Introduction:Early childhood development(ECD)centres are important community hubs in South Africa and act as sites for community detection of childhood nutrition problems.This study aimed to assess the ability of trai...Introduction:Early childhood development(ECD)centres are important community hubs in South Africa and act as sites for community detection of childhood nutrition problems.This study aimed to assess the ability of trained ECD practitioners with optimal support to correctly classify the nutritional status of infants and young children at ECD centres in the Nelson Mandela Bay.Methods:A descriptive,cross-sectional study was used to collect data from 1645 infants and children at 88 ECD centres.Anthropometric measurements were taken by trained fieldworkers and growth monitoring and promotion infrastructure was audited at ECD centres.Results:Of the sample,4.4%(n=72)were underweight by weight for age Z-score(WAZ<-2)and 0.8%(n=13)were severely underweight(WAZ<-3).Results showed that 13.1%(n=214)were stunted by height for age Z-score(HAZ<-2)and 4.5%(n=74)were severely stunted(HAZ<-3).The prevalence of moderate acute malnutrition was 1.2%and severe acute malnutrition was 0.5%,while the prevalence of overweight was 9.2%and the prevalence of obesity was 4%.A significant level of agreement between the correct interpretation and the ECD practitioners'interpretation was observed across all the anthropometric indicators investigated.The true positive wasting cases had a mean mid-upper arm circumference(MUAC)of 14.6 cm,which may explain the high false negative rate found in terms of children identified with wasting,where ECD practitioners fail to use the weight for height Z-score(WHZ)interpretation for screening.Conclusion:By using ECD centres as hub to screen for malnutrition,it may contribute to the early identification of failure to thrive among young children.Although it was concerning that trained ECD practitioners are missing some children with an unacceptably high false negative rate,it may have been due to the fact that wasting in older children cannot be identified with MUAC alone and that accurate WFH plotting is needed.Onsite mentorship by governmental health workers may provide ECD practitioners with more confidence to screen children for growth failure based on regular WFH measurements.Moreover,ECD practitioners will be more confident to monitor the Road to Health booklets for missed vaccinations,vitamin A and deworming opportunities.展开更多
研究具有先驱膜的流体团扩散的模型．流体团和先驱膜作为一个整体用与组分序参数耦合的Navier- Stokes方程,CHW(Cahn,Hilliard,van der Waales)方程和GNBC(广义Navier边界条件)进行数值模拟和分析．流体团在VW(van der Waals)分子长程...研究具有先驱膜的流体团扩散的模型．流体团和先驱膜作为一个整体用与组分序参数耦合的Navier- Stokes方程,CHW(Cahn,Hilliard,van der Waales)方程和GNBC(广义Navier边界条件)进行数值模拟和分析．流体团在VW(van der Waals)分子长程力和表面张力以及黏性力的共同作用下开始扩散,纳米尺度厚的先驱膜在VW力达到一定值时缓慢生成,它的长时间演变的剖面形状表现为与理论结果一致的1/x次律．膜的前沿——接触线随时间演变具有幂次律,这种对时间的依赖关系也在实验结果(Leger,1984)中得出．分界面的相对拉伸对时间也具有幂次相似律,但幂次指数比前者要稍微大一点．展开更多
<strong>Introduction:</strong> DRC is one of Sub-Saharan Africa country with high infant and maternal mortality. The major problem is the underuse of health services because of inaccessibility on all front...<strong>Introduction:</strong> DRC is one of Sub-Saharan Africa country with high infant and maternal mortality. The major problem is the underuse of health services because of inaccessibility on all fronts and also the population under-information to the health and development problems. Community participation is one of the basic requirements and basic principles of the Primary Health Care to solve this problem. That is why we choose Mosango RHZ to assess the improvement of demand for health services with the involvement of community health workers. <strong>Methods:</strong> We conduct a cross-sectional study carried out in Mosango RHZ in 2019. The study combined a mixed method (quantitative and qualitative) based on the realist evaluation approach which takes into account the Context-Mechanisms-Effects explained in the conceptual framework model. <strong>Results:</strong> Four predictive factors determine the improvement of health indicators with the involvement of CHWS in activities of the Mosango RHZ: Having attended school (p = 0.000;OR = 0.150);Having sufficient theoretical knowledge on malaria, diarrhoea, pneumonia, malnutrition, availability of inputs to treat these diseases (p = 0.004;OR = 0.192);Having taken the training as CHWS and Having undergone more than one training as CHW (p = 0.013;OR = 0.074). This result corroborated with other studies carried in low- and middle-income countries like DRC. <strong>Conclusion:</strong> The involvement of CHWs on improving demand for health services is effective in Mosango RHZ. The improvement of health service indicators and the effectiveness of this community intervention were conditioned by capacity building of the CHWs, the availability of inputs and the involvement of the community in the activities of the health zone through the Community Action Cells.展开更多
Community health workers are equipped with the tools and resources necessary to bring about a change in the form of a rapid chain reaction.The community health workers model focuses on the practices,strategies,plans,a...Community health workers are equipped with the tools and resources necessary to bring about a change in the form of a rapid chain reaction.The community health workers model focuses on the practices,strategies,plans,and implementation techniques needed to organize a community health event based on diverse agendas:health,environment,and minorities.This model encompasses past experiences as a guide with tested strategies to assist future health interns with a ground framework and resources to showcase the importance of adopting healthy and environmentally friendly practices.The basic outline of the model is based on data collected from various community health events in Illinois(United States of America)and New Delhi(India).These events included back to school fairs,cleanliness drives,health camps,and educational events.As community health workers can help in implementing better practices in the masses through one-on-one interactions,this model of community health worker programs would outline event organization tips,predicted outcomes,targeted audience,and required material templates.The next phase of this model highlights utilizing the data and experience from these events to report to the health ministries of different countries for the incorporation of the proposed practices in their health agendas and policies.This model,if implemented unanimously,could bring about a revolution in the arena of health workers.They will be assisted at each step,will establish connections with health workers globally,and share their health and environment-based agendas to collaborate and organize important events.This model envisions a strong established network of community health workers,display of their agenda,and creation of a ripple effect throughout the society by the means of these programs.展开更多
This paper describes the conceptual framework and the methodology used to guide the systematic reviews of community-based interventions(CBIs)for the prevention and control of infectious diseases of poverty(IDoP).We ad...This paper describes the conceptual framework and the methodology used to guide the systematic reviews of community-based interventions(CBIs)for the prevention and control of infectious diseases of poverty(IDoP).We adapted the conceptual framework from the 3ie work on the‘Community-Based Intervention Packages for Preventing Maternal Morbidity and Mortality and Improving Neonatal Outcomes’to aid in the analyzing of the existing CBIs for IDoP.The conceptual framework revolves around objectives,inputs,processes,outputs,outcomes,and impacts showing the theoretical linkages between the delivery of the interventions targeting these diseases through various community delivery platforms and the consequent health impacts.We also describe the methodology undertaken to conduct the systematic reviews and the meta-analyses.展开更多
In 2012,an estimated 8.6 million people developed tuberculosis(TB)and 1.3 million died from the disease.With its recent resurgence with the human immunodeficiency virus(HIV);TB prevention and management has become fur...In 2012,an estimated 8.6 million people developed tuberculosis(TB)and 1.3 million died from the disease.With its recent resurgence with the human immunodeficiency virus(HIV);TB prevention and management has become further challenging.We systematically evaluated the effectiveness of community based interventions(CBI)for the prevention and treatment of TB and a total of 41 studies were identified for inclusion.Findings suggest that CBI for TB prevention and case detection showed significant increase in TB detection rates(RR:3.1,95%CI:2.92,3.28)with non-significant impact on TB incidence.CBI for treating patients with active TB showed an overall improvement in treatment success rates(RR:1.09,95%CI:1.07,1.11)and evidence from a single study suggests significant reduction in relapse rate(RR:0.26,95%CI:0.18,0.39).The results were consistent for various study design and delivery mechanism.Qualitative synthesis suggests that community based TB treatment delivery through community health workers(CHW)not only improved access and service utilization but also contributed to capacity building and improving the routine TB recording and reporting systems.CBI coupled with the DOTS strategy seem to be an effective approach,however there is a need to evaluate various community-based integrated delivery models for relative effectiveness.展开更多
基金Nelson Mandela University,London Metropolitan University and UNICEF。
文摘Introduction:Early childhood development(ECD)centres are important community hubs in South Africa and act as sites for community detection of childhood nutrition problems.This study aimed to assess the ability of trained ECD practitioners with optimal support to correctly classify the nutritional status of infants and young children at ECD centres in the Nelson Mandela Bay.Methods:A descriptive,cross-sectional study was used to collect data from 1645 infants and children at 88 ECD centres.Anthropometric measurements were taken by trained fieldworkers and growth monitoring and promotion infrastructure was audited at ECD centres.Results:Of the sample,4.4%(n=72)were underweight by weight for age Z-score(WAZ<-2)and 0.8%(n=13)were severely underweight(WAZ<-3).Results showed that 13.1%(n=214)were stunted by height for age Z-score(HAZ<-2)and 4.5%(n=74)were severely stunted(HAZ<-3).The prevalence of moderate acute malnutrition was 1.2%and severe acute malnutrition was 0.5%,while the prevalence of overweight was 9.2%and the prevalence of obesity was 4%.A significant level of agreement between the correct interpretation and the ECD practitioners'interpretation was observed across all the anthropometric indicators investigated.The true positive wasting cases had a mean mid-upper arm circumference(MUAC)of 14.6 cm,which may explain the high false negative rate found in terms of children identified with wasting,where ECD practitioners fail to use the weight for height Z-score(WHZ)interpretation for screening.Conclusion:By using ECD centres as hub to screen for malnutrition,it may contribute to the early identification of failure to thrive among young children.Although it was concerning that trained ECD practitioners are missing some children with an unacceptably high false negative rate,it may have been due to the fact that wasting in older children cannot be identified with MUAC alone and that accurate WFH plotting is needed.Onsite mentorship by governmental health workers may provide ECD practitioners with more confidence to screen children for growth failure based on regular WFH measurements.Moreover,ECD practitioners will be more confident to monitor the Road to Health booklets for missed vaccinations,vitamin A and deworming opportunities.
文摘研究具有先驱膜的流体团扩散的模型．流体团和先驱膜作为一个整体用与组分序参数耦合的Navier- Stokes方程,CHW(Cahn,Hilliard,van der Waales)方程和GNBC(广义Navier边界条件)进行数值模拟和分析．流体团在VW(van der Waals)分子长程力和表面张力以及黏性力的共同作用下开始扩散,纳米尺度厚的先驱膜在VW力达到一定值时缓慢生成,它的长时间演变的剖面形状表现为与理论结果一致的1/x次律．膜的前沿——接触线随时间演变具有幂次律,这种对时间的依赖关系也在实验结果(Leger,1984)中得出．分界面的相对拉伸对时间也具有幂次相似律,但幂次指数比前者要稍微大一点．
文摘<strong>Introduction:</strong> DRC is one of Sub-Saharan Africa country with high infant and maternal mortality. The major problem is the underuse of health services because of inaccessibility on all fronts and also the population under-information to the health and development problems. Community participation is one of the basic requirements and basic principles of the Primary Health Care to solve this problem. That is why we choose Mosango RHZ to assess the improvement of demand for health services with the involvement of community health workers. <strong>Methods:</strong> We conduct a cross-sectional study carried out in Mosango RHZ in 2019. The study combined a mixed method (quantitative and qualitative) based on the realist evaluation approach which takes into account the Context-Mechanisms-Effects explained in the conceptual framework model. <strong>Results:</strong> Four predictive factors determine the improvement of health indicators with the involvement of CHWS in activities of the Mosango RHZ: Having attended school (p = 0.000;OR = 0.150);Having sufficient theoretical knowledge on malaria, diarrhoea, pneumonia, malnutrition, availability of inputs to treat these diseases (p = 0.004;OR = 0.192);Having taken the training as CHWS and Having undergone more than one training as CHW (p = 0.013;OR = 0.074). This result corroborated with other studies carried in low- and middle-income countries like DRC. <strong>Conclusion:</strong> The involvement of CHWs on improving demand for health services is effective in Mosango RHZ. The improvement of health service indicators and the effectiveness of this community intervention were conditioned by capacity building of the CHWs, the availability of inputs and the involvement of the community in the activities of the health zone through the Community Action Cells.
文摘Community health workers are equipped with the tools and resources necessary to bring about a change in the form of a rapid chain reaction.The community health workers model focuses on the practices,strategies,plans,and implementation techniques needed to organize a community health event based on diverse agendas:health,environment,and minorities.This model encompasses past experiences as a guide with tested strategies to assist future health interns with a ground framework and resources to showcase the importance of adopting healthy and environmentally friendly practices.The basic outline of the model is based on data collected from various community health events in Illinois(United States of America)and New Delhi(India).These events included back to school fairs,cleanliness drives,health camps,and educational events.As community health workers can help in implementing better practices in the masses through one-on-one interactions,this model of community health worker programs would outline event organization tips,predicted outcomes,targeted audience,and required material templates.The next phase of this model highlights utilizing the data and experience from these events to report to the health ministries of different countries for the incorporation of the proposed practices in their health agendas and policies.This model,if implemented unanimously,could bring about a revolution in the arena of health workers.They will be assisted at each step,will establish connections with health workers globally,and share their health and environment-based agendas to collaborate and organize important events.This model envisions a strong established network of community health workers,display of their agenda,and creation of a ripple effect throughout the society by the means of these programs.
文摘This paper describes the conceptual framework and the methodology used to guide the systematic reviews of community-based interventions(CBIs)for the prevention and control of infectious diseases of poverty(IDoP).We adapted the conceptual framework from the 3ie work on the‘Community-Based Intervention Packages for Preventing Maternal Morbidity and Mortality and Improving Neonatal Outcomes’to aid in the analyzing of the existing CBIs for IDoP.The conceptual framework revolves around objectives,inputs,processes,outputs,outcomes,and impacts showing the theoretical linkages between the delivery of the interventions targeting these diseases through various community delivery platforms and the consequent health impacts.We also describe the methodology undertaken to conduct the systematic reviews and the meta-analyses.
文摘In 2012,an estimated 8.6 million people developed tuberculosis(TB)and 1.3 million died from the disease.With its recent resurgence with the human immunodeficiency virus(HIV);TB prevention and management has become further challenging.We systematically evaluated the effectiveness of community based interventions(CBI)for the prevention and treatment of TB and a total of 41 studies were identified for inclusion.Findings suggest that CBI for TB prevention and case detection showed significant increase in TB detection rates(RR:3.1,95%CI:2.92,3.28)with non-significant impact on TB incidence.CBI for treating patients with active TB showed an overall improvement in treatment success rates(RR:1.09,95%CI:1.07,1.11)and evidence from a single study suggests significant reduction in relapse rate(RR:0.26,95%CI:0.18,0.39).The results were consistent for various study design and delivery mechanism.Qualitative synthesis suggests that community based TB treatment delivery through community health workers(CHW)not only improved access and service utilization but also contributed to capacity building and improving the routine TB recording and reporting systems.CBI coupled with the DOTS strategy seem to be an effective approach,however there is a need to evaluate various community-based integrated delivery models for relative effectiveness.
