ASHAs provide essential services to their community by acting as a conduit to healthcare services, but they may require more training about certain services like promoting institutional delivery to be effective in increasing access to these health services.
Purpose: This study seeks to review published research on the global epidemiology of corneal blindness, with a specific focus on the available published estimates of incidence, prevalence, and trends in incidence or prevalence, as well as the contribution of corneal causes to overall burden of blindness. Methods: A scoping review was conducted of the published literature on the global epidemiology of corneal blindness, with emphasis on prevalence and incidence studies. Four databases were searched using both epidemiological and corneal blindness keywords. This review was limited to studies with a primary aim of determining the incidence, prevalence, or trends in corneal blindness or the percentage of blindness due to corneal causes. Only conditions considered to signify current blindness were included, not diseases that eventually could lead to blindness if left untreated. Results: A total of 185 articles met the selection criteria. Of these, 145 articles investigated all-cause blindness prevalence. Only 10 articles specifically aimed to determine estimates of corneal blindness prevalence, 7 articles provided results for all-cause blindness incidence, and no studies focused on obtaining corneal blindness incidence. Data on corneal blindness were most often present in studies investigating all-cause blindness and in trachoma studies. Conclusions: The results demonstrate the somewhat inconsistent and fragmented information regarding corneal causes of vision loss. A significant outcome of this research is the demonstration of a need for further research into global corneal blindness and the necessary steps to address the problem.
Background We characterize the risk factors for delayed polio dose 1, diphtheria-tetanus-pertussis (DTP) dose 1, pentavalent dose 1, and measles dose 1 in Ethiopian infants. We also examine the interaction between institutional delivery and demographic factors on the birth doses of the BCG and polio vaccines to better understand factors influencing vaccination. Methods Using the 2011 Ethiopia Demographic and Health Survey, we calculated the distribution of the study population across different demographic and vaccination characteristics. We computed acceleration factors using a multivariable accelerated failure time model with a Weibull distribution to account for left and right censoring. For the birth doses, we further specified an interaction term between institutional delivery and every other a priori specified independent variable to test whether institutional delivery modifies sociodemographic disparities in vaccination timeliness. Results Low wealth status, home delivery, and ethnicity are risk factors for delayed vaccination of polio 1, DPT 1, pentavalent 1, and measles 1. Religion is a risk factor for measles 1 vaccination delay and rural residence are risk factors for delayed DPT1 and polio 1 doses. For birth doses of polio and BCG, institutional delivery attenuated many sociodemographic disparities in vaccination delay, except for urbanicity, which showed rural dwellers with more delay than urban dwellers with an institutional vs home birth. Conclusions Less delayed vaccination among children with institutional deliveries highlights the importance of perinatal care and the potential for promoting healthy behaviors to parents. Persistent disparities between urban and rural residents, even among those with institutional births, can be targeted for future interventions. Timely vaccination is key to prevention of unnecessary childhood mortality.
Health surveys conducted in low- and middle-income countries typically estimate childhood vaccination status based on written vaccination cards, maternal recall (when cards are not available), or a combination of both. This analysis aimed to assess the accuracy of maternal recall of a child’s vaccination status in Ethiopia. Data came from a 2016 cross-sectional study conducted in the Southern Nations, Nationalities, and Peoples’ (SNNP) Region of Ethiopia. Vaccine doses received by a given 12–23-month-old child were recorded from both a vaccination card and based on maternal recall and then compared. Concordance, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Cohen’s Kappa were calculated. Estimates of full immunization coverage were similar when collected via vaccination card (75%) and maternal recall (74%). For fully vaccinated children, comparison of maternal recall versus vaccination card showed high concordance (96%), sensitivity (97%), specificity (93%), PPV (98%), NPV (92%), and Kappa (90%). Accuracy of maternal recall of a child’s vaccination status is high in the SNNP region of Ethiopia. Although determination of vaccination status via vaccination card is preferred since it constitutes a written record, maternal recall can also be used with confidence when vaccination cards are not available.
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