Context. Sub-Saharan Africa faces an increasing incidence and prevalence of life-limiting and life-threatening conditions. These conditions are associated with a significant burden of pain linked to high morbidity and disability that is poorly assessed and undertreated. Barriers to effective pain management partly relate to lack of access to opioid analgesia and challenges in their administration. Objectives. To identify country-specific and broader regional barriers to access, as well as the administration of opioids, and generate recommendations for advancing pain management in Southern Africa. Methods. A parallel mixed methods design was used across three countries: Mozambique, Swaziland, and Zimbabwe. Three activities were undertaken: 1) a review of regulatory and policy documentation, 2) group interviews, and 3) a self-administered key informant survey. Results. Barriers to accessing opioid analgesics for medical use include overly restrictive controlled medicines' laws; use of stigmatizing language in key documents; inaccurate actual opioid consumption estimation practices; knowledge gaps in the distribution, storage, and prescription of opioids; critical shortage of prescribers; and high out-of-pocket financial expenditures for patients against a backdrop of high levels of poverty. Conclusion. Policies and relevant laws should be updated to ensure that the legislative environment supports opioid access for pain management. Action plans for improving pain treatment for patients suffering from HIV or non-communicable diseases should address barriers at the different levels of the supply chain that involve policymakers, administrators, and service providers.
More than 98% of urban centres exceeding 100,000 people in Low and Middle-Income Countries (LMICs), do not meet the WHO air quality limits. Data on air pollution from LMICs is scarce. We measured the mean concentrations of near-road PM2.5 in the period of Aug.-Dec. 2020, described the Mukono Municipality’s near-road populations’ exposure to PM2.5, and assessed the associated health risk. PurpleAir PA-II laser particle counters, measured near-road ambient air PM2.5 concentration in Mukono Municipality during the period of 09/1/20 to 12/04/20. Excel Toolpak was used for data analysis and the health risk assessed with the WHO AirQ+ tool. The mean ambient near–road PM2.5 in Mukono Municipality were 30.97, 33.84 and 47.74 ug/m3for background, near-unpaved and near-paved roads, respectively. Mukono Municipality’s population was exposed to ambient PM2.5 concentrations higher than the WHO annual limit of 10 ug/m3. This level of air pollution is associated with preventable annual premature deaths of up to 133.11 per 100,000 population. Vehicles were assumed to be the predominant source of near-road ambient air PM2.5 pollution. The Municipality’s population was exposed to near-road ambient air PM2.5 exceeding the WHO annual limit by as much as *4.7 for the paved roads, *3.3 for the unpaved roads and *3 for the background. This leads to increased risk of preventable premature deaths in the Municipality.Mukono Municipality could monitor PM2.5; guide developers to placebuildings more than 100 meters away from roadsides and should promotepolicies for newer vehicles on Ugandan roads.
Uganda Christian University's records of 2013-2014 show that approximately 30% of the 3,300 students in the Easter Semester did not register for and therefore could not use the University's health services. This study analysed Uganda Christian University students' health seeking behaviour in order to identify their preferred health care services and rationale for their choice, and the barriers to the University's health system. A cross-sectional and mixed design was applied. Data was collected with a questionnaire administered to a sample of 424 Uganda Christian University students in April 2015. Quantitative data was analysed with SPSS 16. Qualitative data was analysed by content analysis. Most students came from urban (51%) or peri-urban (23.4%) homes and had parents or guardians with post-secondary school education (80%). Most of the students used the university's Allan Galpin Health Centre (78%) when in need of health care but given choice, they would prefer other health facilities, especially those nearest. The most frequent reason for choice was convenience. The females perceived their state of health differently from the males (p-value 0.03) and they had more unmet health needs. Barriers include unavailability of needed services, long queues, poor customer care, lack of trust in the service, waiting to see if the health problem would resolve and lack of relevant information. The findings are similar to those from studies done in similar contexts. Key influencers of health seeking behaviour were convenience and gender. Unavailability of needed services and customer care issues were barriers to the University health services.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.