Hypertension: A National Cross-Sectional Study in India.

OBJECTIVE: Hypertension is a global public health problem. This article aimed to estimate the national prevalence of hypertension in India for both women and men. The study had also examined the demographic and socioeconomic status of hypertensive women and men. METHODS: The study used the National Family Health Survey 4 from all over India. Hypertension of 661 771 women (15-49 years) and 104 357 men (15-54 years) and their demographic and socioeconomic variables were assessed. Crosstabulation, chi-square tests, and multivariate logistic regression were used. RESULTS: The prevalence of hypertension in women and men were 11.40% and 18.10%, respec- tively. State-wise, Sikkim had shown the maximum prevalence. Older women (45-49 years) and men (50-54 years) had the highest hypertension prevalence among all age groups. Urban people had shown proportionately more hypertension than rural people. Education, working status, and richer economic status emerged as significant risk factors. Women with lower edu- cational status and men with higher educational status were more likely to be hypertensive. Working people were more hypertensive than their non-working peers. Economically, sound men were more hypertensive than poor people. Hypertensive people accessed medical care more. CONCLUSION: There are various modifiable risk socioeconomic factors associated with hyperten- sion. Policymakers can consider the current findings for better preventive planning. The risk factors identified in the study should be considered with appropriate weightage.

Perceptions and practices on newborn care and managing complications at rural communities in Bangladesh: a qualitative study.

BACKGROUND: Community misperception on newborn care and poor treatment of sick newborn attributes to neonatal death and illness severity. Misperceptions and malpractices regarding neonatal care and neonatal complications are the leading causes of neonatal deaths in Bangladesh. The study was conducted to explore neonatal care's perceptions and practices and manage complications among Bangladesh's rural communities. METHODS: A qualitative study was conducted in Netrakona district of Bangladesh from April to June 2015. Three sub-districts (Upazilas) including Purbadhala, Durgapur and Atpara of Netrakona district were selected purposively. Five focus group discussions (FGDs) and twenty in-depth interviews (IDIs) were conducted in the rural community. Themes were identified through reading and re-reading the qualitative data and thematic analysis was performed. RESULTS: Community people were far behind, regarding the knowledge of neonatal complications. Most of them felt that the complications occurred due to lack of care by the parents. Some believed that mothers did not follow the religious customs after delivery, which affected the newborns. Many of them followed the practice of bathing the newborns and cutting their hair immediately after birth. The community still preferred to receive traditional treatment from their community, usually from Kabiraj (traditional healer), village doctor, or traditional birth attendant. Families also refrained from seeking treatment from the health facilities during neonatal complications. Instead, they preferred to wait until the traditional healers or village doctors recommended transferring the newborn. CONCLUSIONS: Poor knowledge, beliefs and practices are the key barriers to ensure the quality of care for the newborns during complications. The communities still depend on traditional practices and the level of demand for facility care is low. Appropriate interventions focusing on these issues might improve the overall neonatal mortality in Bangladesh.

Prevalence of intimate partner violence against women in Republic of Benin.

The present study was conducted to estimate the prevalence of intimate partner violence against women (IPVAW) of reproductive age in Benin and to assess the factors related to the experience of IPVAW and attitude towards wife beating among women. The study also assessed whether a family history of violence is a risk factor for experiencing IPVAW. The study used the Benin Demographic and Health Survey 2017-18 data for analyses. A national representative sample of 4488 ever married women was selected to respond to a domestic violence and abuse questionnaire. Cross-tabulation and multivariate logistic regression analyses were performed. The prevalence of IPVAW experience in Benin was as follows: emotional violence, 35.4%; physical violence, 18.4%; and sexual violence, 8.2%. Older age, rural residence, the practice of Vodoun religion, living in a household headed by a male member, family history of domestic violence, and attitudes towards wife beating were significantly associated with the prevalence of IPVAW. Thirty-two percent of women supported wife beating. Women residing in urban areas, having higher educational qualification, higher socioeconomic status, and no family history of domestic violence were less likely to support wife beating. Policymakers should place emphasis on evidence-based prevention programs, gender equality, women empowerment, and policy priority for curbing IPVAW.

Maternal Delivery at Home: Issues in India.

INTRODUCTION: Maternal delivery at home without skilled care at birth is a major public health issue. The current study aimed to assess the various contributing and eliminating factors of maternal delivery at home in India. The reasons for not delivering at healthcare facilities were also explored. METHODS: The study used the National Family Health Surveys (NFHS)-4 (2015-2016) data from states and union territories of India for analysis. A national representative sample of 699,686 women of reproductive age group (15-49 years) was used. Cross-tabulation and multivariate logistic regression analyses were performed. RESULTS: The prevalence of home delivery in India was 22%, among which 34% of women believed that institutional delivery was not a necessity. Financial constraints, lack of proper transportation facilities, non-accessibility of healthcare institutions and not getting permission from family members were the main reasons cited by the women for delivering at home. The proportion of home deliveries was much higher among women from more disadvantaged socioeconomic areas than women from less disadvantaged socioeconomic areas. Domestic violence and partner control were essential factors contributing to the prevalence of home delivery. However, the women who owned mobile phones and used a short message service (SMS) facility delivered at home less often. CONCLUSION: Policymakers should focus more on the women living in disadvantaged socioeconomic areas and other marginalised populations with less education and low economic levels to provide them with optimum delivery care utilisation. Strengthening of public healthcare facilities and more effective use of skilled birth attendents and their networking are essential steps. Electronic and economic empowerment of women should be emphasised to bring about a significant reduction in the proportion of home deliveries in India.

Occupational burnout and lifestyle in Kazakhstan cardiologists.

BACKGROUND: No data exist in the published literature on burnout in physicians from Central Asia. The aim of this analysis was to assess burnout prevalence in doctors and nurses of a cardiological hospital in Almaty, Kazakhstan and ascertain whether smoking, alcohol and physical activity may predict job-associated burnout. METHODS: The staff of the City Cardiological Centre of Almaty (N = 259, 82% females) filled in the questionnaire with the questions on demographics, lifestyle, including smoking, alcohol and physical activity, as well as fatigue (using Fatigue Severity Scale (FSS)) and burnout using Maslach Burnout Inventory (MBI) Human Services Survey for Medical Personnel. We compared the scores of emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA) between doctors and nurses. RESULTS: We found significant differences in the smoking prevalence, alcohol use and regular physical activity, but no mean scores of burnout between men and women. High DP was prevalent in 52% doctors and 45% nurses, whereas high EE was found in 32 and 26% and PA in 16 and 32%, accordingly. In contrast with EE and DP, PA score was greater in nurses (median 38, interquartile range (IQR) 17) compared to doctors (median 41, IQR 9). Age, sex, work duration, smoking or physical activity could not predict higher burnout, whereas FSS score was associated with higher burnout of all dimensions (p < 0.05), and never-alcohol could predict higher PA burnout (p < 0.05). CONCLUSIONS: In Kazakhstan cardiologists, high prevalence of DP burnout should target specific preventive strategies and the association of alcohol use with PA needs further deeper insight.

Adolescent girls' attitudes toward female genital mutilation: a study in seven African countries.

Background: The study's aim is to examine adolescent girls' attitudes toward the continuation or discontinuation of female genital mutilation (FGM) in association with their demographics in seven different countries in Africa. Methods: Data from the women's survey of the Demographic and Health Surveys (DHS) conducted by the respective ministries (of Health and Family Welfare) in Egypt, Guinea, Kenya, Mali, Niger, Senegal and Sierra Leone were used. Adolescent girls (15-19 years) were included in the current analysis: Egypt (N=636), Guinea (N=1994), Kenya (N= 1767), Mali (N=2791), Niger (N=1835), Senegal (N=3604), Sierra Leone (N=1237). Results: Prevalence of supporting the continuation of FGM among adolescent girls was in Egypt 58%, Guinea 63%, Kenya 16%, Mali 72%, Niger 3%, Senegal 23%, and Sierra Leone 52%. Being Muslim and having low economic status were significantly associated with supporting the continuation of FGM in five of the participating countries. Girls having no education or only primary education in Guinea, Kenya, Mali and Sierra Leone exhibited a higher likelihood of supporting FGM than girls with secondary or higher education. In Egypt, Niger and Senegal there was no association between education and supporting FGM. The girls who stated that they had no exposure to media showed the higher likelihood of supporting FGM in Guinea, Kenya, and Senegal than those with exposure to media. Conclusions: The current study argues that increasing media coverage and education, and reducing poverty are of importance for shifting adolescent girls' attitudes in favor of discontinuation of FGM.

Out-of-pocket health expenditure and fairness in utilization of health care facilities in Cambodia in 2005 and 2010.

Background: Out-of-pocket (OOP) payments for health care are highly pervasive in several low-and-middle income countries. The Cambodian health system has envisaged massive repositioning of various health care financing to ensure equitable access to health care. This analysis examines catastrophic, economic, as well as fairness, impacts of OOP health care payments on households in Cambodia over time. Methods: Data from two waves of a nationally representative household survey conducted in Cambodia (CDHS Surveys 2005 and 2010) were utilized. Healthcare utilizations based on economic status were compared during 2005 and 2010. Variables of interests were i) where care was sought and the instances of treatments, i.e. was treatment sought the first, second or third time; (ii) the mode of payment for treatment of the respondent or for any household member due to sickness or injury in the last 30 days prior to the survey period. Lorenz curves were applied to assess the degree of distribution of inequality in OOP expenditures between different income brackets. Results: The findings revealed that there was inequality and unfairness in health care payments, and catastrophic spending is more common among the poor in Cambodia. The majority of people from poorer households experienced economic hardship and have taken to catastrophic health care spending through sales of personal possessions.  Conclusion: Based on the findings from this analysis, more attention is needed on effective financial protection for Cambodians to promote fairness. The government should increase spending on services being provided at public health care facilities to reduce ever increasing reliance on private sector providers. These approaches would go a long way to reduce the economic burden of care utilization among the poorest.

Seatbelt and child-restraint use in Kazakhstan: attitudes and behaviours of medical university students.

Traffic fatalities in Kazakhstan increased from 15 to more than 30 per 100 000 between 2001 and 2006. Mortality remains high compared with developed nations. Safety-restraint laws have been enacted, but little data exist regarding usage of seatbelts, particularly among children and passengers. This cross-sectional study surveyed medical university students about attitudes and behaviours regarding seatbelt and child safety-restraint usage. Seatbelts are widely used in the front seat (81%) but not in the back seat (79% 'never' or 'rarely' use a seatbelt in the back seat). Fewer than half reported 'always' or 'almost always' providing restraint for children under 7 years and 24% reported children secure the seatbelts themselves. Safety in the back seat merits attention. Adults generally do not buckle in the back seat despite a law requiring seatbelt use. Promotion of child safety restraints should be prioritised in prevention education for physicians and the community.