Abstract Malawian women in all sectors of society are suffering from social implications of unwanted pregnancy and unsafe abortion. Unwanted pregnancies occur among women who have limited access to ...family planning and safe abortion. A legally restrictive setting for safe abortion services leads many women to unsafe abortion, which has consequences for them and their families. In-depth interviews were conducted with 485 Malawian stakeholders belonging to different political and social structures. Interviewees identified the impact of unwanted pregnancy and unsafe abortion to be the greatest on young women. Premarital and extramarital pregnancies were highly stigmatized; stigma directly related to abortion was also found. Community-level discussions need to focus on reduction of stigma.
Attitudes toward abortion in Zambia Geary, Cynthia Waszak; Gebreselassie, Hailemichael; Awah, Paschal ...
International journal of gynaecology and obstetrics,
September 2012, Letnik:
118, Številka:
S2
Journal Article, Conference Proceeding
Recenzirano
Despite Zambia's relatively progressive abortion law, women continue to seek unsafe, illegal abortions. Four domains of abortion attitudes – support for legalization, immorality, rights, and access ...to services – were measured in 4 communities. A total of 668 people were interviewed. Associations among the 4 domains were inconsistent with expectations. The belief that abortion is immoral was widespread, but was not associated with lack of support for legalization. Instead, it was associated with belief that women need access to safe services. These findings suggest that increasing awareness about abortion law in Zambia may be important for encouraging more favorable attitudes.
This article describes the setting-up process for nurse-led pilot clinics for the management of four chronic diseases: asthma, type 2 diabetes mellitus, epilepsy and hypertension at the primary ...health care level in urban and rural Cameroon.
The Biyem-Assi urban and the Bafut rural health districts in Cameroon served as settings for this study. International and local guidelines were identified and adapted to the country's circumstances. Training and follow-up tools were developed and nurses trained by experienced physicians in the management of the four conditions. Basic diagnostic and follow-up materials were provided and relevant essential drugs made available.
Forty six nurses attended six training courses. By the second year of activity, three and four clinics were operational in the urban and the rural areas respectively. By then, 925 patients had been registered in the clinics. This represented a 68.5% increase from the first year. While the rural clinics relied mainly on essential drugs for their prescriptions, a prescription pattern combining generic and proprietary drugs was observed in the urban clinics.
In the quest for cost-effective health care for NCD in sub-Saharan Africa, rethinking health workforce and service delivery has relevance. Nurse-led clinics, algorithm driven service delivery stands as alternatives to overcome the shortage of trained physicians and other issues relating to access to care.
Previous studies have highlighted how African genomes have been shaped by a complex series of historical events. Despite this, genome-wide data have only been obtained from a small proportion of ...present-day ethnolinguistic groups. By analyzing new autosomal genetic variation data of 1333 individuals from over 150 ethnic groups from Cameroon, Republic of the Congo, Ghana, Nigeria, and Sudan, we demonstrate a previously underappreciated fine-scale level of genetic structure within these countries, for example, correlating with historical polities in western Cameroon. By comparing genetic variation patterns among populations, we infer that many northern Cameroonian and Sudanese groups share genetic links with multiple geographically disparate populations, likely resulting from long-distance migrations. In Ghana and Nigeria, we infer signatures of intermixing dated to over 2000 years ago, corresponding to reports of environmental transformations possibly related to climate change. We also infer recent intermixing signals in multiple African populations, including Congolese, that likely relate to the expansions of Bantu language-speaking peoples.
In in vitro analyses, extracts from these plants have been shown to have anti-inflammatory and antibacterial properties; an ethanol extract from the bark of E. suaveolens has been specifically tested ...for activity against M. ulcerans 21-25. Since spontaneous healing of BU cases has been reported 26, it is not firmly established that the healing of the lesion of the patient presented here was supported by herbal remedies. Learning Points * The combination of rifampicin with streptomycin or clarithromycin, given for eight weeks, is a well-established first-line therapy for all forms of active M. ulcerans disease. * In African Buruli ulcer endemic areas, herbal remedies nevertheless continue to be applied to lesions of Buruli ulcer patients. * Details of possible anti-mycobacterial activities of herbal remedies--obtained from plants that are repeatedly reported to be applied to Buruli ulcer lesions in several endemic countries in West Africa--may be worth further investigation. * Given the possibility of spontaneous remission, the potential contribution of herbal remedies to the healing of Buruli ulcer lesions remains to be critically assessed.
Key historical landmark research malpractice scandals that shocked the international community (Nazi doctors’ experiments, Tuskegee study, Jewish chronic disease experiments, Krugman’s Willowbrook ...hepatitis study) were the origin of the institution of ethics review prior to carrying out research involving humans. Nonetheless, it is plausible that unethical research is ongoing or may have been conducted in recent times that has escaped public notice, especially in the vulnerable low- and middle-income country contexts. The basic constitution of these committees at some point has not been clearly defined, with most scientists declaring political maneuvers at times. These committees today are characterized by bureaucratic bottlenecks, financial interests, inadequate training in research ethics, and lack of control and coordination of their functions. Compulsory and adequate research ethics training for researchers and ethical committee members could guarantee trust, and appreciation of the utmost importance of the latter. The independence of protocol review should be guaranteed as much as possible so that the process attains its set goals. It might be too simplistic, and hypocritical, to allow ethics committees to continue to function on an ‘altruistic’ basis. Governments must strengthen the roles of national ethics committees – their independence, oversight roles, and as monitoring and evaluation bodies for smaller research ethics committees. Funding and objective constitution of board members is critical. Only then would research ethics committees be metamorphosed from the ‘bad guys’ to the trusted friends. The fear is preventing the research ethics committee from being seen and thus becoming an ethical oxymoron.
Abstract Aims To implement a protocol-driven primary nurse-led care for type 2 diabetes in rural and urban Cameroon. Methods We set-up three primary healthcare clinics in Yaounde (Capital city) and ...two in the Bafut rural health district. Participants were 225 (17% rural) patients with known or newly diagnosed type 2 diabetes, not requiring insulin, referred either from a baseline survey (38 patients, 17%), or secondarily attracted to the clinics. Protocol-driven glucose and blood pressure control were delivered by trained nurses. The main outcomes were trajectories of fasting capillary glucose and blood pressure indices, and differences in the mean levels between baseline and final visits. Results The total duration of follow-up was 1110 patient-months. During follow-up, there was a significant downward trend in fasting capillary glucose overall ( p < 0.001) and in most subgroups of participants. Between baseline and final visits, mean fasting capillary glucose dropped by 1.6 mmol/L (95% CI: 0.8–2.3; p ≤ 0.001). Among those with hypertension, blood pressure also decreased significantly for systolic and marginally for diastolic blood pressure. No major significant change was noticed for body weight. Conclusions Nurses may be potential alternatives to improve access to diabetes care in settings where physicians are not available.
Despite legal restriction, induced abortions and resulting complications are common in Nigeria. Misoprostol administration for incomplete abortion was introduced in 3 Nigerian hospitals. The ...feasibility of the hospitals, patient and provider acceptability were assessed using questionnaire and interview guides administered to 205 women and 17 providers respectively. Amongst the women, 194 (95%) were satisfied and very satisfied with misoprostol, 176 (86%) would choose misoprostol again if another incomplete abortion occurred and 191 (93%) would recommend it to another woman in a similar situation. Providers were highly satisfied with misoprostol. The ease of use and ability to redirect surgical resources to more complicated issues were positive features cited by them. The providers agreed that integration of misoprostol was straightforward and required few resources. Therefore, misoprostol for incomplete abortion is safe, efficacious and acceptable to providers and patients. In remote areas of Nigeria with limited post-abortion care (PAC), misoprostol administration is an important potential PAC treatment modality. Features of misoprostol-low cost, room temperature stability, and ease of introduction-render it an important treatment option, particularly in low resource and rural settings Malgré la limitation judiciaire, les avortements provoqués et les implications éventuelles sont communs au Nigéria. L'administration de Misoprostol pour l'avortement inachevé a été introduite dans trois hôpitaux nigérians. Nous avons évalué la faisabilité des hôpitaux, l'acceptabilité des patientes et des dispensateurs é l'aide des questionnaires et des interviews auprès des 205 femmes et 17 dispensateurs respectivement. Parmi les femmes, 194 (95%) ont été satisfaites et très satisfaites de Misoprostol. 176 (86%) choisiraient Misoprostol encore si elles subissent un autre avortement inachevé et 191 (93%) le proposeraient aux autres femmes qui se trouvent dans une situation pareille. Les dispensateurs étaient hautement satisfaits de Misoprostol. La facilité de l'utilisation et la capacité de réorienter les ressources chirurgicales vers les problèmes plus compliqués constituent des qu'elles ont citées. Les dispensateurs étaient d'accord que l'intégration de Misoprostol est facile et ne demande que peu de ressources. En conséquence, Misoprostol n'est pas dangereux pour le traitement de l'avortement inachevé, il est efficace et acceptable aux dispensateurs et aux patientes. Dans les régions rurales isolées au Nigeria, qui ne disposent que très peu de soins du post-avortement (SPA) limités, l'administration de Misoprostol est une modalité de traitement du SPA potentiel important. Les caractéristiques de Misoprostol: bon marché, stabilité à la température ordinaire et la facilité de l'introduction, le rend une option de traitement importante, surtout dans les milieux é faibles revenus et dans les régions rurales
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