Using Geographic Information Systems and Spatial Analysis Methods to Assess Household Water Access and Sanitation Coverage in the SHINE Trial.

Access to water and sanitation are important determinants of behavioral responses to hygiene and sanitation interventions. We estimated cluster-specific water access and sanitation coverage to inform a constrained randomization technique in the SHINE trial. Technicians and engineers inspected all public access water sources to ascertain seasonality, function, and geospatial coordinates. Households and water sources were mapped using open-source geospatial software. The distance from each household to the nearest perennial, functional, protected water source was calculated, and for each cluster, the median distance and the proportion of households within <500 m and >1500 m of such a water source. Cluster-specific sanitation coverage was ascertained using a random sample of 13 households per cluster. These parameters were included as covariates in randomization to optimize balance in water and sanitation access across treatment arms at the start of the trial. The observed high variability between clusters in both parameters suggests that constraining on these factors was needed to reduce risk of bias.

Quality of antiretroviral therapy in public health facilities in Nigeria and perceptions of end users.

AIM: This paper describes perceptions of the end users on quality of antiretroviral therapy (ART) in public health facilities in Nigeria. BACKGROUND: Health care services in Nigeria face challenges of meeting end users' requirements and expectations for quality ART service provision. METHOD: A qualitative design was followed. Unstructured focus group discussions were conducted with end users (n = 64) in six locations across the six geopolitical zones of Nigeria. RESULTS: The findings indicate that end users were satisfied with uninterrupted antiretroviral drug supplies, courtesy treatment, volunteerism of support group members and quality counselling services. CONCLUSION: End users expect effective collaboration between healthcare providers and support group members, to enhance the quality of life of people living with HIV. IMPLICATIONS FOR NURSING MANAGEMENT: A best practice guideline for the provision of end user focused ART service provision was developed for nurse managers.

South African rural community understanding of fermented foods preparation and usage.

BACKGROUND: The benefits of fermented foods consumption have been demonstrated in a number of research reports. These qualities have been demonstrated, for example, to reduce childhood diseases such as diarrhea and malnutrition. Thus, fermented foods may be recommended for improving the health and nutritional quality of traditional African foods and regular inclusion of fermented foods as part of the daily diet would be desirable. AIMS: Lack of knowledge and understanding toward fermented food preparation may limit their usage. This study explores the South African community's understanding of fermented foods preparation and usage. MATERIALS AND METHODS: This was a qualitative study using focus group interviews to determine the community's understanding and their perception of fermented foods preparation in the rural villages of Odi, in Gauteng Province between May and June 2012. The target population was the caregivers of children under 5 years, attending the hospital's antenatal clinic at the time of study. The information was transcribed, coded, and analyzed using NVivo software. RESULTS: Most caregivers were aware of food fermentation process, and some of them could not clearly differentiate between fermented and unfermented foods. Although most participants knew what fermented foods were, there were misconceptions on how they were made. This was exemplified by the undesirable artifacts, labeled as ingredients, in the fermentation process. CONCLUSION: Caregivers demonstrated a fair knowledge of fermented foods but lack a standard preparation procedure for these foods. There is an urgent need to educate communities and conduct a health promotion campaign on the fermented foods and probiotics.

Caregivers' knowledge and use of fermented foods for infant and young children feeding in a rural community of odi, gauteng province, South Africa.

BACKGROUND: Fermented foods have positive health effects in adults and children if consumed regularly. However, lack of knowledge and perceptions to-wards fermented foods may limit their usage. This study aimed to assess the caregivers' awareness and usage of fermented foods for feeding children in peri-urban/rural communities of Gauteng Province. METHODS: A qualitative exploratory study was conducted in June, 2012, in a peri-urban/rural community to assess the awareness and use of fermented foods by child caregivers attending a local antenatal clinic through focus group discussions. RESULTS: Thirty three caregivers participated in the study; however 29 indicated their demographic profiles. Four major themes that emerged from the analysis included knowledge on fermented foods, perceived benefits of fermentation, varied views about fermentation and feeding practices. Fermented foods that caregivers, their families and community members consume include ting, fat cakes, dumplings, sorghum beer and mageu. Findings also showed that children consumed fermented foods in form of soft ting porridge; and yoghurt, marketed as Activia and Danone commercial brands. Also, caregivers were not comfortable feeding their children with fermented foods, indicating their limited knowledge on the nutri-tional value of these foods. CONCLUSION: It is critical to promote caregivers' knowledge and use of fermented foods for feeding infants and young children in South African rural communities.