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1.
S Afr Med J ; 114(7): e1882, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-39041517

RESUMEN

Caesarean sections (CSs) have increased globally, with concerns being raised involving overutilisation and inequalities in access. In Zimbabwe, where healthcare access varies greatly, we aimed to analyse factors associated with ever having a CS using the 2019 National Multiple Indicator Cluster Survey. The weighted national CS rate was 10.3%, and CS happened more commonly among women in urban than rural areas (15.7% v. 7.4%; odds ratio (OR) 2.34; (95% confidence interval (CI)) 1.71 - 3.20; p=0.001). Percentages of those having a CS significantly increased with education: overall χ2 for a trend of p=0.001 and wealth quintile, and overall χ2 for a trend of p=0.001. Women with insurance coverage were more likely to have had a CS than those without: 26.7% v. 8.7%; OR 3.82; 95% CI 2.51 - 5.83; p=0.001. The same was the case for women with access to the internet: 15.4% v. 7.0%, OR 2.42; 95%CI 1.71 - 3.41; p=0.001). These findings show an association that could indicate this being overutilised by insured women in urban settings, rather than being accessible based on clinical needs. Further research should explore reasons for these disparities and inform interventions to ensure equitable access to optimum childbirth in Zimbabwe.


Asunto(s)
Cesárea , Accesibilidad a los Servicios de Salud , Disparidades en Atención de Salud , Población Rural , Factores Socioeconómicos , Población Urbana , Humanos , Zimbabwe , Femenino , Adulto , Embarazo , Población Rural/estadística & datos numéricos , Cesárea/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Disparidades en Atención de Salud/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Adulto Joven , Encuestas y Cuestionarios , Adolescente , Cobertura del Seguro/estadística & datos numéricos
2.
S Afr Med J ; 114(6b): e1439, 2024 Jun 24.
Artículo en Inglés | MEDLINE | ID: mdl-39041524

RESUMEN

HIV/AIDS remains one of the world's most significant public health and economic challenges, with approximately 36 million people currently living with the disease. Considerable progress has been made to reduce the impact of HIV/AIDS in the past years through successful multiple HIV/AIDS prevention and treatment interventions. However, barriers such as lack of engagement, limited availability of early HIV-infection detection tools, high rates of HIV/sexually transmitted infections (STIs), barriers to access antiretroviral therapy, lack of innovative resource optimisation and distribution strategies, and poor prevention services for vulnerable populations still exist and substantially affect the attainment of the UNAIDS 95-95-95 targets. A rapid review was conducted from 24 October 2022 to 5 November 2022. Literature searches were conducted in different prominent and reputable electronic database repositories including PubMed, Google Scholar, Science Direct, Scopus, Web of Science, IEEE Xplore, and Springer. The study used various search keywords to search for relevant publications. From a list of collected publications, researchers used inclusion and exclusion criteria to screen and select relevant papers for inclusion in this review. This study unpacks emerging opportunities that can be explored by applying machine learning techniques to further knowledge and understanding about HIV service design, prediction, implementation, and evaluation. Therefore, there is a need to explore innovative and more effective analytic strategies including machine learning approaches to understand and improve HIV service design, planning, implementation, and evaluation to strengthen HIV/AIDS prevention, treatment, and awareness strategies.


Asunto(s)
Infecciones por VIH , Aprendizaje Automático , Humanos , Infecciones por VIH/prevención & control , Infecciones por VIH/epidemiología
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