Medicine and Health Sciences Commons^™

Balancing Life After Spousal Loss: A Cross-Sectional Study Investigating The Mental Well-Being And Life Satisfaction Of Martyrs’ Wives, Mehreen Aslam, Ambreen Tharani, Yasmin Parpio, Rafat Jan

Journal of Asian Midwives (JAM)

Background: The wives who have lost their spouses in conflict zones are known as martyrs’ wives. After sacrificing the martyrs’ lives, their wives not only face the traumatic experience of losing their loved ones, but this loss may substantially affect their physical, socioeconomic, and emotional health. It may serve as a "vulnerability factor," raising the risk of depression.
Objective: To assess the levels of life satisfaction and mental well-being within the wives of martyrs residing in Karachi, Pakistan.
Methodology: A descriptive cross-sectional study was conducted to assess the mental well-being and life satisfaction of martyrs’ wives living in Karachi Pakistan. …

The Effectiveness Of Nurse Assistants Training Programme On Safe Motherhood: A Study On Bhutanese Nurse Assistants, Jureerat Kijsomporn, Nualyai Pitsachart, Phayong Thepaksorn, Ling Shing Wong, Vinodhkumar Ramalingam, Voon Wan Niu

Journal of Asian Midwives (JAM)

Background: This study aims to investigate the ability of nurse assistants in midwifery care in Bhutan to apply their knowledge and skills after attending the training programme.
Methods: A qualitative methodology was utilized in this study, in-depth interviews using a semi-structured interview guide questionnaire with five nurse assistants, three district health officers, and two medical doctors from hospitals. The interviews (n=10) were conducted on-site at basic health units in URA and Tang, Bhutan.
Results: The data analysis of their perceptions yielded three major categories: (1) Confirmability, the Quality of knowledge and skills of the program; (2) Credibility, Effectiveness, and comprehensiveness …

Determinants Of Underutilization Of Maternal Health Services In Anc Clinics In Lmics: A Narrative Review, Jonathan Johnson, Rubeka Mansha, Abeer Musaddique

Journal of Asian Midwives (JAM)

Background: Antenatal care (ANC) is critical for achieving Sustainable Development Goals (SDG) 3.1 and 3.2, aiming to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030, and to decrease neonatal and under-5 mortality rates. Despite its importance, approximately 830 women die daily from preventable pregnancy and childbirth causes, predominantly in low-resource settings.
Methods: The study conducted a comprehensive literature search from January 1, 2009, to December 30, 2020, focusing on delayed initiation of ANC in low- and middle-income countries (LMICs). The search used multiple databases and included observational research and Demographic …

Heparin-Binding Protein Stratifies Mortality Risk Among Ugandan Children Hospitalized With Respiratory Distress, Hridesh Mishra, Núria Balanza, Caroline Francis, Kathleen Zhong, Julie Wright, Andrea Conroy, Robert Opoka, Quique Bassat, Sophie Namasopo, Kevin Kain

Paediatrics and Child Health, East Africa

Background Current prognostic tools do not reliably and objectively identify children with pneumonia at risk of a severe or life-threatening episode. Heparin-binding protein (HBP) is a host immune protein that is released in response to infection. We hypothesized that measuring HBP concentrations at hospital admission could help risk-stratify children with pneumonia and identify those at higher risk of an adverse prognosis.

Methods We evaluated the prognostic accuracy of HBP for predicting in-hospital mortality among children with respiratory distress, and whether HBP could improve the accuracy of validated composite clinical severity scores.

Results Of 778 Ugandan children under 5 years of …

The Ugandan Sickle Pan-African Research Consortium Registry: Design, Development, And Lessons, Mike Nsubuga, Henry Mutegeki, Daudi Jjingo, Deogratias Munube, Ruth Namazzi, Robert Opoka, Philip Kasirye, Grace Ndeezi, Heather Hume, Ezekiel Mupere

Paediatrics and Child Health, East Africa

Background Sub-Saharan Africa bears the highest burden of sickle cell disease (SCD) globally with Nigeria, Democratic Republic of Congo, Tanzania, Uganda being the most affected countries. Uganda reports approximately 20,000 SCD births annually, constituting 6.67% of reported global SCD births. Despite this, there is a paucity of comprehensive data on SCD from the African continent. SCD registries offer a promising avenue for conducting prospective studies, elucidating disease severity patterns, and evaluating the intricate interplay of social, environmental, and genetic factors. This paper describes the establishment of the Sickle Pan Africa Research Consortium (SPARCo) Uganda registry, encompassing its design, development, data …

Knowledge, Attitudes, And Practices On Child And Adolescent Mental Health Among Healthcare Workers In Sub-Saharan Africa: A Scoping Review, Beatrice Mkubwa, Vibian Angweny, Brenda Nzioka, Charles Newton, Marit Sijbrandij, Amina Abubakar

Institute for Human Development, East Africa

Introduction Child and adolescent mental health is a global priority. In sub-Saharan Africa, despite the high burden, there is a gap in health services for children and adolescents with mental health disorders. To bridge this gap, health-care workers require a good understanding of child and adolescent mental health, the right attitude, and practices geared to improving child and adolescent mental health. This scoping review examined the knowledge, attitudes, and practices related to child and adolescent mental health among sub-Saharan African healthcare workers.

Methods The search was restricted between January 2010, the year when the Mental Health Gap Action Programme guidelines …

Role Of Hospital Leadership In Pandemic Preparedness: Experience At A Tertiary Hospital In Kenya During The Covid-19 Pandemic, Lucy Wangari, William Macharia, Benjamin Wachira, Jemimah Kimeu, Boniface Mativa, Lukoye Atwoli

Emergency Medicine, East Africa

Introduction Pandemic preparedness refers to being ready for, responding to and recovering from public health crises, and is integral for health security. Hospital leadership is a critical building block of an effective healthcare system, providing policy, accountability and stewardship in a health crisis.

Objectives and methods We aimed to describe the leadership and governance structures put in place at the Aga Khan University Hospital, Nairobi, a private not-for-profit tertiary healthcare facility, following the COVID-19 pandemic. We reviewed over 200 hospital documents archived in the COVID-19 repository including those received from the Kenya Ministry of Health, emails, memos, bulletins, meeting minutes, …

Future Directions For Emergency Medical Services Development In Low- And Middle-Income Countries, Peter Delaney, Jon Moussally, Benjamin Wachira

Emergency Medicine, East Africa

The lack of prehospital care access in low- and middle-income countries is one of the greatest unmet needs and, therefore, one of the most urgent priorities in global health. Establishing emergency medical services in low- and middle-income countries poses significant challenges and complexities, requiring solutions tailored to prevailing conditions, informed by needs assessments, and adapted to meet local demands in a culturally appropriate and sustainable manner. In areas without existing emergency medical services, patients must rely on informal networks of untrained bystanders and community members to provide first aid and transport to definitive care. Since 2005, training lay first responders …

Psychosocial And Mental Health Challenges Facing Perinatally Hiv-Infected Adolescents Along The Kenyan Coast: A Qualitative Inquiry Using The Socioecological Model, Stanley W. Wanjala, Moses Nyongesa, Stanley Luchters, Amina Abubakar

Institute for Human Development, East Africa

Background: The advent of antiretroviral therapy has led perinatally HIV-infected (PHI) adolescents to live long, fulfilling lives through lifelong treatment. However, there is limited knowledge about the lived experiences and psychosocial and mental health challenges faced by PHI adolescents in sub-Saharan Africa, where 80% of PHI adolescents reside. To address this gap, we adapted the socioecological model to investigate the challenges and lived experiences of PHI adolescents in rural coastal Kenya.

Methods: Between October and November 2018, a sample of 40 participants (20 PHI adolescents and their 20 primary caregivers) participated in a qualitative study using an H-assessment data collection …

A Landscape Evaluation Of Caffeine Citrate Availability And Use In Newborn Care Across Five Low- And Middle-Income Countries, Osayame Ekhaguere, Olufunke Bolaji, Helen Nabwera, Andrew Storey, Nicholas Embleton, Stephen Allen, Zelalem Demeke, Olufunke Fasawe, Betty Wariari, Mansharan Seth

Centre of Excellence in Women and Child Health

Apnoea of prematurity (AOP) is a common complication among preterm infants (< 37 weeks gestation), globally. However, access to caffeine citrate (CC) that is a proven safe and effective treatment in high-income countries is largely unavailable in low- and-middle income countries, where most preterm infants are born. Therefore, the overall aim of this study was to describe the demand, policies, and supply factors affecting the availability and clinical use of CC in LMICs. A mixed methods approach was used to collect data from diverse settings in LMICs including Ethiopia, Kenya, Nigeria, South Africa, and India. Qualitative semi-structured interviews and focus group discussions were conducted with 107 different health care providers, and 21 policymakers and other stakeholders from industry. Additional data was collected using standard questionnaires. A thematic framework approach was used to analyze the qualitative data and descriptive statistics were used to summarize the quantitative data. The findings indicate that there is variation in in-country policies on the use of CC in the prevention and treatment of AOP and its availability across the LMICs. As a result, the knowledge and experience of using CC also varied with clinicians in Ethiopia having no experience of using it while those in India have greater knowledge and experience of using it. This, in turn, influenced the demand, and our findings show that only 29% of eligible preterm infants are receiving CC in these countries. There is an urgent need to address the multilevel barriers to accessing CC for managing AOP in Africa. These include cost, lack of national policies, and, therefore, lack of demand stemming from its clinical equivalency with aminophylline. Practical ways to reduce the cost of CC in LMICs could potentially increase its availability and use.

Development Of The Paediatric Society Of The African League Against Rheumatism (Paflar) Jia Registry And Clinical Profile Of Jia In Africa From The Paflar Jia Registry, Angela Migowa, Wafa Hamdi, Soad Hashad, Hala Etayari, Awatif Abushhaiwia, Hanene Ferjani, Dorra Nessib, Lobna Kharrat, Rachel Odhiambo, James Orwa

Paediatrics and Child Health, East Africa

No abstract provided.

Menstrual Hygiene Amongst School Girls: Still A Messy Business, Naghma Rizvi, Saleema A. Gulzar, Tazeen S. Ali, Syeda Aleena Fazal, Alishah Aziz Gulzar, Yasmin Parpio, Rimsha Hirani

Journal of Asian Midwives (JAM)

Background: Menstruation has become a taboo topic among adolescent females, affecting their reproductive health, particularly in more traditional South Asian nations such as Pakistan. The study highlights the societal silence surrounds menstruation, which leads to detrimental practices and attitudes among school-age females. The study reveals the sociocultural, psychological, and educational challenges that teenagers encounter. The presence of myths and misconceptions adds to unsanitary habits, which undermine education and reproductive health.
Methodology: A descriptive cross-sectional study was conducted in urban Karachi. The participants were 850 unmarried school-going female adolescents aged 13 to 19. The data were collected using a pre-coded questionnaire. …

Use Of Social Media For Receiving Professional Support In Enhancing Mothers’ Lactation Self-Efficacy, Mehtab Lalwani, Zohra Kurji, Salma Rattani, Zahra Shaheen, Hussain Maqbool Ahmed Khuwaja, Shabina Ariff

Journal of Asian Midwives (JAM)

Background: Insufficient support for breastfeeding and limited exclusive breastfeeding rates emphasize the need for high-impact approaches to enhance maternal confidence in lactation. Social media has emerged as a promising platform for professional support and information dissemination in this context. This review aims to examine the role of social media in providing professional lactation support to mothers in enhancing their lactation self-efficacy.
Method: Employing PRISMA guidelines, the review sought relevant literature on professional assistance in enhancing breastfeeding self-efficacy. Major databases, including PubMed, CINAHL, Google Scholar, and Science Direct, were meticulously queried using targeted keywords. Every selected article underwent screening for English …

Strengthening Lady Health Visitors And Midwives For Sindh, Pakistan For Non-Communicable Diseases (Ncds) Prevention And Management With Refresh Essential Skills, Zulekha Saleem Tharwani, Khairunnissa Mansoor, Zahra Tharani, Ambreen Merchant, Zohra Asif Jetha

Journal of Asian Midwives (JAM)

They were addressing the rising burden of non-communicable diseases (NCDs), particularly in Low-Middle Income Countries (LMICs) like Pakistan. A proactive initiative undertaken by a Primary Health Service (PHS) in collaboration with a Private School of Nursing and Midwifery in Karachi conducted a 14-week project. 28 LHVs and Midwives (MWs) working in the community of PHS in various parts of Sindh, Pakistan were equipped with some common NCD prevention and management through online sessions and in-person refresher essential skills. The project aimed to equip them with the knowledge of early identification and management of some common NCDs and freshen some skills …

Post-Partum Hemorrhage (Pph) Management In Emergency, Learning Experience, Gul Raihan

Journal of Asian Midwives (JAM)

No abstract provided.

Complicated Home Delivery: A Real Story, Nusrat Jahan

Journal of Asian Midwives (JAM)

No abstract provided.

Enhancing Maternal And Fetal Well-Being: Exploring The Determinants Of Preconception Care, Mahak Mehdi Hashim Mehdi Hashim, Nurmeen Anwar Ali

Journal of Asian Midwives (JAM)

Preconception care is the delivery of biomedical, behavioral, and social health interventions to women and couples of reproductive ages. The significance of care is emphasized by the World Health Organization (WHO), as it greatly affects the quality of life of the mother and child. However, the uptake of pre-conception care services in Low and Middle-income countries (LMIC) such as Pakistan is low due to several factors. This discussion paper will identify some of the contextual factors related to the quality of health care services, acceptability due to cultural value beliefs, and affordability that largely influence the utilization of preconception care …

Burnout Among Medical Residents, Coping Mechanisms And The Perceived Impact On Patient Care In A Low/ Middle Income Country, Charles Muteshi, Elizabeth Ochola, Dorothy Kamya

Obstetrics and Gynaecology, East Africa

Background: Burnout is a syndrome that result from chronic workplace stress and it characterized by emotional exhaustion, depersonalization and low personal accomplishments. Studies report higher burnout levels in medical personnel compared to the general population. Workplace burnout has been directly linked to medical errors and negative coping strategies such as substance abuse. The aims of this study were to assess the level of burnout in medical residents, evaluate their impressions about coping mechanisms and assess perceived impact on patient care in a low/ middle income country setting.

Methods: This was a cross sectional, mixed methods survey carried out at Aga …

Editorial – July 2024, Edwin Van Teijlingen, Abeer Musaddique, Rafat Jan

Journal of Asian Midwives (JAM)

No abstract provided.

Baseline Assessment Of Cervical Cancer Screening And Treatment Capacity In 25 Counties In Kenya, 2022, Valerian Mwenda, David Murage, Catherine Kilonzo, Joan-Paula Bor, Patricia Njiri, Lance Osiro, Mary Nyangasi, Marc Arbyn, Philippe Tummers, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background: Cervical cancer is the leading cause of cancer deaths among women in Kenya. In the context of the Global strategy to accelerate the elimination of cervical cancer as a public health problem, Kenya is currently implementing screening and treatment scale-up. For effectively tracking the scale-up, a baseline assessment of cervical cancer screening and treatment service availability and readiness was conducted in 25 priority counties. We describe the findings of this assessment in the context of elimination efforts in Kenya.

Methods: The survey was conducted from February 2021 to January 2022. All public hospitals in the target counties …

In Their Voices: Kenyan Women's Experiences With Cancer Treatment–Related Side Effects, Tayreez Mushani, Dinah Kassaman, Sharon Brownie, Peterson Kiraithe, Margaret Barton-Burke

School of Nursing & Midwifery, East Africa

Objective This article reports on a secondary analysis of a qualitative study conducted in Nairobi, Kenya that reported several initial themes. In this article, the authors explore the theme of treatment-related side effect management by women receiving treatment for breast or cervical cancer.

Methods Women were interviewed at three points during their active treatment trajectory. Participants were purposefully selected and saturation was reached when interviews did not yield any new themes. The interviews were transcribed and analyzed for internal consistency, frequency, extensiveness, intensity and specificity. The Nvivo pro 12 software was used in organizing and managing the data to facilitate …

Interdisciplinary Perspectives On Multimorbidity In Africa: Developing An Expanded Conceptual Model, Justin Dixon, Ben Morton, Misheck Nkhata, Alan Silman, Ibrahim Simiyu, Stephen Spencer, Myrna Van Pinxteren, Edna Bosire, Christopher Bunn, Claire Calderwood

Brain and Mind Institute

Multimorbidity is an emerging challenge for health systems globally. It is commonly defined as the co-occurrence of two or more chronic conditions in one person, but its meaning remains a lively area of academic debate, and the utility of the concept beyond high-income settings is uncertain. This article presents the findings from an interdisciplinary research initiative that drew together 60 academic and applied partners working in 10 African countries to answer the questions: how useful is the concept of multimorbidity within Africa? Can the concept be adapted to context to optimise its transformative potentials? During a three-day concept-building workshop, we …

A Global Perspective On The Treatment And Maintenance Of Mature Skin Using Gentle Cleansers And Moisturizers, Joachim Fluhr, Andrew Alexis, Anneke Andriessen, Olga Barrios, Peter Bjerring, Peter Foley, Michael Gold, Hashim Kaderbhai, Chengfeng Zhang

Internal Medicine, East Africa

Xerosis is highly prevalent in the population aged over 50 years and substantially impacts quality of life due to the associated stigma, related pruritus, and potential sequelae. We propose that the term mature xerosis be used for subjects over 50 who suffer from age-related xerosis and replace senile xerosis to describe the phenomenon. The etiology of xerosis depends on genetic and environmental factors that affect stratum corneum hydration and skin barrier function. Skincare to restore barrier function is essential in xerosis treatment and is relevant for maintaining and preventing its progression. Many moisturizers and cleansers are available for xerosis; however, …

Community Health Volunteers’ Experiences Of Implementing Covid-19 Vaccine Education And Promotion In Kenya: A Qualitative Descriptive Study, Constance Shumba, Peterson Kiraithe, Isabel Kambo, Sheila Shaibu

School of Nursing & Midwifery, East Africa

Background: Vaccination was a key measure in the COVID-19 pandemic response, though much work was needed to promote vaccine uptake and acceptance. In Kenya, Community Health Volunteers (CHVs) played a key role in vaccine education and promotion. We conducted this study to explore CHVs’ experiences of implementing COVID-19 vaccine education and promotion during the pandemic to increase COVID-19 vaccine uptake in two areas of Kenya.

Methods: In a qualitative descriptive study, we conducted 30 structured in-depth interviews with 20 CHVs and 10 Community Health Assistants from rural Kilifi County and Kangemi, an urban informal settlement of Nairobi County in Kenya …

Is Mechanism Of Injury Associated With Outcome In Spinal Trauma? An Observational Cohort Study From Tanzania, Chibuikem Ikwuegbuenyi, Julie Woodfield, François Waterkeyn, Scott Zuckerman, Beverly Cheserem, Andreas Leidinger, Albert Lazaro, Hamisi Shabani, Roger Härtl, Halinder Mangat

General Surgery, East Africa

Background Traumatic spinal injury (TSI) is a disease of significant global health burden, particularly in low and middle-income countries where road traffic-related trauma is increasing. This study compared the demographics, injury patterns, and outcomes of TSI caused by road traffic accidents (RTAs) to non-traffic related TSI.

Methods A retrospective analysis was conducted using a neurotrauma registry from the Muhimbili Orthopaedic Institute (MOI) in Tanzania, a national referral center for spinal injuries. Patient sociodemographic characteristics, injury level, and severity were compared across mechanisms of injury. Neurological improvement, neurological deterioration, and mortality were compared between those sustaining TSI through an RTA versus …

Clinical Presentation And Outcomes Of Care In Adults With Diabetic Ketoacidosis Pre-Covid-19 And During-Covid-19 At A Tertiary, Referral Hospital In Nairobi, Kenya, Sairabanu Sokwalla, Jasmit Shah, Sangeeta Chauhan, Reena Shah, Salim Surani, Eric Njenga, Nancy Kunyiha

Internal Medicine, East Africa

Background: Prognosis of DKA has improved over time with the availability of evidence-based protocols and resources. However, in Kenya, there are limited resources for the appropriate diagnosis and management of DKA, mostly limited to tertiary-level referral facilities. This study aimed to review the clinical presentation, management, and outcomes of adult patients admitted with DKA and assess differences in these parameters before and during the COVID-19 pandemic.

Methods: This was a retrospective study of DKA admissions from January 2017 to December 2021. Patient data were retrieved from the medical records department using ICD-10 codes, and individual details were abstracted on clinical …

Open-Label, Dose-Escalation Fight-101 Study Of Pemigatinib Combined With Targeted Therapy, Chemotherapy, Or Immunotherapy In Patients With Advanced Malignancies, Mansoor Saleh, Minal Barve, Vivek Subbiah, Kyriakos Papadopoulos, Daniel Morgensztern, Niharika Mettu, Sameek Roychowdhury, Iben Spanggaard, Maria Luisa Veronese, Chenwei Tian

Haematology and Oncology, East Africa

Background Pemigatinib is an oral, potent, selective fibroblast growth factor receptor (FGFR) 1-3 inhibitor. FIGHT-101, a three-part, open-label, first-in-human, phase I/II study (NCT02393248), evaluated pemigatinib in patients with advanced solid tumors. In parts 1 and 2, pemigatinib monotherapy had a manageable safety profile and antitumor activity in FGFR-altered tumors. Part 3 (pemigatinib combination therapies) results are presented here.

Patients and methods Patients received 9, 13.5, or 20 mg oral once-daily pemigatinib on continuous or intermittent schedules with gemcitabine and cisplatin (pemi/gem/cis), docetaxel (pemi/doc), trastuzumab (pemi/tras), pembrolizumab (pemi/pembro), or retifanlimab (pemi/reti) irrespective of whether the tumor was confirmed as FGFR altered. …

Predictors Of Hiv Knowledge, Perceived Stigma And Risk Among Transport Workers In Mbarara City, Southwestern Uganda, Benjamin Betunga, Lilian Nuwabaine, Eve Katushabe, Grace Among, Grace Nakate, Ahmed Sarki, Diana Mbattude, Mary Namuguzi, John Baptist Asiimwe

School of Nursing & Midwifery, East Africa

Background: The human immunodeficiency virus (HIV) prevalence among transport workers in sub-Saharan Africa remains high, estimated at as high as 9.9% in western Uganda compared with the national prevalence of 5.4%. The prevalence of HIV among transport workers has been partly attributed to the level of knowledge regarding HIV prevention, perceived HIV risk, and stigma. Accordingly, these have been linked to high-risk HIV transmission behaviours that increase the chances of acquiring HIV among adults. Therefore, this study investigated the predictors of HIV knowledge, perceived HIV risk, and stigma among transport workers in Mbarara city in southwestern Uganda.

Methods: The …

Inspire : Vol 7 Issue 6, Department Of Medicine

INSPIRE – Department of Medicine Archives

• Message from the Chair
• Medicine at National and International Forums Digestive disease week (DDW) 2024
• ACGME-I Self-Empowerment Workshop for Program Coordinators
• The 2nd International Collaborative Mycology Conference
• World hypertension day
• Research Module
• SIMPACT 2024
• Combatting Corticosteroid Misuse: Safeguarding Skin Health in Pakistan
• 2024 Inter Departmental Cricket Tournament
• Featured Fellow: Dr. Shahid Khan
• Poem Section
• What Academics Are Reading

Who Should Pay The Bill For The Mental Health Crisis In Africa?, Cyprian Mostert, Olivera Nesic Taylor,, Chinedu Momoh, Murad M. Khan Dr., Thomas Thesen, Edna Bosire, Dominic Trepel, Karen Blackmon, Manasi Kumar, Zul Merali

Brain and Mind Institute

No abstract provided.