services. <br /> <br />Results: Following 3 years of intervention exposure (CSE-Health Facility linkages), findings showed a significant decline of in-school pregnancies amongst AGYW in both intervention arms, with arm two exhibiting a more significant decline, having recorded only 0.74% pregnancies at endline (p &lt; 0.001), as well as arm 3, which recorded 1.34% pregnancies (p &lt; 0.001). No significant decline was recorded in the CSE only control arm. Trends in decline of pregnancies started to show by midline, and persisted at endline (2020), and when difference in differences test was applied, the incident rate ratios (IRR) between the none and exposed arms were equally significant (p &lt; 0.001). <br /> <br />Conclusion: Linking provision of CSE with accessible SRH services that are receptive to needs of adolescents and young people reduces EUP, which provides the opportunity for higher retention in school for adolescent girls. <br />-- <br /> <br />COMMENTS (NPW): <br />1. The UNESCO site &#39;CSE implementation at regional and country levels&#39; notes that &#39;Western Europe pioneered the introduction of school-based sexuality education programmes 50 years ago. Countries such as Sweden, Norway, and the Netherlands, with long-standing sexuality education programmes in schools, have significantly lower adolescent birth rates than countries in Eastern Europe and Central Asia, where open discussion of issues related to sexuality and sexual and reproductive health and rights (SRHR) in schools remains more sensitive.&#39; https://csetoolkit.unesco.org/toolkit/getting-started/cse-implementation-regional-and-country-levels <br />2. As we have noted previously, universal access to reliable sexual and reproductive services is emphasised in the sustainable development goals, which have been ratified all the world&#39;s 191 countries. How do policymakers in CSE-restricted countries justify their contradictory stance? Do they fully understand the benefits of CSE? <br /> <br />Join HIFA: www.hifa.org/joinhifa <br />Join HIFA-Zambia: http://www.hifa.org/join/join-hifa-zambia <br /> <br />Best wishes, Neil <br /> <br />Joint coordinator, HIFA project on Mental health: meeting information needs for substance use disorders - Tobacco, Alcohol, Opiates https://www.hifa.org/projects/mental-health-meeting-information-needs-substance-use-disorders <br /> <br />HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org <br /> <br />Wed, 01 Mar 2023 09:59:03 ZNeil Pakenham-Walshcca168ce-0cbf-46f0-b44b-995074b60d23https://hifaforums.org/_/y9acnwb0discussionTobacco - Q1. Do people understand the harms of using tobacco products? (1) How can people be better informed?Dear HIFA and HIFA-Zambia colleagues, <br /> <br />&quot;Q1. Do people understand the health, socio-economic and environmental harms of using tobacco products? What matters to them? How can they be better informed?&quot; <br /> <br />How can people be better informed? Citation and abstract of an interesting new paper in the journal Tobacco Control, and a comment from me below. <br /> <br />CITATION: Quasi-experimental evaluation of Kenya’s pictorial health warnings versus Zambia’s single text-only warning: findings from the International Tobacco Control (ITC) Project <br />Susan Cherop Kaai1 et al. Corresponding author: skaai@uwaterloo.ca <br />Tobacco Control 2023 <br />https://tobaccocontrol.bmj.com/content/32/2/139 <br /> <br />ABSTRACT <br />Background: Population studies in mostly high-income countries have shown that pictorial health warnings (PHWs) are much more effective than text-only warnings. This is the first quasi-experimental evaluation of the introduction of PHWs in Africa, comparing the change from text-only to PHWs in Kenya to the unchanged text-only health warning in Zambia. <br /> <br />Methods: Data were from International Tobacco Control (ITC) Surveys in Kenya (n=1495), and Zambia (n=1628), cohort surveys of nationally representative samples of adult smokers in each country. The ITC Kenya Survey was conducted in 2012 and 2018 (2 years after the 2016 introduction of three PHWs). The ITC Zambia Survey was conducted in 2012 and 2014 with no change to the single text-only warning. Validated indicators of health warning effectiveness (HWIs) (salience: noticing, reading; cognitive reactions: thinking about health risks, thinking about quitting; and behavioural reactions: avoiding warnings; forgoing a cigarette because of the warnings), and a summary measure—the Labels Impact Index (LII)—measured changes in warning impact between the two countries. <br /> <br />Results: PHWs implemented in Kenya led to a significant increase in all HWIs and the LII, compared with the text-only warning in Zambia. The failure to implement PHWs in Zambia led to a substantial missed opportunity to increase warning effectiveness (eg, an estimated additional 168 392 smokers in Zambia would have noticed the warnings). <br /> <br />Conclusions: The introduction of PHWs in Kenya substantially increased the effectiveness of warnings. These results provide strong empirical support for 34 African countries that still have text-only warnings, of which 31 are Parties of the Framework Convention on Tobacco Control and are thus obligated to implement PHWs. <br /> <br />COMMENTS (NPW): <br />1. From the WHO website: &#39;To address the tobacco epidemic, WHO Member States adopted the WHO Framework Convention on Tobacco Control (WHO FCTC) in 2003. Currently 182 countries have ratified this treaty.&#39; It would be interesting to know which countries have not signed, and why. <br />2. &#39;Pictorial health warnings (PHWs) are much more effective than text-only warnings&#39;. However, &#39;only 13 (Burkina Faso, Cameroon, Chad, Ethiopia, Gabon, Ghana, Kenya, Madagascar, Mauritius, Namibia, Senegal, Seychelles and Togo) out of 47 countries from the African Region have successfully implemented PHWs&#39;. What can be done to accelerate progress towards universal pictorial health wornings? <br />3. I remember when pictorial health warnings first came out in the UK. They had a big impact. I have a few friends who smoke and they claim they now just ignore the pictures. How can pictures have the maximum impact? What types of pictures are especially effective in discouraging young people from taking up the habit, or in helping to persuade established smokers to quit? <br /> <br />Join HIFA: www.hifa.org/joinhifa <br />Join HIFA-Zambia: http://www.hifa.org/join/join-hifa-zambia <br /> <br />Best wishes, Neil <br /> <br />Co-chair, HIFA project on Mental health: meeting information needs for substance use disorders - Tobacco, Alcohol, Opiates https://www.hifa.org/projects/mental-health-meeting-information-needs-substance-use-disorders <br /> <br />HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org <br /> <br /> <br /> <br />Wed, 01 Mar 2023 09:41:58 ZNeil Pakenham-Walsha94e3883-f362-4e2a-9c2c-e94d9594f3f2https://hifaforums.org/_/39szrkjkdiscussionKnowledge, Attitudes, and Acceptance of COVID-19 Vaccines among Secondary School Pupils in ZambiaVaccine hesitancy was associated with lower knowledge in this study of schoolchildren in Zambia: <br /> <br />CITATION: Vaccines (Basel) 2022 Dec 14;10(12):2141. doi: 10.3390/vaccines10122141. <br />Knowledge, Attitudes, and Acceptance of COVID-19 Vaccines among Secondary School Pupils in Zambia: Implications for Future Educational and Sensitisation Programmes <br />Steward Mudenda et al. <br /> <br />ABSTRACT: The coronavirus disease 2019 (COVID-19) pandemic resulted in the closure of schools to slow the spread of the virus across populations, and the administration of vaccines to protect people from severe disease, including school children and adolescents. In Zambia, there is currently little information on the acceptance of COVID-19 vaccines among school-going children and adolescents despite their inclusion in the vaccination programme. This study assessed the knowledge, attitudes, and acceptance of COVID-19 vaccines among secondary school pupils in Lusaka, Zambia. A cross-sectional study was conducted from August 2022 to October 2022. Of the 998 participants, 646 (64.7%) were female, and 127 (12.7%) would accept to be vaccinated. Those who were willing to be vaccinated had better knowledge (68.5% vs. 56.3%) and a positive attitude (79.1% vs. 33.7%) compared to those who were hesitant. Overall, the odds of vaccine acceptance were higher among pupils who had higher knowledge scores (AOR = 11.75, 95% CI: 6.51-21.2), positive attitude scores (AOR = 9.85, 95% CI: 4.35-22.2), and those who knew a friend or relative who had died from COVID-19 (AOR = 3.27, 95% CI: 2.14-5.09). The low vaccine acceptance among pupils is of public health concern, emphasising the need for heightened sensitisation programmes that promote vaccine acceptance among pupils in Zambia. <br /> <br />Dr Neil Pakenham-Walsh, HIFA Coordinator <br />Healthcare Information For All <br />Global Healthcare Information Network <br />Working in Official Relations with the World Health Organization <br />20,000 members, 400 supporting organisations, 180 countries, 6 forums, 4 languages <br />www.hifa.org neil@hifa.orgWed, 01 Feb 2023 11:14:35 ZNeil Pakenham-Walsh0091c287-615d-48ce-9fa6-1eeba2a651f5https://hifaforums.org/_/vnm0cp0ddiscussionCare delays for adults with meningitis in ZambiaCitation, abstract and a comment from me below. <br /> <br />Dear HIFA and HIFA-Zambia colleagues, <br /> <br />CITATION: Trans R Soc Trop Med Hyg <br />2022 Dec 2;116(12):1138-1144. doi: 10.1093/trstmh/trac049. <br />A qualitative study of factors resulting in care delays for adults with meningitis in Zambia <br />Melissa A Elafros et al. <br />PMID: 35653707 PMCID: PMC9717355 (available on 2023-06-02) DOI: 10.1093/trstmh/trac049 <br />https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)00054-6/fulltext <br /> <br />ABSTRACT <br />Background: Meningitis causes significant mortality in regions with high comorbid HIV and TB. Improved outcomes are hindered by limited understanding of factors that delay adequate care. <br /> <br />Methods: In-depth interviews of patients admitted to the University Teaching Hospital with suspected meningitis, their caregivers, doctors and nurses were conducted. Patient/caregiver interviews explored meningitis understanding, treatment prior to admission and experiences since admission. Provider interviews addressed current and prior experiences with meningitis patients and hospital barriers to care. A conceptual framework based on the Three Delays Model identified factors that delayed care. <br /> <br />Results: Twenty-six patient/caregiver, eight doctor and eight nurse interviews occurred. Four delays were identified: in-home care; transportation to a health facility; clinic/first-level hospital care; and third-level hospital. Overcrowding and costly diagnostic testing delayed outpatient care; 23% of patients began with treatment inside the home due to prior negative experiences with biomedical care. Admission occurred after multiple clinic visits, where subsequent delays occurred during testing and treatment. <br /> <br />Conclusions: Delays in care from home to hospital impair quality meningitis care in Zambia. Interventions to improve outcomes must address patient, community and health systems factors. Patient/caregiver education regarding signs of meningitis and indications for care-seeking are warranted to reduce treatment delays. <br /> <br />COMMENT (NPW): In almost every area of healthcare, from infectious diseases to cancer, lack of availability of basic reliable healthcare information - including awareness of the signs of meningitis - contribute to delays and deaths. Access to, and use of, a book such as Where there is no doctor, could make all the difference. Mobile health can and should mean universal access to reliable healthcare information, as proposed by HIFA members: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)00054-6/fulltext Some of us have argued for such information to be preloaded onto all phones before, or at, point of sale (or, at least, for buyers to have that option). The reality is that the vast majority of people do not have basic healthcare information on their phones. The Red Cross First Aid app is freely available, but is not widely known. I would like to invite HIFA members to comment on next steps. What apps/content currently exists that could serve this purpose (basic offline healthcare information for patients and caregivers across health conditions, with a focus on recognition of danger signs)? How can apps/content be made more available and accessible to all? <br /> <br />Join HIFA: www.hifa.org/joinhifa <br />Join HIFA-Zambia: http://www.hifa.org/join/join-hifa-zambia <br /> <br />Dr Neil Pakenham-Walsh, HIFA Coordinator <br />Healthcare Information For All <br />Global Healthcare Information Network <br />Working in Official Relations with the World Health Organization <br />20,000 members, 400 supporting organisations, 180 countries, 6 forums, 4 languages <br />www.hifa.org neil@hifa.orgMon, 02 Jan 2023 09:10:54 ZNeil Pakenham-Walsh1e22f27e-f500-482f-a280-19bcd9492b41https://hifaforums.org/_/px3kpt84discussionAntibiotic Prescribing Patterns in Adult Patients According to the WHO AWaRe Classification: A Multi-Facility Cross-Sectional Study in Primary Healthcare Hospitals in Lusaka, ZambiaDear HIFA and HIFA-Zambia colleagues, <br /> <br />CITATION: Pharmacology &amp; Pharmacy &gt; Vol.13 No.10, October 2022 <br />Antibiotic Prescribing Patterns in Adult Patients According to the WHO AWaRe Classification: A Multi-Facility Cross-Sectional Study in Primary Healthcare Hospitals in Lusaka, Zambia <br />Steward Mudenda et al. <br />https://www.scirp.org/journal/paperinformation.aspx?paperid=120529 <br /> <br />ABSTRACT <br />Introduction: Indiscriminate prescribing and using of antibiotics have led to the development of antimicrobial resistance (AMR). To reduce this problem, the World Health Organization (WHO) developed the “Access”, “Watch”, and “Reserve” (AWaRe) classification of antibiotics that promotes antimicrobial stewardship (AMS). In Zambia, there are gaps in practice regarding prescribing of antibiotics based on the AWaRe protocol. This study assessed antibiotic prescribing patterns in adult in-patients in selected primary healthcare hospitals in Lusaka, Zambia. Materials and Methods: This retrospective cross-sectional study was conducted using 388 patient medical files from September 2021 to November 2021, five primary healthcare hospitals namely; Chawama, Matero, Chilenje, Kanyama, and Chipata. Data analysis was performed using the Statistical Package for Social Sciences version 23. Results: Of the selected medical files, 52.3% (n = 203) were for male patients. Overall, the prevalence of antibiotic use was 82.5% (n = 320) which was higher than the WHO recommendation of a less than 30% threshold. The most prescribed antibiotic was ceftriaxone (20.3%), a Watch group antibiotic, followed by metronidazole (17.8%) and sulfamethoxazole/trimethoprim (16.3%), both belonging to the Access group. Furthermore, of the total antibiotics prescribed, 41.9% were prescribed without adhering to the standard treatment guidelines. Conclusion: This study found a high prescription of antibiotics (82.5%) that can be linked to non-adherence to the standard treatment guidelines in primary healthcare hospitals. The most prescribed antibiotic was ceftriaxone which belongs to the Watch group, raising a lot of concerns. There is a need for rational prescribing of antibiotics and implementation of AMS programs in healthcare facilities in Zambia, and this may promote surveillance of irrational prescribing and help reduce AMR in the future. <br /> <br />COMMENT (NPW): This study highlights a lack of adherence to national guidelines, resulting in gross misuse of antibiotics. This is a major concern. What is needed is to better understand *why* health workers do not adhere to guidance? Do they have immediate access to such guidelines, and is the guidance in a format that is easy to use? What is the level of trust of health workers in the guidelines? What are other reasons for overprescription of antibiotics? Expectation from patients (who may not themselves be aware that antibiotics may be ineffective and even harmful in some cases)? Profit motivation (HIFA colleagues have previously emphasised the fact that prescription of drugs may bring added income to the health facility)? <br /> <br />Best wishes, Neil <br /> <br />Join HIFA: www.hifa.org/joinhifa <br />Join HIFA-Zambia: http://www.hifa.org/join/join-hifa-zambia <br /> <br />Dr Neil Pakenham-Walsh, HIFA Coordinator <br />Healthcare Information For All <br />Global Healthcare Information Network <br />Working in Official Relations with the World Health Organization <br />20,000 members, 400 supporting organisations, 180 countries, 6 forums, 4 languages <br />www.hifa.org neil@hifa.org <br /> <br />Sun, 01 Jan 2023 16:44:43 ZNeil Pakenham-Walshc6724aca-03be-48c8-9939-72329add82dfhttps://hifaforums.org/_/c6t6m7zfdiscussionBridging the gap in neonatal resuscitation in ZambiaDear CHIFA and HIFA-Zambia colleagues, <br /> <br />Happy new year! Here is an interesting new paper from Zambia. Citation, abstract and a comment from me below. <br /> <br />CITATION: Bridging the gap in neonatal resuscitation in Zambia <br />Kunda Mutesu-Kapembwa et al. <br />Front. Pediatr., 05 December 2022 <br />Sec. Neonatology <br />https://doi.org/10.3389/fped.2022.103823 <br /> <br />ABSTRACT: Neonatal resuscitation has been poorly instituted in many parts of Africa and most neonatal resuscitation algorithms are adapted from environments with abundant resources. Helping Babies Breathe (HBB) is an algorithm designed for resourcelimited situations and most other algorithms are designed for resource-rich countries. However, there are neonatal referral centers in resource-limited countries who may provide more advanced resuscitation. Thus, we developed a neonatal resuscitation algorithm for a resource-limited country (Zambia) which considers more advanced interventions in situations where they can be provided. The algorithm described in this paper is based on the Newborn Life Support algorithm from the UK as well as the HBB algorithm and accounts for all situations in a resource-limited country. Most importantly, it focuses on noninvasive ventilation but includes advice on more advanced resuscitation including intravenous access, fluid management, chest compressions and adrenaline for resuscitation. Although intubation skills are included in neonatal training workshops, it is not the main focus of the algorithm as respiratory support equipment is scarce or lacking in most health facilities in Zambia. A home-grown neonatal resuscitation algorithm for a resource-limited country such as Zambia is likely to bridge the gap between limited situations requiring only bag and mask ventilation and better equipped institutions where more advanced resuscitation is possible. This algorithm will be rolled out in all training institutions and delivery facilities across Zambia over the next months. <br /> <br />COMMENT (NPW): The authors conclude: &#39;The Zambian neonatal resuscitation algorithm is the first algorithm crafted by experts working in Zambia, making it a suitable algorithm for all levels of care in this country. This home-grown neonatal resuscitation algorithm is likely to bridge the gap between limited situations requiring only bag and mask ventilation and better equipped institutions where more advanced resuscitation is possible.&#39; They state that &#39;The algorithm is currently rolled out across Zambia in order to unify neonatal resuscitation across the country&#39;. <br /> <br />The method of development is interesting: &#39;This algorithm was designed by people who are familiar with the country&#39;s specific needs. The group consists of clinicians from various specialties including anaesthetists, midwives, nurses, paediatricians, and neonatologists who came together for regular meetings to discuss the ideal approach to neonatal resuscitation in Zambia. The final version incorporates ideas from the HBB and the NLS algorithm and was generated in an iterative process through group discussions among the members of this working group.&#39; <br /> <br />I would like to invite comment on the drivers and barriers to the successful development of clinical algorithms for neonatal resuscitation (and other aspects of health care) in low-resource settings. <br /> <br />Join CHIFA (child health and rights): http://www.hifa.org/joinchifa <br />Join HIFA-Zambia: http://www.hifa.org/join/join-hifa-zambia <br /> <br />Best wishes, Neil <br /> <br />Dr Neil Pakenham-Walsh, HIFA Coordinator <br />Healthcare Information For All <br />Global Healthcare Information Network <br />Working in Official Relations with the World Health Organization <br />20,000 members, 400 supporting organisations, 180 countries, 6 forums, 4 languages <br />www.hifa.org neil@hifa.org <br /> <br /> <br />Sun, 01 Jan 2023 16:29:26 ZNeil Pakenham-Walsh29477cdc-71c8-48f6-be0b-a16c132c64cdhttps://hifaforums.org/_/5c7g6grtdiscussionZambia becomes the 64th state worldwide to ban all violent punishment in childraising.The announcement below is forwarded from the International Society for Social Paediatrics and Child Health (HIFA&#39;s partner for our global child health forum CHIFA) <br /> <br />-- <br />Dear friends and colleagues, <br /> <br />Zambia prohibits all corporal punishment of children! <br /> <br />We are delighted to tell you that Zambia has become the 64th state worldwide and the 11th in Africa to prohibit all corporal punishment of children! Zambia achieved full prohibition with the enactment of the Children’s Code Act No. 12 of 2022. Section 22 of the Children’s Code Act No. 12 of 2022 states: “A person shall not impose corporal punishment <br />as a form of punishment on a child.” <br /> <br />The new Code also enacted many other critical reforms and protections for children, including the prohibition of child marriage, FGM, sexual harassment, an obligation on all institutions to implement child safeguarding and protection procedures, and more. <br /> <br />Read more about Zambia’s milestone Children’s Code here. <br />[ https://endcorporalpunishment.org/zambia-prohibits-all-corporal-punishment/ ] <br />-- <br /> <br />Download the latest ISSOP newsletter here: https://www.issop.org/cmdownloads/issop-e-bulletin-november-2022-no-60/ <br /> <br />Join CHIFA (child health and rights): http://www.hifa.org/joinchifa <br /> <br />Dr Neil Pakenham-Walsh, HIFA Coordinator <br />Healthcare Information For All <br />Global Healthcare Information Network <br />Working in Official Relations with the World Health Organization <br />20,000 members, 400 supporting organisations, 180 countries, 6 forums, 4 languages <br />www.hifa.org neil@hifa.orgMon, 19 Dec 2022 17:46:48 ZNeil Pakenham-Walsh003fcfb0-4562-4249-bca9-1eca38eb2e11https://hifaforums.org/_/v3vcpx7bdiscussionMorgue Data Reveal Africa’s High COVID-19 Death TollDear HIFA and HIFA-Zambia colleagues, <br /> <br />Extracts below. Full text here: https://www.bu.edu/sph/news/articles/2022/morgue-data-reveals-true-covid-19-death-toll-in-africa/ <br /> <br />-- <br />A new study led by Christopher Gill and Lawrence Mwananyanda found that nearly 90 percent of deceased individuals at a Zambian morgue were infected with COVID-19, but only 10 percent tested positive while alive. <br />https://www.bu.edu/sph/news/articles/2022/morgue-data-reveals-true-covid-19-death-toll-in-africa/ <br /> <br />Since the start of the pandemic, Africa has reported more than 12 million COVID-19 cases and 255,000 deaths... <br /> <br />Africa’s low death count has baffled health experts and government officials... <br /> <br />A new study led by School of Public Health researchers suggests that the reported COVID-19 death toll in Africa is substantially higher than official records indicate. <br /> <br />Available as a preprint on medRxiv ahead of peer-reviewed publication, the study found that nearly 90 percent of deceased individuals at a crowded morgue in Lusaka, Zambia were infected with COVID-19 during peak transmission periods between July 2020-June 2021 — and only 10 percent of these individuals tested positive for COVID while alive... <br /> <br />Gill says “... Rather than an ‘African paradox,’ the far simpler explanation is that COVID-19 has affected African countries just as the virus has everywhere else, but has gone undocumented.” <br />-- <br /> <br />COMMENT (NPW): The authors are interviewed by the BBC here in a podcast here https://www.bbc.co.uk/sounds/play/w3ct32w5 - It certainly seems that the number of deaths from COVID-19 in Africa is far higher than the 255,000 previously reported. But the true number remains unknown. <br /> <br />Join HIFA: www.hifa.org/joinhifa <br />Join HIFA-Zambia: http://www.hifa.org/join/join-hifa-zambia <br /> <br />Dr Neil Pakenham-Walsh, HIFA Coordinator <br />Healthcare Information For All <br />Global Healthcare Information Network <br />Working in Official Relations with the World Health Organization <br />20,000 members, 400 supporting organisations, 180 countries, 6 forums, 4 languages <br />www.hifa.org neil@hifa.orgSat, 17 Dec 2022 12:08:29 ZNeil Pakenham-Walsh2ac60a8c-3953-4aa3-b8bc-9e18a82213d0https://hifaforums.org/_/xRjnzOUMdiscussionSuper Better Children for Health - Developed in ZAMBIA!Dear Friends <br /> <br />I am delighted to share the launch of our new publication Superbetter Children for Health. <br /> <br />SuperBetter Children for Health is a Toolkit for teachers, co-created by Children for Health and Kelvin Nsekwila. The content and activities have all been tested and revised with the children of the SuperBetter Children’s Club, Sansamwenje, Isoka District, Zambia. <br /> <br />The idea is to build up children’s social and emotional vocabulary and skills, provide tools that promote wellbeing and then work alongside them to solve real life health challenges by undertaking quests. As with all our publications, at the heart of the approach running through this book, we seek to mobilise and support children as resourceful agents of change. <br /> <br />The Toolkit was developed with the support of our ally, SuperBetter. SuperBetter and the SuperBetter logo are registered trademarks of SuperBetter, LLC. The SuperBetter model was invented by Jane McGonigal, an American researcher and video game designer. SuperBetter is available as a book and an app. We have repurposed the SuperBetter model as a curriculum that can be used in low-resource settings, in mainstream schools, or as part of an after-school club. <br /> <br />Thank you <br /> <br />Read more about it here <br />https://www.childrenforhealth.org/news/superbetter-children-for-health-launch/ <br /> <br />Download the SuperBetter Toolkit here <br />https://www.childrenforhealth.org/SuperBetterChildrenforHealth <br /> <br />HIFA profile: Clare Hanbury is director of Children for Health. She qualified as a teacher in the UK and then worked in schools in Kenya and Hong Kong. After an MA in Education in Developing Countries and for many years, Clare worked for The Child-to-Child Trust based at the University of London&#39;s Institute of Education where, alongside Hugh Hawes and Professor David Morley she worked to help embed the Child-to-Child ideas of children&#39;s participation in health – into government and non-government cchild health and education programmes in numerous countries. Clare has worked with these ideas alongside vulnerable groups of children such as refugees and street children. Since her MSc in International Maternal and Child Health, Clare focused on helping government and non-government programmes to design and deliver child-centered health and education programmes where children are active participants. Clare has worked in many countries in East and Southern Africa and in Pakistan, Cambodia and the Yemen. In July 2013, Clare founded the NGO, Children for Health and develops health education materials and and works on health education programmes alongside partners all over the world. Clare is a member of the HIFA Working Group on Information for Citizens, Parents and Children and the CHIFA (child health and rights) Steering Group. <br />https://www.hifa.org/support/members/clare <br />http://www.hifa.org/projects/citizens-parents-and-children <br />Email: clare.hanbury AT zen.co.uk <br /> <br /> <br /> <br /> <br />Thu, 08 Dec 2022 07:55:22 ZClare Hanbury38dfdd35-0fcf-414e-9797-c571dd9236f4https://hifaforums.org/_/p2137nl4discussionDeveloping and Testing a Chatbot to Integrate HIV Education Into Family Planning Clinic Waiting AreasDear HIFA and HIFA-Zambia colleagues, <br /> <br />This paper describes a novel way to share healthcare information: using a chatbot (a web-based program that engages users in a digital conversation about HIV and FP, including content about PrEP and dual protection) in the pre-consultation waiting-area. Citation and abstract below. I would be interested to hear from HIFA members about their experience with this approach. <br /> <br />CITATION: Developing and Testing a Chatbot to Integrate HIV Education Into Family Planning Clinic Waiting Areas in Lusaka, Zambia <br />Eileen A. Yam, Edith Namukonda, Tracy McClair, Samir Souidi, Nachela Chelwa, Nelly Muntalima, Michael Mbizvo and Ben Bellows <br />Global Health: Science and Practice October 2022, 10(5):e2100721; https://doi.org/10.9745/GHSP-D-21-00721 <br />https://www.ghspjournal.org/content/10/5/e2100721 <br /> <br />ABSTRACT <br />Background: To maximize protection against both unintended pregnancy and HIV, it is important that family planning (FP) services integrate HIV counseling, both to support method choice and identify potential HIV services of interest, such as pre-exposure prophylaxis (PrEP). However, FP providers often lack sufficient time and knowledge to address HIV vulnerability with clients. To potentially offload some of the initial HIV counseling burden from FP providers, we developed and tested a chatbot that provided information about HIV and dual protection to FP clients in waiting areas of FP clinics in Lusaka, Zambia. <br /> <br />Chatbot Development: We drafted a scripted conversation and tested it in English in formative workshops with Zambian women between the ages of 15 and 49 years. After translating the content to Bemba and Nyanja, we conducted a second round of workshops to validate the translations, before uploading the content into the chatbot platform. <br /> <br />Chatbot User Test: Thirty volunteers tested the chatbot in 3 Lusaka FP clinics, completing an exit survey to provide feedback. A large majority (83%) said they learned new HIV information from the chatbot. Twenty (67%) learned about PrEP for the first time through the chat. Most (96%) reported discussing HIV with the provider, after engaging with the chatbot. In response to an open-ended question, several testers volunteered that they wanted to learn more about PrEP. <br /> <br />Conclusions: Pre-consultation waiting-area time is an underutilized opportunity to impart HIV information to FP clients, thereby preparing them to discuss their dual HIV and pregnancy prevention needs when they see their providers. FP clients expressed particular interest in learning more about PrEP, underscoring the importance of integrating HIV into FP services. <br /> <br />Best wishes, Neil <br /> <br />Join HIFA: www.hifa.org/joinhifa <br />Join HIFA-Zambia: http://www.hifa.org/join/join-hifa-zambia <br /> <br />Let&#39;s build a future where every person has access to reliable healthcare information and is protected from misinformation - Join HIFA: www.hifa.org <br /> <br />HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health movement (Healthcare Information For All - www.hifa.org ), a global community with more than 20,000 members in 180 countries, interacting on six global forums in four languages in collaboration with WHO. HIFA brings stakeholders together to accelerate progress towards universal access to reliable healthcare information. HIFA is administered by Global Healthcare Information Network, a UK based non-profit in official relations with the World Health Organization. Twitter: @hifa_org neil@hifa.orgThu, 01 Dec 2022 11:11:30 ZNeil Pakenham-Walsh2ee9942b-7784-4c9f-9344-c06b140a5af0https://hifaforums.org/_/xmatyhvldiscussionKnowledge, attitudes, and practices of pregnant women regarding COVID-19 vaccination in pregnancy in 7 LMICsDear HIFA and HIFA-Zambia colleagues, <br /> <br />CITATION: Knowledge, attitudes, and practices of pregnant women regarding COVID-19 vaccination in pregnancy in 7 low- and middle-income countries: An observational trial from the Global Network for Women and Children’s Health Research <br />Seemab Naqvi et al. <br />First published: 21 May 2022 https://doi.org/10.1111/1471-0528.17226Citations <br /> <br />ABSTRACT <br />Objectives: We sought to determine the knowledge, attitudes and practices of pregnant women regarding COVID-19 vaccination in pregnancy in seven low- and middle-income countries (LMIC). <br /> <br />Design: Prospective, observational, population-based study. <br /> <br />Settings: Study areas in seven LMICs: Bangladesh, India, Pakistan, Guatemala, Democratic Republic of the Congo (DRC), Kenya and Zambia. <br /> <br />Population: Pregnant women in an ongoing registry. <br /> <br />Methods: COVID-19 vaccine questionnaires were administered to pregnant women in the Global Network&#39;s Maternal Newborn Health Registry from February 2021 through November 2021 in face-to-face interviews. <br /> <br />Main outcome measures: Knowledge, attitude and practice regarding vaccination during pregnancy; vaccination status. <br /> <br />Results: No women were vaccinated except for small proportions in India (12.9%) and Guatemala (5.5%). Overall, nearly half the women believed the COVID-19 vaccine is very/somewhat effective and a similar proportion believed that the COVID-19 vaccine is safe for pregnant women. With availability of vaccines, about 56.7% said they would get the vaccine and a 34.8% would refuse. Of those who would not get vaccinated, safety, fear of adverse effects, and lack of trust predicted vaccine refusal. Those with lower educational status were less willing to be vaccinated. Family members and health professionals were the most trusted source of information for vaccination. <br /> <br />Conclusions: This COVID-19 vaccine survey in seven LMICs found that knowledge about the effectiveness and safety of the vaccine was generally low but varied. Concerns about vaccine safety and effectiveness among pregnant women is an important target for educational efforts to increase vaccination rates. <br />-- <br /> <br />Best wishes, Neil <br /> <br />Join HIFA: www.hifa.org/joinhifa <br />Join HIFA-Zambia: http://www.hifa.org/join/join-hifa-zambia <br /> <br />Let&#39;s build a future where every person has access to reliable healthcare information and is protected from misinformation - Join HIFA: www.hifa.org <br /> <br />HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health movement (Healthcare Information For All - www.hifa.org ), a global community with more than 20,000 members in 180 countries, interacting on six global forums in four languages in collaboration with WHO. HIFA brings stakeholders together to accelerate progress towards universal access to reliable healthcare information. HIFA is administered by Global Healthcare Information Network, a UK based non-profit in official relations with the World Health Organization. <br />Twitter: @hifa_org neil@hifa.org <br /> <br />Thu, 01 Dec 2022 10:54:26 ZNeil Pakenham-Walsh9c23f565-9deb-4464-9f97-7614785d0c3fhttps://hifaforums.org/_/kk9gzvdcdiscussionMental health literacy among primary healthcare workers in South Africa and ZambiaDear HIFA and HIFA-Zambia colleagues, <br /> <br />Citation, abstract, questions and a comment from me below. <br /> <br />CITATION: Mental health literacy among primary healthcare workers in South Africa and Zambia <br />Joonas Korhonen et al. Brain Behav. 2022 Nov 3;e2807. doi: 10.1002/brb3.2807 <br />https://pubmed.ncbi.nlm.nih.gov/36326480/ <br /> <br />ABSTRACT <br />Background: In developing countries, mental health literacy (MHL) still needs to be improved due to the high prevalence of mental disorders. It is widely recognized that MHL can improve health outcomes for both individuals and populations. Healthcare professionals&#39; development in MHL is crucial to the prevention of mental disorders. The aim of this study was to assess MHL of primary healthcare (PHC) workers in South Africa (SA) and Zambia and determinants thereof. Limited evidence is available on the levels of MHL among PHC workers in the sub-Saharan Africa region, which faces a large burden of mental disorders. <br /> <br />Methods: The study population for this cross-sectional survey comprised PHC workers (n = 250) in five provinces of SA and Zambia. MHL was measured with the Mental Health Literacy Scale (MHLS). We conducted a multivariate analysis to explore determinants of MHL. <br /> <br />Results: Results showed moderate MHL among PHC professionals, but with a wide range from low to high MHL. Knowledge-related items had a greater dispersion than other attributes of MHL. PHC workers with more education showed a greater ability to recognize mental health-related disorders. Those who had experience in the use of mental health-related assessment scales or screening tools reported a higher total MHL. The results confirmed strong internal consistency for the MHLS. <br /> <br />Conclusion: The results highlighted varying mental health perceptions and knowledge in PHC. Implementation of specifically developed formal training programs and interventions to improve MHL in PHC workers to strengthen their competence may help bridge the treatment gap. <br /> <br />QUESTIONS <br /> <br />Below are examples of the questions that were asked. Respondents were directed to answer on a four-point scale: <br />Very unlikely <br />Unlikely <br />Likely <br />Very Likely <br /> <br />Q8: To what extent do you think it is likely that the diagnosis of “Substance Abuse Disorder” can include physical and psychological tolerance of the drug (i.e., require more of the drug to get the same effect)? <br /> <br />Q7: To what extent do you think it is likely that the diagnosis of “Bipolar Disorder” includes experiencing periods of extremely elevated (i.e., high) and periods of depressed (i.e., low) mood? <br /> <br />Q5: To what extent do you think it is likely that “Persistent Depressive Disorder (Dysthymia)” is a mental disorder? <br /> <br />Q3: If someone experienced a low mood for two or more weeks, had a loss of pleasure or interest in their normal activities, and experienced changes in their appetite and sleep, then to what extent do you think it is likely they have “Major Depressive Disorder?” <br /> <br />Q14: Mental health professionals are bound by confidentiality; however, there are certain conditions under which this does not apply. To what extent do you think it is likely that the following is a condition that would allow a mental health professional “to break confidentiality”: if a patient is at immediate risk of harm to oneself or others? <br /> <br />Q13: To what extent do you think it is likely that “Cognitive Behavior Therapy (CBT)” is a therapy based on challenging negative thoughts and increasing helpful behaviors? <br /> <br />Q4: To what extent do you think it is likely that “Personality Disorders” are a category of mental illness? <br /> <br />Q2: If someone experienced excessive worry about a number of events or activities where this level of concern was not warranted, had difficulty controlling this worry, and had physical symptoms such as having tense muscles and feeling fatigued, then to what extent do you think it is likely they have “Generalised Anxiety Disorder?” <br /> <br />Q1: If someone became extremely nervous or anxious in one or more situations with other people (e.g., in social gatherings) or performance situations (e.g., presenting at a meeting) in which they were afraid of being evaluated by others and that they would act in a way that was humiliating or feel embarrassed, then to what extent do you think it is likely they have “Social Phobia?” <br /> <br />Q6: To what extent do you think it is likely that the diagnosis of “Agoraphobia” includes anxiety about situations (e.g., open market place) where escape may be difficult or embarrassing? Q11: To what extent do you think it would be helpful for someone to “improve their quality of sleep” if they were having difficulties managing their emotions (e.g., becoming very anxious or depressed)? <br /> <br />Q9: To what extent do you think it is likely that in general, “women are more likely to experience some mental illnesses compared to men?” <br /> <br />Q15: Mental health professionals are bound by confidentiality; however, there are certain conditions under which this does not apply. To what extent do you think it is likely that the following is a condition that would allow a mental health professional to “break confidentiality”: if patient&#39;s problem is not life-threatening and professionals want to assist others to better support a patient (Reversed scoring)? <br /> <br />Q10: To what extent do you think it is likely that, in general, “men are more likely to experience an anxiety disorder compared to women” (Reversed scoring)? <br /> <br />Q12: To what extent do you think it would be helpful for someone to “avoid all activities or situations that made them feel anxious” if they were having difficulties managing their emotions (Reversed scoring)? <br /> <br />COMMENT (NPW): To what extent can the above questions measure mental health literacy? What are the limitations of such an approach? What other approaches are possible to measure mental health literacy? <br /> <br />Best wishes, Neil <br /> <br />Join HIFA: www.hifa.org/joinhifa <br />Join HIFA-Zambia: http://www.hifa.org/join/join-hifa-zambia <br /> <br />Let&#39;s build a future where every person has access to reliable healthcare information and is protected from misinformation - Join HIFA: www.hifa.org <br /> <br />HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health movement (Healthcare Information For All - www.hifa.org ), a global community with more than 20,000 members in 180 countries, interacting on six global forums in four languages in collaboration with WHO. HIFA brings stakeholders together to accelerate progress towards universal access to reliable healthcare information. HIFA is administered by Global Healthcare Information Network, a UK based non-profit in official relations with the World Health Organization. <br />Twitter: @hifa_org neil@hifa.org <br /> <br />Thu, 01 Dec 2022 10:46:10 ZNeil Pakenham-Walsh3161985b-b167-4195-ae32-bb1fb9cd5a5ehttps://hifaforums.org/_/u8g2S4M9discussionDemystifying Negative Menstrual Myths in Zambia (4)Dear all, <br /> <br />Adolescence is a crucial life stage and the adolescent has several challenges navigating Adolescence and it&#39;s physical, psychosocial, mental and cognitive development. <br /> <br />Indeed, the girl child must not be left to suffer in shame and distress for a natural phenomenon/process. We must empower them with knowledge and options so menses dont derail their life and education. This ha to scaled up in parts of Zambia ensuring that no child is left behind. <br /> <br />I am strategically positioned in Mufumbwe district if North Western province and l work with adolescents everyday. Unfortunately the resources are inadequate to enable me and the team to reach to all adolescents including those in hard to reach area who are the most vulnerable. How l wish there could be deliberate program to reach out to every child and adolescent. <br /> <br />Banda Simon <br />+260976562942 <br />Mufumbwe, NWP <br /> <br />HIFA-Zambia profile: Simon McShy Banda is a Nurse at the Ministry of Health in Zambia. Professional interests: Paediatric Nurse Educator. simonmcshy.banda AT gmail.comWed, 02 Nov 2022 06:05:34 Zsimonmcshybanda@gmail.com16de783c-5a00-43bf-b0f3-5abb0b8d5b26https://hifaforums.org/_/9SAbPe0RdiscussionDemystifying Negative Menstrual Myths in Zambia (3)The girl child must not be left to suffer in shame and distress for a natural phenomenon/process. We must empower them with knowledge and options so menses dont derail their life and education. <br /> <br />Warm regards, <br /> <br />Emmanuel M Makasa <br />Plot L/23328/M Silverest, Chongwe <br />P.O Box 50048, Ridgeway <br />Lusaka Province <br />Republic of Zambia <br />Mobile: +260-961-566-065 <br />E-mail: emakasa@gmail.com <br />Skype: eMakasa <br />Twitter: @emakasa <br /> <br />HIFA-Zambia profile: Emmanuel Makasa is Counsellor - Health, Permanent Mission of the Republic of Zambia to the UN at Geneva, Switzerland. Professional interests: Global Health Diplomacy, Epidemiology, Orthopedic Surgery, m-Health, Remote Sensing &amp; GIS. Email address: emmanuel.makasa AT fulbrightmail.org <br /> <br /> <br />Tue, 01 Nov 2022 13:53:00 Zemakasa@gmail.com88f981a7-9f02-4d45-806c-c7af7dbae9a8https://hifaforums.org/_/dhyh9jmfdiscussionMenstruation (2)Thank you Bridget for your message, (apologies that I inadvertently sent this through my account) <br /> <br />And thanks to your previous message on our sister forum HIFA, we are having a vigorous discussion about the issues raised. You can see the latest messages here: https://www.hifa.org/rss-feeds/17 <br /> <br />Meanwhile here is a related new paper on stigma towards Zambian adolescent girls and young women (although it does not specifically address menstruation): <br /> <br />CITATION: Health worker perceptions of stigma towards Zambian adolescent girls and young women: a qualitative study <br />Caroline Meek, Drosin M. Mulenga, Patrick Edwards, Sophie Inambwae, Nachela Chelwa, Michael T. Mbizvo, Sarah T. Roberts, Sujha Subramanian &amp; Laura Nyblade <br />BMC Health Services Research volume 22, Article number: 1253 (2022) <br />https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-022-08636-5 <br /> <br />Abstract <br />Background <br />The high prevalence of HIV among adolescent girls and young women aged 15–24 in Eastern and Southern Africa indicates a substantial need for accessible HIV prevention and treatment services in this population. Amidst this need, Zambia has yet to meet global testing and treatment targets among adolescent girls and young women living with HIV. Increasing access to timely, high-quality HIV services in this population requires addressing the intensified anticipated and experienced stigma that adolescent girls and young women often face when seeking HIV care, particularly stigma in the health facility setting. To better understand the multi-level drivers and manifestations of health facility stigma, we explored health workers’ perceptions of clinic- and community-level stigma against adolescent girls and young women seeking sexual and reproductive health, including HIV, services in Lusaka, Zambia. <br /> <br />Methods <br />We conducted 18 in-depth interviews in August 2020 with clinical and non-clinical health workers across six health facilities in urban and peri-urban Lusaka. Data were coded in Dedoose and thematically analyzed. <br /> <br />Results <br />Health workers reported observing manifestations of stigma driven by attitudes, awareness, and institutional environment. Clinic-level stigma often mirrored community-level stigma. Health workers clearly described the negative impacts of stigma for adolescent girls and young women and seemed to generally express a desire to avoid stigmatization. Despite this lack of intent to stigmatize, results suggest that community influence perpetuates a lingering presence of stigma, although often unrecognized and unintended, in health workers and clinics. <br /> <br />Conclusions <br />These findings demonstrate the overlap in health workers’ clinic and community roles and suggest the need for multi-level stigma-reduction approaches that address the influence of community norms on health facility stigma. Stigma-reduction interventions should aim to move beyond fostering basic knowledge about stigma to encouraging critical thinking about internal beliefs and community influence and how these may manifest, often unconsciously, in service delivery to adolescent girls and young women. <br /> <br />Neil Pakenham-Walsh, Global Coordinator HIFA, www.hifa.org neil@hifa.org <br />Global Healthcare Information Network: Working in official relations with WHOTue, 01 Nov 2022 10:57:13 ZNeil Pakenham-Walsh2e89c351-0f47-44fc-b0e8-d30d0fd162b9https://hifaforums.org/_/lzx69n5ddiscussionDemystifying Negative Menstrual Myths in ZambiaDear HIFA-Zambia Members, <br /> <br />How can we best support girls to stay longer in school, seeing that their normal biological process hinders especially the vulnerable rural girls attain a decent education? I produced the film Distressed Distressed depicting a true story of a girl called Luse. After watching it? Do you think the topic should remain closed as usual, or should we start talking about how best we support the girl child? <br /> <br />Distressed: https://www.youtube.com/watch?v=1fsxBSG1pTs&amp;t=9s <br /> <br />Thanks, <br />Bridget Kakuwa-Kasongamulilo <br /> <br />HIFA-Zambia profile: Bridget Kakuwa-Kasongamulilo is a PhD student of Communication Science at University of South Africa. She has published on communication strategies used to promote regional integration in Africa and runs a family life and parenting blog on WordPress. Her professional interests are in participatory communication; educational child development and Psychology; Information management; water, sanitation and hygiene education; knowledge management and organizational learning; children broadcasting /television and film production. She has worked as Knowledge Management, Partnerships and Communication Advisor for FHI 360 . She previously worked as Regional Communications Officer for Feed the Future Harmonized Seed Regulations Project in Southern Africa, as Knowledge Management Manager at John Snow Inc(JSI). She has also worked for GIZ/SADC. She is currently working for the Centre for Coordination Of Agriculture Research &amp; Development in Southern Africa (CCARDESA) as Information, Communication &amp; Knowledge Management Officer. kakuwabridget AT yahoo.com <br />Tue, 01 Nov 2022 09:52:25 ZNeil Pakenham-Walsha6f3774d-e1f5-48c0-9f6e-a4dd2f622a9fhttps://hifaforums.org/_/dfpnb92rdiscussionDr Sylvia Masebo, Minister of Health, THET conference keynoteDr Sylvia Masebo, Minister of Health for Zambia, has just given a keynote at <br />the THET conference. MoH-THET partnership has led to improvements in health in Zambia, particularly in Medical education, Postgrad education, Training of biomed technicians, and partnerships with Provincial and district health teams. #THETCONF <br /> <br />Registration is free for health workers from LMICs. <br />https://www.thetconference.org/ <br /> <br />Best wishes, Neil (HIFA-Zambia moderator)Thu, 13 Oct 2022 08:44:16 ZNeil Pakenham-Walshbc1ae819-c68b-4f8a-beb5-6f8d41065dc0https://hifaforums.org/_/755xvr84discussionHealthcare workers’ perspectives on access to SRH services in Kenya, Tanzania, Uganda and ZambiaDear HIFA and HIFA-Zambia, <br /> <br />&#39;According to healthcare workers, the most common barrier to accessing sexual and reproductive health services was poor patient knowledge (37.1%)&#39; This is the main finding of a paper from Kenya, Tanzania, Uganda and Zambia. Citation, abstract and a comment from me below. <br /> <br />CITATION: Healthcare workers’ perspectives on access to sexual and reproductive health services in the public, private and private not-for-profit sectors: insights from Kenya, Tanzania, Uganda and Zambia <br />Gaby I. Ooms et al. <br />BMC Health Services Research volume 22, Article number: 873 (2022) Cite this article <br />https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-022-08249-y <br /> <br />ABSTRACT <br />Background: Access to sexual and reproductive health services remains a challenge for many in Kenya, Tanzania, Uganda and Zambia... <br /> <br />Methods: A cross-sectional survey was conducted among healthcare workers working in health facilities offering sexual and reproductive health services in Kenya (n = 212), Tanzania (n = 371), Uganda (n = 145) and Zambia (n = 243)... <br /> <br />Results: According to healthcare workers, the most common barrier to accessing sexual and reproductive health services was poor patient knowledge (37.1%). Following, issues with supply of commodities (42.5%) and frequent stockouts (36.0%) were most often raised in the public sector; in the other sectors these were also raised as an issue. Patient costs were a more significant barrier in the private (33.3%) and private not-for-profit sectors (21.1%) compared to the public sector (4.6%), and religious beliefs were a significant barrier in the private not-for-profit sector compared to the public sector (odds ratio = 2.46, 95% confidence interval = 1.69–3.56). In all sectors delays in the delivery of supplies (37.4-63.9%) was given as main stockout cause. Healthcare workers further believed that it was common that clients were reluctant to access sexual and reproductive health services, due to fear of stigmatisation, their lack of knowledge, myths/superstitions, religious beliefs, and fear of side effects. Healthcare workers recommended client education to tackle this. <br /> <br />Conclusions: Demand and supply side barriers were manifold across the public, private and private not-for-profit sectors, with some sector-specific, but mostly cross-cutting barriers. To improve access to sexual and reproductive health services, a multi-pronged approach is needed, targeting client knowledge, the weak supply chain system, high costs in the private and private not-for-profit sectors, and religious beliefs. <br /> <br />The authors conclude that: &#39;Efforts should focus on improving knowledge through client education, HCW sensitisation and education regarding unhelpful religious and cultural beliefs, improving supply chain systems through strengthening logistic management information systems, training staff in supply chain management, and allocating sufficient budget to commodity procurement.&#39; <br />-- <br /> <br />COMMENT (NPW): This paper confirms yet again the importance of access to reliable, relevant healthcare information. However, the author&#39;s concluding sentence &quot;Efforts should...&quot; cannot be derived on the basis of a relatively small survey of health workers&#39; perceptions. What is needed is more research on the role of (lack of) healthcare information (among patients and health workers) vis a vis other drivers/barriers to high-quality care. <br /> <br />Join HIFA: www.hifa.org/joinhifa <br />Join HIFA-Zambia: http://www.hifa.org/join/join-hifa-zambia <br /> <br />Neil Pakenham-Walsh, Global Coordinator HIFA, www.hifa.org neil@hifa.org <br />Working in official relations with WHOTue, 02 Aug 2022 14:15:39 ZNeil Pakenham-Walsh8c17373c-4407-4d87-92b6-3eecff8c7e8ahttps://hifaforums.org/_/rlsf0bhgdiscussionAccess to mass media and teenage pregnancy among adolescents in Zambia: a national cross-sectional surveyDear HIFA and HIFA-Zambia colleagues, <br /> <br />CITATION: Access to mass media and teenage pregnancy among adolescents in Zambia: a national cross-sectional survey <br />Quraish Sserwanja1 et al. BMJ Open 2022 <br />https://bmjopen.bmj.com/content/12/6/e052684 <br /> <br />ABSTRACT <br />Objective: Teenage pregnancies and childbirths are associated with negative health outcomes. Access to health information enables adolescents to make appropriate decisions. However, the relationship between access to health information through mass media and teenage pregnancy has not received much attention in existing literature. We therefore examined the association between access to mass media and teenage pregnancy in Zambia. <br /> <br />Design: Cross-sectional. <br /> <br />Setting: Zambia. <br /> <br />Participants: Weighted sample of 3000 adolescents aged 15–19 years. <br /> <br />Outcome measure: Teenage pregnancy that included adolescents who were currently pregnant or had had an abortion or had given birth in the last 5 years preceding the survey. <br /> <br />Results: Out of 3000 adolescents, 897 (29.9%, 95% CI: 28.1% to 31.3%) were pregnant or had ever been pregnant. Majority of the adolescents resided in rural areas (55.9%) and had secondary education (53.6%). Adolescents who had exposure to internet, newspapers or magazines, radio and television were 10.5%, 22.6%, 43.1% and 43.1%, respectively. Adolescents who had daily access to newspapers or magazines (adjusted OR (AOR): 0.33, 95% CI: 0.13 to 0.82) or using internet (AOR: 0.54, 95% CI: 0.30 to 0.95) were less likely to be pregnant or to have had a pregnancy compared with those with no access to newspapers and internet, respectively. <br /> <br />Conclusion: Our study suggests that internet use and reading of newspapers or magazines may trigger behavioural change as an effective approach to reducing teenage pregnancy. Behavioural change communicators can implement mass media campaigns using newspapers, magazines and the internet to publicise adolescent health messages that can encourage adolescents to adopt healthy behaviours and prevent teenage pregnancies. <br /> <br />COMMENT (NPW): The full text of the paper acknowledges that &#39;The observed association between watching TV and listening to radio with teenage pregnancy at bivariable analysis level was lost when socioeconomic variables were included during multivariable analysis&#39;. <br /> <br />Neil Pakenham-Walsh, Global Coordinator HIFA, www.hifa.org neil@hifa.org <br />Working in official relations with WHO <br /> <br />Join HIFA: www.hifa.org/joinhifa <br />Join HIFA-Zambia: http://www.hifa.org/join/join-hifa-zambia <br /> <br />Sat, 02 Jul 2022 08:53:43 ZNeil Pakenham-Walsh3b128852-6091-460d-8ab7-0d4fa75a22f4https://hifaforums.org/_/bdrp48hvdiscussionHealth care in pregnancy during the COVID-19 pandemic and pregnancy outcomes in six LMICsDear HIFA and HIFA-Zambia colleagues, <br /> <br />This paper concludes &#39;there was not an increase in the stillbirth, neonatal mortality, maternal mortality, low birthweight, or preterm birth rates during the COVID-19 period compared with the previous year&#39;. <br /> <br />CITATION: Health care in pregnancy during the COVID-19 pandemic and pregnancy outcomes in six low- and-middle-income countries: Evidence from a prospective, observational registry of the Global Network for Women’s and Children’s Health. Seemab Naqvi et al. <br />First published: 04 April 2022 https://doi.org/10.1111/1471-0528.17175 <br /> <br />ABSTRACT <br />Objective: To assess, on a population basis, the medical care for pregnant women in specific geographic regions of six countries before and during the first year of the coronavirus disease 2019 (COVID-19) pandemic in relationship to pregnancy outcomes. <br /> <br />Design: Prospective, population-based study. <br /> <br />Setting: Communities in Kenya, Zambia, the Democratic Republic of the Congo, Pakistan, India and Guatemala. <br /> <br />Population: Pregnant women enrolled in the Global Network for Women&#39;s and Children&#39;s Health&#39;s Maternal and Newborn Health Registry. <br /> <br />Methods: Pregnancy/delivery care services and pregnancy outcomes in the pre-COVID-19 time-period (March 2019–February 2020) were compared with the COVID-19 time-period (March 2020–February 2021). <br /> <br />Main outcome measures: Stillbirth, neonatal mortality, preterm birth, low birthweight and maternal mortality. <br /> <br />Results: Across all sites, a small but statistically significant increase in home births occurred between the pre-COVID-19 and COVID-19 periods (18.9% versus 20.3%, adjusted relative risk [aRR] 1.12, 95% CI 1.05–1.19). A small but significant decrease in the mean number of antenatal care visits (from 4.1 to 4.0, p = &lt;0.0001) was seen during the COVID-19 period. Of outcomes evaluated, overall, a small but significant decrease in low-birthweight infants in the COVID-19 period occurred (15.7% versus 14.6%, aRR 0.94, 95% CI 0.89–0.99), but we did not observe any significant differences in other outcomes. There was no change observed in maternal mortality or antenatal haemorrhage overall or at any of the sites. <br /> <br />Conclusions: Small but significant increases in home births and decreases in the antenatal care services were observed during the initial COVID-19 period; however, there was not an increase in the stillbirth, neonatal mortality, maternal mortality, low birthweight, or preterm birth rates during the COVID-19 period compared with the previous year. Further research should help to elucidate the relationship between access to and use of pregnancy-related medical services and birth outcomes over an extended period <br />-- <br /> <br />Join HIFA: www.hifa.org/joinhifa <br />Join HIFA-Zambia: http://www.hifa.org/join/join-hifa-zambia <br /> <br />Best wishes, Neil <br /> <br />Coordinator, WHO-HIFA project on Essential Health Services and COVID-19 <br />https://www.hifa.org/projects/essential-health-services-and-covid-19 <br /> <br />Let&#39;s build a future where every person has access to reliable healthcare information and is protected from misinformation - Join HIFA: www.hifa.org <br /> <br />HIFA profile: Neil Pakenham-Walsh is global coordinator of Healthcare Information For All - www.hifa.org - a global health community with more than 20,000 members in 180 countries, interacting on six global forums in four languages in official relations with WHO. HIFA brings stakeholders together to accelerate progress towards universal access to reliable healthcare information. Twitter: @hifa_org neil@hifa.org <br /> <br /> <br />Sat, 02 Jul 2022 08:08:48 ZNeil Pakenham-Walshba53d8f7-98ef-49ae-90da-03530c00ebf1https://hifaforums.org/_/zWuIIYzEdiscussionExperiences of teachers and community health workers implementing sexuality and life skills education in youth clubs in Zambia (2)Hi Neil, <br /> <br />Thank you for sharing this. <br /> <br />I am interested in getting full access to this publication, can anyone with full access kindly share the pdf with me. Will love to learn from the study. [*see note below] <br /> <br />So how do we tackle those perceived bottlenecks? Whats on the menu? <br /> <br />Regards, <br /> <br />Dr. Wezi P. M. Sunkutu, <br />Clinical Research Fellow, <br />University North Carolina -Global Projects Zambia (UNC-GPZ) <br />Cell: +260-977-518-949 <br />Skype name: wezi_sunkutu <br />&quot;The most important question to ask on the job is not, &quot;what am I getting?&quot; The most important question to ask on the job is, &quot;what am I becoming?&quot; - Jim Rohn. <br /> <br />HIFA profile: Wezi P. M. Sunkutu is a medical doctor (GP) with over 5yrs exposure in the rural parts of the country at both clinical and administrative level. He is now in the private sector and developing his special interest in the role nutrition plays in the management of diseases. http://www.wezisunkutu.flp.com/home.jsf drwezisunkutu AT gmail.com <br /> <br />[*Note from NPW, moderator: I have just done a search on Google Scholar and the full text article is available on ResearchGate here: <br />https://www.researchgate.net/profile/Malizgani-Chavula/publication/349822845_Experiences_of_teachers_and_community_health_workers_implementing_sexuality_and_life_skills_education_in_youth_clubs_in_Zambia/links/608f0510a6fdccaebd02d338/Experiences-of-teachers-and-community-health-workers-implementing-sexuality-and-life-skills-education-in-youth-clubs-in-Zambia.pdf ] <br /> <br />Wed, 08 Jun 2022 07:00:23 ZWezi Sunkutud582c926-d91b-4c51-b11f-1fad421b974ehttps://hifaforums.org/_/8vd9xwtfdiscussionExperiences of teachers and community health workers implementing sexuality and life skills education in youth clubs in ZambiaDear HIFA, CHIFA and HIFA-Zambia colleagues, <br /> <br />The conclusion of this paper is perhaps predictable: &#39;piloting of the curriculum with local facilitators and translating the manuals into the local languages before they are implemented, is recommended&#39;. Unfortunately the full text of the paper is restricted-access and is therefore not available to most of us. <br /> <br />CITATION: Chavula MP, Svanemyr J, Zulu JM, Sand&#248;y IF. Experiences of teachers and community health workers implementing sexuality and life skills education in youth clubs in Zambia. Glob Public Health. 2022 Jun;17(6):926-940. doi: 10.1080/17441692.2021.1893371. Epub 2021 Mar 4. PMID: 33661081. <br />Download citation https://doi.org/10.1080/17441692.2021.1893371 <br /> <br />ABSTRACT <br />Zambia, like other low- and middle-income countries, faces numerous adolescent sexual and reproductive health challenges such as teenage pregnancies. This study aimed at understanding teachers&#39; and community health workers&#39; (CHWs) implementation of comprehensive sexuality education (CSE) as part of a comprehensive support package for adolescent girls to prevent early childbearing. Data collected using in-depth interviews [n = 28] with teachers [n = 15] and community health workers [n = 13] were analysed using thematic analysis. The teachers and CHWs reported that the use of participatory approaches and collaboration between them in implementing CSE enabled them to increase girls&#39; and boys&#39; participation youth clubs. However, some teachers and CHWs experienced practical challenges with the manuals because some concepts were difficult to understand and translate into local language. The participants perceived that the youth club increased knowledge on CSE, assertiveness and self-esteem among the learners. Training and providing a detailed teaching manual with participatory approaches for delivering CSE, and collaborative teaching enabled teachers and CHWs to easily communicate sensitive SRH topics to the learners. However, for the adoption of CSE to be even more successful, piloting of the curriculum with local facilitators and translating the manuals into the local languages before they are implemented, is recommended. <br /> <br />Join HIFA: www.hifa.org/joinhifa <br />Join CHIFA (child health and rights): http://www.hifa.org/joinchifa <br />Join HIFA-Zambia: http://www.hifa.org/join/join-hifa-zambia <br /> <br />Best wishes, Neil <br /> <br />Let&#39;s build a future where every person has access to reliable healthcare information and is protected from misinformation - Join HIFA: www.hifa.org <br /> <br />HIFA profile: Neil Pakenham-Walsh is global coordinator of Healthcare Information For All - www.hifa.org - a global health community with more than 20,000 members in 180 countries, interacting on six global forums in four languages in official relations with WHO. HIFA brings stakeholders together to accelerate progress towards universal access to reliable healthcare information. Twitter: @hifa_org neil@hifa.org <br /> <br /> <br />Tue, 07 Jun 2022 10:42:15 ZNeil Pakenham-Walshc26be6c1-81bc-4677-8bd2-026dc7bb5368https://hifaforums.org/_/w13b72b0discussionMCH Journal: Care-Seeking Behavior for Newborns in Rural ZambiaDear CHIFA and HIFA-Zambia members <br /> <br />This paper concludes: &#39;Training both Traditional Birth Attendants and CHWs in providing community-based newborn care and appropriate referrals could improve care-seeking and prevent newborn mortality in rural Zambia.&#39; Citation and abstract below. The full text is unfortunately restricted-access and therefore is unavailable to many of us. <br /> <br />CITATION: Care-Seeking Behavior for Newborns in Rural Zambia <br />Lucy Thairu, Hanna Gehling, Sarah Kafwanda, Kojo Yeboah-Antwi, Davidson H. Hamer &amp; Karsten Lunze <br />Maternal and Child Health Journal volume 26, pages1375–1383 (2022)Cite this article <br />Published: 14 January 2022 <br />https://link.springer.com/article/10.1007/s10995-021-03329-7 <br /> <br />ABSTRACT <br />Objectives: Mothers in resource-limited areas face barriers in initiating care for ill newborns, leading to delays that may contribute to newborn mortality. This qualitative study conducted in rural Lufwanyama District in Zambia aimed to (1) explore mothers’ healthcare-seeking related to newborn illness and (2) identify reasons for delaying care-seeking for ill newborns. <br /> <br />Methods: We examined the perspectives of 60 mothers and 77 grandmothers of children under three years of age in 14 focus group discussions as part of the Lufwanyama Integrated Neonatal and Child Health Program study. We conducted a thematic analysis of verbatim transcripts using dedicated software. <br /> <br />Results: Mothers and grandmothers were generally able to identify newborn danger signs and established a hierarchy of care-seeking based on the perceived severity of danger signs. However, inability to afford transportation, inaccessible health care facilities, high costs of medication prescribed at the health clinics, lack of respectful treatment and fear of newborns dying in the hospital prevented participants from seeking timely care. As traditional birth attendants (TBAs) and community health care workers (CHWs) have limited roles in newborns care beyond the immediate delivery setting, mothers often resorted to traditional healers for newborn care. <br /> <br />Conclusions: Based on cultural beliefs and influenced by traditions, mothers in Lufwanyama have developed hierarchical strategies to seek care for ill newborns. Barriers to treatment at health facilities often resulted in traditional care. Training both TBAs and CHWs in providing community-based newborn care and appropriate referrals could improve care-seeking and prevent newborn mortality in rural Zambia. <br /> <br />Join CHIFA (child health and rights): http://www.hifa.org/joinchifa <br />Join HIFA-Zambia: http://www.hifa.org/join/join-hifa-zambia <br /> <br />Best wishes, Neil <br /> <br />Let&#39;s build a future where every person has access to reliable healthcare information and is protected from misinformation - Join HIFA: www.hifa.org <br /> <br />HIFA profile: Neil Pakenham-Walsh is global coordinator of Healthcare Information For All - www.hifa.org - a global health community with more than 20,000 members in 180 countries, interacting on six global forums in four languages in official relations with WHO. HIFA brings stakeholders together to accelerate progress towards universal access to reliable healthcare information. Twitter: @hifa_org neil@hifa.org <br /> <br /> <br />Tue, 07 Jun 2022 10:33:14 ZNeil Pakenham-Walsh14ffe05c-a136-43a0-93fb-4532a94f8102https://hifaforums.org/_/7pdsy1jadiscussionCOVID-19 vaccine hesitancy in Zambia (2)This paper finds that only one-third of participants would accept the COVID-19 vaccine if made available to them. <br /> <br />CITATION: Prevalence and factors associated with COVID-19 vaccine acceptance in Zambia: a web-based cross-sectional study. <br />Pan African Medical Journal. 41 (no pagination), 2022. Article Number: 112. Date of Publication: Jan-Apr 2022. <br />Mudenda S. et al. <br />https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8994469/ <br /> <br />ABSTRACT <br />Introduction: vaccinations against COVID-19 have been instituted to contain the pandemic. However, information about the acceptability of COVID-19 vaccines in Zambia is lacking. Therefore, the study assessed the prevalence and factors associated with COVID-19 vaccine acceptance among the general population in Zambia. <br /> <br />Methods: this was an online questionnaire-based cross-sectional study conducted from 13th April to 21st May 2021. We included adult Zambians who had access to Facebook and WhatsApp. A multivariable logistic regression model was fitted to determine factors influencing vaccine acceptability. Data were analysed using Stata version 16.1. <br /> <br />Results: of the 677 participants, only 33.4% (n = 226) would accept the vaccine if made available to them. In multivariable regression analysis, respondents who were older than 41 years compared to the 18 to 23 years age group (aOR: 2.77, 95% CI: 1.03-7.48), those who agreed (aOR; 22.85, 95% CI: 11.49-45.49) or did not know (aOR; 3.73, 95% CI: 2.29-6.07) compared to those who disagreed that the COVID-19 vaccine passed through all the necessary stages to ensure its safety and effectiveness, and those who were aware (aOR; 11.13, 95% CI: 5.31-23.35) compared to those who were not aware that the COVID-19 vaccine reduces virus transmission, were more likely to accept the vaccine. Conversely, entrepreneurs compared to government employees (aOR; 0.24, 95% CI: 0.07-0.79) were less likely to accept vaccination. <br /> <br />Conclusion: awareness of the COVID-19 vaccine was high despite low acceptability levels. These findings are significant as they highlight the need to develop strategies for improving vaccine acceptability in Zambia. <br /> <br />Neil Pakenham-Walsh, Global Coordinator HIFA, www.hifa.org neil@hifa.org <br /> <br />Coordinator, HIFA project on COVID-19, supported by University of Edinburgh <br />https://www.hifa.org/projects/covid-19 <br /> <br />Join HIFA: www.hifa.org/joinhifa <br />Join HIFA-Zambia: http://www.hifa.org/join/join-hifa-zambia <br /> <br />Sun, 01 May 2022 11:37:32 ZNeil Pakenham-Walsh1ab8c018-d5ce-43aa-9c52-36c12cf1ffb3https://hifaforums.org/_/7slssj96discussionCOVID-19 vaccine hesitancy in ZambiaDear HIFA and HIFA-Zambia colleagues, <br /> <br />Below are the citation and abstract of a new paper that looks at vaccine hesitancy among parents in Zambia, which found &#39;high acceptability of COVID-19 vaccination of their children, but substantial uncertainty and hesitancy about receiving the vaccine themselves&#39;. <br /> <br />CITATION: COVID-19 vaccine hesitancy in Zambia: a glimpse at the possible challenges ahead for COVID-19 vaccination rollout in sub-Saharan Africa. <br />Human Vaccines and Immunotherapeutics. 18(1) (pp 1-6), 2022. Date of Publication: 2022. <br />Carcelen A.C. et al. <br />https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8920139/ <br /> <br />ABSTRACT <br />With unprecedented speed, multiple vaccines against SARS-CoV-2 are available 1 year after the COVID-19 pandemic was first identified. As we push to achieve global control through these new vaccines, old challenges present themselves, including cold-chain storage, the logistics of mass vaccination, and vaccine hesitancy. Understanding how much hesitancy toward COVID-19 vaccines might occur and what factors may be driving these concerns can improve the ability of public health workers and communicators to maximize vaccine uptake. We nested a survey within a measles-rubella mass vaccination campaign in Zambia in November 2020 and asked about sentiments and beliefs toward COVID-19 and COVID-19 vaccines. Among parents bringing their children to receive a measles-rubella vaccine, we found high acceptability of COVID-19 vaccination of their children, but substantial uncertainty and hesitancy about receiving the vaccine themselves. COVID-19 vaccination hesitancy was correlated with beliefs around COVID-19 severity and risk, as well as vaccine safety and effectiveness. <br /> <br />Neil Pakenham-Walsh, Global Coordinator HIFA, www.hifa.org neil@hifa.org <br /> <br />Coordinator, HIFA project on COVID-19, supported by University of Edinburgh <br />https://www.hifa.org/projects/covid-19 <br /> <br />Join HIFA: www.hifa.org/joinhifa <br />Join HIFA-Zambia: http://www.hifa.org/join/join-hifa-zambia <br />Sun, 01 May 2022 11:25:38 ZNeil Pakenham-Walsh9afe1b42-34bd-4149-86a0-30e38590f0f9https://hifaforums.org/_/r84tzka2discussionZambia's response to the COVID-19 pandemicDear HIFA and HIFA-Zambia colleagues, <br /> <br />&#39;A lack of resources, misinformation, myths and vaccine hesitancy posed challenges in the fight against COVID-19 in Zambia. There is a need for continuous public education and sensitization on COVID-19 and the importance of vaccinations&#39;. <br /> <br />CITATION: Mudenda, S.; Chileshe, M.; Mukosha, M.; Hikaambo, C. N.; Banda, M.; Kampamba, M.; Mwila, K.; Banda, D. C.; Mufwambi, W.; Daka, V. <br />Zambia&#39;s response to the COVID-19 pandemic: exploring lessons, challenges and implications for future policies and strategies. <br />Pharmacology and Pharmacy; 2022. 13(1):11-33. 122 ref. <br />https://www.scirp.org/journal/paperinformation.aspx?paperid=115052 <br /> <br />ABSTRACT <br /> <br />The coronavirus disease 2019 (COVID-19) pandemic is a global public health problem that has affected the globe in different ways. There is little information published on the challenges and lessons learnt in responding to the COVID-19 epidemic in Zambia. Objective: To establish Zambia’s response, lessons and the challenges experienced in the fight against COVID-19. Results: Since the emergence of COVID-19, Zambia has experienced three waves, with the third wave being the most severe. The Zambian government responded positively and effectively to all three pandemics with the help of cooperating partners. Zambia adopted the World Health Organization (WHO) recommended prevention methods such as hand hygiene, masking up in public, physical distancing, avoiding crowded areas and staying at home to prevent the further spread of the disease. Additionally, surveillance of COVID-19 was strengthened, which led to the early detection of cases. Besides, there has been a strong call for all Zambian adults to receive the COVID-19 vaccine as a way of controlling the epidemic. However, since the launch of the COVID-19 vaccination programs, there has been a high level of vaccine hesitancy, causing Zambia to fall below the 10% of the adult population required to be vaccinated. Conclusion: The Zambian government put in place effective strategies in the fight against COVID-19. However, a lack of resources, misinformation, myths and vaccine hesitancy posed challenges in the fight against COVID-19 in Zambia. There is a need for continuous public education and sensitization on COVID-19 and the importance of vaccinations. <br /> <br />Join HIFA: www.hifa.org/joinhifa <br />Join HIFA-Zambia: http://www.hifa.org/join/join-hifa-zambia <br /> <br />Neil Pakenham-Walsh, Global Coordinator HIFA, www.hifa.org neil@hifa.orgSat, 02 Apr 2022 09:22:45 ZNeil Pakenham-Walshf7943e2b-125d-48ba-88ee-c184dc524ed8https://hifaforums.org/_/xl8nfkc3discussionSUPPORT-SYSTEMS (1) Open public meetings and community health in ZambiaDear HIFA and HIFA-Zambia colleagues, <br /> <br />Over the next 3 years HIFA is contributing to a new research project: Can decision-making processes for health systems strengthening and universal health coverage be made more inclusive, responsive and accountable? https://www.hifa.org/news/can-decision-making-processes-health-systems-strengthening-and-universal-health-coverage-be <br /> <br />With this in mind I was interested to see this new paper in the International journal of health policy and management. <br /> <br />CITATION: Using Open Public Meetings and Elections to Promote Inward Transparency and Accountability: Lessons From Zambia. <br />International journal of health policy and management. 11(2) (pp 160-172), 2022. Date of Publication: 01 Feb 2022. <br />Vian T.; Fong R.M.; Kaiser J.L.; Bwalya M.; Sakanga V.I.R.; Ngoma T.; Scott N.A. <br />https://www.ijhpm.com/article_3837.html <br /> <br />ABSTRACT <br /> <br />Background: Community-led governance can ensure that leaders are accountable to the populations they serve and strengthen health systems for maternal care. A key aspect of democratic accountability is electing respective governance bodies, in this case community boards, and holding public meetings to inform community members about actions taken on their behalf. After helping build and open 10 maternity waiting homes (MWHs) in rural Zambia as part of a randomized controlled trial, we assisted community governance committees to plan and execute annual meetings to present performance results and, where needed, to elect new board members. <br /> <br />Methods: We applied a principally qualitative design using observation and analysis of written documentation of public meetings to answer our research question: how do governance committees enact inward transparency and demonstrate accountability to their communities. The analysis measured participation and stakeholder representation at public meetings, the types and purposes of accountability sought by community members as evidenced by questions asked of the governance committee, and responsiveness of the governance committee to issues raised at public meetings. <br /> <br />Results: Public meetings were attended by 6 out of 7 possible stakeholder groups, and reports were generally transparent. Stakeholders asked probing questions focused mainly on financial performance. Governance committee members were responsive to questions raised by participants, with 59% of answers rated as fully or mostly responsive (showing understanding of and answering the question). Six of the 10 sites held elections to re-elect or replace governance committee members. Only 2 sites reached the target set by local stakeholder committees of 50% female membership, down from 3 at formation. To further improve transparency and accountability, community governance committees need to engage in advance preparation of reports, and should consult with stakeholders on broader measures for performance assessment. Despite receiving training, community-level governance committees lacked understanding of the strategic purpose of open public meetings and elections, and how these relate to democratic accountability. They were therefore not motivated to engage in tactics to manage stakeholders effectively. <br /> <br />Conclusion: While open meetings and elections have potential to enhance good governance at the community level, continuous training and mentoring are needed to build capacity and enhance sustainability. <br />-- <br /> <br />Join HIFA: www.hifa.org/joinhifa <br />Join HIFA-Zambia: http://www.hifa.org/join/join-hifa-zambia <br /> <br />Best wishes, Neil <br /> <br />Neil Pakenham-Walsh, Global Coordinator HIFA, www.hifa.org neil@hifa.org <br /> <br />Sat, 02 Apr 2022 09:13:03 ZNeil Pakenham-Walsh76fb9f47-0c9b-4aa5-ad67-dd9079338d75https://hifaforums.org/_/0mh2m33qdiscussionAfrican Alliance for Maternal Mental HealthAfrican Alliance for Maternal Mental Health <br /> <br />Dear Health Information for All - Zambia <br /> <br />Greetings from the African Alliance for Maternal Mental Health. <br /> <br />I am a research epidemiologist with a PhD in perinatal psychiatry from the UK and I am currently working with the African Alliance for Maternal Mental Health (AAMMH) and with Dr Robert Stewart (cc’d) who is a perinatal psychiatrist and founder member of the AAMMH working in Malawi. We have recently joined HIFA. <br /> <br />The African Alliance of Maternal Mental Health African Alliance for Maternal Mental Health (aammh.org) is an alliance of organisations working to improve and advocate for the mental health of mothers across Africa. We are registered as a Non Governmental Organization in Malawi and are aiming to expand across the continent by partnering with organizations in various disciplines, including those covering mental health, maternal and child health, women’s rights, people with lived experience, disability, education etc. This we hope will facilitate networking within and between countries. We are part of the Global Alliance for Maternal Mental Health, a coalition of international organisations committed to improving the mental health and wellbeing of women and children during pregnancy and the first postnatal year throughout the world (globalalliancematernalmentalhealth.org). <br /> <br />We are looking to partner with organizations in each country spanning a variety of relevant disciplines, and are currently in the process of establishing a database of organisations including hospitals and health care services, NGOs, professional associations, educational institutions etc. This we hope will facilitate networking within countries and across Africa and I am currently looking for organisations in Zambia who might wish to join us. I previously emailed this forum and had a great response. At the moment, I am particularly I am looking to add those who work in Women’s Rights, and of course any organisations across health and mental health. Please find attached an information sheet with further details about AAMMH and a membership form for organizations to fill out. We are also running a free webinar series for members of the African Alliance for Maternal Mental Health starting in April. I have attached the flyer also. [HIFA does not carry attachments - Neil] <br /> <br />AAMMH will only succeed with the support of its members. We look forward to a fruitful partnership. <br /> <br />Please feel free to forward this email to other organizations in your networks that will be interested or to pass on any contact details you feel may be of interest to us. <br /> <br />If you have any further questions please do not hesitate to contact me. <br /> <br />Kind regards, <br />Dr Clare Taylor <br /> <br />HIFA profile: Clare Taylor is a research epidemiologist with a PhD in perinatal psychiatry from the UK, currently working with the African Alliance for Maternal Mental Health African Alliance for Maternal Mental Health (aammh.org). The African Alliance for Maternal Mental Health is an alliance of organisations working to improve and advocate for the mental health of mothers across the Africa. clarabella18 AT hotmail.com <br />Thu, 17 Mar 2022 07:16:25 Zclarabella18@hotmail.coma74a532f-8df5-44a3-b841-b4813a05350dhttps://hifaforums.org/_/gxa2gagpdiscussionThe Current State of Snakebite Care in Kenya, Uganda, and ZambiaCITATION: The Current State of Snakebite Care in Kenya, Uganda, and Zambia: Healthcare Workers&#39; Perspectives and Knowledge, and Health Facilities&#39; Treatment Capacity <br />Gaby I Ooms 1 2, Janneke van Oirschot 1, Benjamin Waldmann 1, Sophie von Bernus 1, Hendrika A van den Ham 2, Aukje K Mantel-Teeuwisse 2, Tim Reed 1 <br />Am J Trop Med Hyg. 2020 Nov 23;104(2):774-782. doi: 10.4269/ajtmh.20-1078. <br />https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7866361 <br /> <br />ABSTRACT <br />Snakebites continue to be a public health concern in sub-Saharan Africa, where availability of appropriate medical treatment is rare, even though death and disability can be prevented with timely intervention. A challenge is the lack of sociopolitical studies to inform health policies. This study aimed to identify snakebite patient profiles, healthcare workers&#39; (HCWs) knowledge of snakebite, and facilities&#39; snakebite treatment capacity in Kenya, Uganda, and Zambia to inform interventions to improve access to appropriate treatment. <br /> <br />The research comprised a cross-sectional key informant survey among HCWs from health facilities in Kenya (n = 145), Uganda (n = 144), and Zambia (n = 108). Data were collected between March 2018 and November 2019. <br /> <br />Most of the HCWs suggested that the number of snakebite incidents was similar between the genders, that most patients were aged 21-30 years, and most people were bitten when farming or walking. Overall, only 12% of HCWs had received formal training in snakebite management. Only about 20% of HCWs in each country said their health facility had the medicines needed to treat snakebites, with antivenom available in 0-34% of facilities across the sectors and countries, and snakebites were not systematically recorded. <br /> <br />This research shows that an integrative approach through policies to increase resource allocation for health system strengthening, including community education, HCW training, and improved access to snakebite treatment, is needed. Part of this approach should include regulations that ensure antivenoms available in health facilities meet quality control standards and that snakebites are accommodated into routine reporting systems to assess progress. <br />-- <br /> <br />Neil Pakenham-Walsh, HIFA Coordinator, neil@hifa.org www.hifa.org <br />Mon, 28 Feb 2022 11:21:08 ZNeil Pakenham-Walshe06f7a57-9c1b-49bf-95b3-6d87e445df4ehttps://hifaforums.org/_/32yvlr12discussionDementia knowledge in three countries in sub-Saharan AfricaDementia knowledge in three countries in sub-Saharan Africa. <br /> <br />Citation and abstract of a paper in the journal of the Alzheimer&#39;s Association. <br /> <br />CITATION: Dementia knowledge in three countries in sub-Saharan Africa. <br />Alzheimer&#39;s &amp; dementia : the journal of the Alzheimer&#39;s Association. <br />17(Supplement 7) (pp e057649), 2021. Date of Publication: 01 Dec 2021. <br />Willis R.; Manful A.S.; Igbafe L.; Mukayagi P. <br />https://alz-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/alz.057649 <br /> <br />ABSTRACT <br />BACKGROUND: Limited research has been carried out in sub-Saharan Africa about knowledge of dementia, although studies report that supernatural causes predominate while the biomedical model has less adherence. The biomedical model has been called the pathway to care, but this is less useful when infrastructure and services for dementia are limited. Three African researchers sought to explore knowledge about dementia in three sub-Saharan African countries. This article provides added value by performing a synthesis across the three countries. <br />METHOD(S): Qualitative research was performed in Zambia (healthcare professionals and the general public), Kenya (people providing care for parents), and Nigeria (family members providing care for relatives). Individual interviews were analysed with thematic analysis. The findings from the three countries were synthesised to identify shared messages and areas of transferability. <br />RESULT(S): Zambian findings showed partial adherence to the biomedical model of dementia among professionals but not among the general public. There was evidence of othering those who believed in supernatural origins. In Kenya information-seeking strategies were used when carers realised something unusual was happening, indicating high levels of social capital are necessary. Nigerian findings demonstrated a similar process of gradual recognition of symptoms, but also labels of madness and expectations of recovery. <br />CONCLUSION(S): Overall, the three sets of data imply that adherence to the biomedical model of dementia is more widespread in sub-Saharan Africa than has been previously thought, but without care and support services and accompanying policies this will not benefit people with dementia and their families. <br /> <br />Neil Pakenham-Walsh, HIFA Coordinator, neil@hifa.org www.hifa.orgMon, 28 Feb 2022 11:13:29 ZNeil Pakenham-Walsh