Abstract:ObjectivesNeonatal mortality remains persistently high in low-income and middle-income countries. In Cambodia, there is a paucity of data on the perception of neonatal health and care-seeking behaviours at the community level. This study aimed to identify influencers of neonatal health and healthcare-seeking behaviour in a rural Cambodian province.DesignA qualitative study using focus group discussions and thematic content analysis.SettingFour health centres in a rural province of Northern Cambodia.Participant… Show more
“…56 Community healthcare workers have been an essential link between health centres and the community and are seen as key for health education and promotion of prevention activities. 57 Stigma and lack of understanding of disease requires education and cultural change, where again local or regional community engagement may be relevant as well as communication and policy change at the national level.…”
Section: Discussionmentioning
confidence: 99%
“… 56 Community healthcare workers have been an essential link between health centres and the community and are seen as key for health education and promotion of prevention activities. 57 Stigma and lack of understanding of disease requires education and cultural change, where again local or regional community engagement may be relevant as well as communication and policy change at the national level. Despite the reported high prevalence of ear disease in Southeast Asia, few studies have explored access to care for those with chronic suppurative otitis media Cambodia has seen significant improvements in health outcomes since the introduction of health financing policies to improve service delivery amongst the most vulnerable Findings indicate the otological disease progression and associated hearing loss for this hospital cohort is amongst the most severe reported globally Patients described numerous barriers to accessing ear care Adopting policies that integrate quality ear and hearing care into primary care provision can provide a continuum of care …”
Section: Discussionmentioning
confidence: 99%
“…A model utilising community healthcare workers has been used to deliver ear and hearing care in other low resource settings, 53 – 55 although the current structure to support such workers in Cambodia is somewhat fragmented 56 . Community healthcare workers have been an essential link between health centres and the community and are seen as key for health education and promotion of prevention activities 57 . Stigma and lack of understanding of disease requires education and cultural change, where again local or regional community engagement may be relevant as well as communication and policy change at the national level.…”
Objective
Chronic suppurative otitis media is a major global disease disproportionately affecting low- and middle-income countries, but few studies have explored access to care for those with ear and hearing disorders.
Method
In a tertiary hospital in Cambodia providing specialist ear services, a mixed method study was undertaken. This study had three arms: (1) quantitative analysis of patients undergoing ear surgery, (2) a questionnaire survey and (3) semi-structured in-depth interviews.
Results
Patients presented with advanced middle-ear disease and associated hearing loss at rates that are amongst the highest per capita levels globally. Patients reported several structural, financial and socio-cultural barriers to treatment. This study showed a significant burden of ear disease in Cambodia, which reflects a delay in receiving timely and effective treatment.
Conclusion
This study highlights the opportunity to integrate effective ear and hearing care into primary care service provision, strengthening the package of activities delivered at government facilities.
“…56 Community healthcare workers have been an essential link between health centres and the community and are seen as key for health education and promotion of prevention activities. 57 Stigma and lack of understanding of disease requires education and cultural change, where again local or regional community engagement may be relevant as well as communication and policy change at the national level.…”
Section: Discussionmentioning
confidence: 99%
“… 56 Community healthcare workers have been an essential link between health centres and the community and are seen as key for health education and promotion of prevention activities. 57 Stigma and lack of understanding of disease requires education and cultural change, where again local or regional community engagement may be relevant as well as communication and policy change at the national level. Despite the reported high prevalence of ear disease in Southeast Asia, few studies have explored access to care for those with chronic suppurative otitis media Cambodia has seen significant improvements in health outcomes since the introduction of health financing policies to improve service delivery amongst the most vulnerable Findings indicate the otological disease progression and associated hearing loss for this hospital cohort is amongst the most severe reported globally Patients described numerous barriers to accessing ear care Adopting policies that integrate quality ear and hearing care into primary care provision can provide a continuum of care …”
Section: Discussionmentioning
confidence: 99%
“…A model utilising community healthcare workers has been used to deliver ear and hearing care in other low resource settings, 53 – 55 although the current structure to support such workers in Cambodia is somewhat fragmented 56 . Community healthcare workers have been an essential link between health centres and the community and are seen as key for health education and promotion of prevention activities 57 . Stigma and lack of understanding of disease requires education and cultural change, where again local or regional community engagement may be relevant as well as communication and policy change at the national level.…”
Objective
Chronic suppurative otitis media is a major global disease disproportionately affecting low- and middle-income countries, but few studies have explored access to care for those with ear and hearing disorders.
Method
In a tertiary hospital in Cambodia providing specialist ear services, a mixed method study was undertaken. This study had three arms: (1) quantitative analysis of patients undergoing ear surgery, (2) a questionnaire survey and (3) semi-structured in-depth interviews.
Results
Patients presented with advanced middle-ear disease and associated hearing loss at rates that are amongst the highest per capita levels globally. Patients reported several structural, financial and socio-cultural barriers to treatment. This study showed a significant burden of ear disease in Cambodia, which reflects a delay in receiving timely and effective treatment.
Conclusion
This study highlights the opportunity to integrate effective ear and hearing care into primary care service provision, strengthening the package of activities delivered at government facilities.
“…The finding is similar to studies conducted in Indonesia ( 31 ) and developing countries ( 32 ). This could be because women who live a long distance away from a healthcare facility may have difficulty obtaining transportation ( 33 , 34 ). Furthermore, it causes a maternal delay in seeking healthcare services ( 35 ).…”
BackgroundHigh neonatal mortality rates continue to be a major public health issue in Ethiopia. Despite different maternal and neonatal care interventions, neonatal mortality in Ethiopia is at a steady state. This could be due to the low utilization of neonatal checkups. Thus, nationally assessing the level and predictors of postnatal checkups could provide important information for further improving neonatal healthcare services.Materials and MethodsA secondary data analysis of the 2016 Ethiopia Demographic and Health Survey (EDHS) was performed on 7,586 women who had live births in the 2 years before the survey. All variables with a p-value of ≤0.25 in the bivariable analysis were entered into the final model for multivariable analysis, and the level of statistical significance was declared at a P-value of <0.05.ResultsAccording to the national survey, only 8.3% [95% CI: 8.19, 8.41] of neonates received postnatal checkups. About two-thirds of women, 62.8% had antenatal care visits, 67.9%, gave birth at home, and 95.7% were unaware of neonatal danger signs. Distance from health care institutions [AOR = 1.42; 95% CI: 1.06, 1.89], giving birth in a healthcare facility [AOR = 1.55; 95% CI: 1.12, 2.15], antenatal care visit [AOR = 3.0; 95% CI: 1.99, 4.53], and neonatal danger signs awareness [AOR = 3.06; 95% CI: 2.09, 4.5] were all associated with postnatal care visits.ConclusionThe number of neonates who had a postnatal checkup was low. Increasing antenatal care visit utilization, improving institutional delivery, raising awareness about neonatal danger signs, increasing access to health care facilities, and implementing home-based neonatal care visits by healthcare providers could all help to improve postnatal checkups.
“…The studies that investigated the reasons behind the difference in mortality highlighted that the barriers to efficient care were twofold. On the one hand, people tend to delay seeking care due to lack of knowledge about neonatal health, sociocultural behaviors (e.g., relying on traditional practices), and several concerns about the cost of healthcare, the attitude of NICU staff, and the lack of appropriate medical equipment ( Watson et al, 2020 ). On the other hand, obstetrics and neonatal evidence-based practices fail to be introduced due to lack of financial resources, workforce capacity, and specific training in case of emergency.…”
Section: The Future Perspectives For the Clinical Use Of Hrv In The Nmentioning
Neonatal intensive care units (NICUs) greatly expand the use of technology. There is a need to accurately diagnose discomfort, pain, and complications, such as sepsis, mainly before they occur. While specific treatments are possible, they are often timeconsuming, invasive, or painful, with detrimental effects for the development of the infant. In the last 40 years, heart rate variability (HRV) has emerged as a noninvasive measurement to monitor newborns and infants, but it still is underused. Hence, the present paper aims to review the utility of HRV in neonatology and the instruments available to assess it, showing how HRV could be an innovative tool in the years to come. When continuously monitored, HRV could help assess the baby's overall wellbeing and neurological development to detect stress-/painrelated behaviors or pathological conditions, such as respiratory distress syndrome and hyperbilirubinemia, to address when to perform procedures to reduce the baby's stress/pain and interventions, such as therapeutic hypothermia, and to avoid severe complications, such as sepsis and necrotizing enterocolitis, thus reducing mortality. Based on literature and previous experiences, the first step to efficiently introduce HRV in the NICUs could consist in a monitoring system that uses photoplethysmography, which is low-cost and non-invasive, and displays one or a few metrics with good clinical utility. However, to fully harness HRV clinical potential and to greatly improve neonatal care, the monitoring systems will have to rely on modern bioinformatics (machine learning and artificial intelligence algorithms), which could easily integrate infant's HRV metrics, vital signs, and especially past history, thus elaborating models capable to efficiently monitor and predict the infant's clinical conditions. For this reason, hospitals and institutions will have to establish tight collaborations between the obstetric, neonatal, and pediatric departments: this way, healthcare would truly improve in every stage of the perinatal period (from conception to the first years of life), since information about patients' health would flow freely among different professionals, and high-quality research could be performed integrating the data recorded in those departments.
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