American Journal of Public Health Research

Delivery assisted by skilled birth attendant is recommended as a means to reduce maternal mortality. However untrained traditional birth attendant (UTBA) assisted home is very high in developing countries. The objective of this study is to assess socio-demographic determinants of UTBA assisted home delivery in rural Bangladesh. Data used in this study was obtained from women questionnaire of the 2011 Bangladesh Demographic and Health Survey (BDHS). Mothers residing in rural Bangladesh, who gave valid information on both delivery place and assistance during delivery, were included in this study (n = 4983). Binary logistic regression model was used to explore factors influencing home delivery assisted by untrained traditional birth attendant. Most of the mothers (79%) reported to have delivered at home and of these home deliveries, 76% were assisted by untrained traditional birth attendant. In multivariate regression model, it is found that the odds of UTBA assisted home delivery decreased with mother’s education, husband’s education, higher wealth index, number of Antenatal Care (ANC) visits and media exposure. To reduce maternal mortality in rural areas of Bangladesh, program managers and policy makers should consider these factors in designing programs and implementing interventions.

American Journal of Public Health Research. 2013, 1(8), 226-230. DOI: 10.12691/ajphr-1-8-6
Pub. Date: December 15, 2013

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Knowledge and Awareness of Papillomavirus and Cervical Cancer among College Students and Health Care Workers Women in Diyala, Iraq

by Asmaa Haseeb Hwaid

Original Research

Background: Human papillomavirus (HPV) is one of the most common causes of sexually transmitted infection and it's now known to be a risk factors for the development of cervical cancer. Cervical cancer is the second most common cancer in women and it's one of the leading causes of morbidity and mortality amongst the gynecological cancers worldwide, especially in developing countries. Objectives: This study sough to evaluate knowledge and awareness about Human Papillomavirus (HPV) and cervical cancer among women. Subjects and methods: The present study are cross sectional study was conducted in Diyala, Iraq during the period from 1/ November / 2012 to 30 / September / 2013, this study included 198 women, the mean age was (27.29±9.63) years, the age range was (17-60) years, the participants were divided into two groups, group I, (students group) includes (99) female college students who studies in Diyala university, group II, (health care workers group), includes (99) female physicians and nurses who worked in AL-Batol Maternity and Children Teaching Hospital. Data was collected using questionnaire that was adopted from previous studies. All data were statistically analysis. Results: The present results show that the women demonstrated poor levels of knowledge about HPV and cervical cancer, 106(53.54%) of them had heard about HPV, while, only 73(36.87%), 60(30.30%) knew that the cervical cancer and genital warts caused by HPV respectively. This study showed that the participants had very limited knowledge about pap smear, only 57(28.79%) knew that pap smear is the test to detect abnormal cervical cells, the results show highest level of knowledge and awareness about HPV, cervical cancer was among health care workers group, participants who live in urban and married with statistically significant difference (P<0.05), (P<0.01). Conclusion: This study highlights the need for educational programs regarding HPV infection and it's complications such as cervical cancer. In conclusion, the present study shows inadequate levels of knowledge and awareness about HPV and it's relation to cervical cancer, genital warts as well as transmission of infection and Pap smear test among study groups especially the university students.

American Journal of Public Health Research. 2013, 1(8), 221-225. DOI: 10.12691/ajphr-1-8-5
Pub. Date: December 11, 2013

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Identification and Prioritization of Grain Discharging Operations Risks by Using ORESTE Method

by Hassan Jafari

Original Research

Exposing the acts of unloader, sucker and Grab in the grain terminal of Imam Khomeini Port by manipulating ORESTE and Shannon's Entropy Methods in the three phases will lead to identification and prioritization of the grain discharging processes risks from the ship. In the first phase, by the analysis of the events and occurred incidents information bank about the surveyed matters and also setting brainstorming sessions with the terminal’s experts, 22 risks were identified. In the second phase by using from the Shannon’s Entropy, the criteria (occurrence frequency, severity and detection) were weighted. Then based on the criteria of determination of causes occurrence probability (occurrence frequency), the extent of its impact on process after occurrence (severity) and probability of its identification prior to having impact on the process (detection), the identified risks were scored in form of a scale from 1 to 10. Finally according to the obtained scores of each risk, the ORSTE decision matrix was conducted and subsequently in the third phase by using this method, all of the identified risks were prioritized. Based to the achieved results, the slippery one (falling from the stairs) and the risk of the operator’s chair shaking and the risk of the grain discharging dust and vacuuming the filters were attained the top priority respectively.

American Journal of Public Health Research. 2013, 1(8), 214-220. DOI: 10.12691/ajphr-1-8-4
Pub. Date: December 04, 2013

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Self Assessment of Motahari Hospital, Jahrom, Iran Based on European Foundation for Quality Management (EFQM) Model

by Nahid Hatam, Vahid Kohpeyma, Zahra Kavosi and Erfan Kharazmi

Original Research

Introduction: Assessment helps the organizations’ managers to identify the strong as well as the weak points and, at the same time, develop programs for the organizations’ improvement. Therefore, the present study aimed to evaluate the performance of Motahari hospital, Jahrom, Iran based on the EFQM model. Methods: In this interventional study, 58 managers of Motahari hospital took part in two self-assessment in order to evaluate the performance of the hospital through the workshop approach in 2010-2011. The strength points as well as the areas for improvement obtained from the primary self-assessment were analyzed and action plans were developed. After conducting the action plans in the hospital, the performance of the hospital was assessed again and the results were gathered based on the EFQM model and RADAR logic. Results: The hospital’s total score was obtained as 71 and 145 in the primary and the final self-assessment, respectively. Overall, the findings of the study revealed the improvement of quality in all the 9 criteria of the EFQM model, particularly the society results (24%), partnerships and resources (12%), and strategy (12%). Discussion: According to the results of the present study, action plans must focus on the areas which are most beneficial for the hospital.

American Journal of Public Health Research. 2013, 1(8), 209-213. DOI: 10.12691/ajphr-1-8-3
Pub. Date: November 22, 2013

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Obesity in West Virginia: Control and Costs

by Janaranjana Herath and Cheryl Brown

Original Research

West Virginia reports a high obesity rate, and the prevalence of obesity is 8 percent higher than the national rate. Obesity is linked with several health diseases, certain psychological disorders, quality of life, premature deaths as well as healthcare costs. Prevention of obesity is a must and changing behavioral factors is one way of controlling obesity. This research study attempts to examine the potential use of physical exercise and fewer calorie intakes in controlling obesity, and to estimate costs of obesity in West Virginia using Behavioral risk Factor Surveillance System data of 2001 and 2009. Three logit equations were used in the analysis. Results reveal that potential of using physical exercise in controlling obesity in West Virginia has increased from 2001 to 2009, though the desire of engaging in physical exercise of obese people has decreased. However, the willingness of taking fewer calories of obese individuals has increased significantly from 2001 to 2009. The cost estimations indicate that direct medical cost of obesity and total costs associated with obesity have increased by $51 million and $704 million respectively from 2001 to 2009.

American Journal of Public Health Research. 2013, 1(8), 203-208. DOI: 10.12691/ajphr-1-8-2
Pub. Date: November 13, 2013

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The Impacts of User Fees on Health Services in Sub-Saharan African Countries: A Ctirical Analysis of the Evidence

by Ejughemre Ufuoma John

Review Article

The momentum towards achieving the United Nations Millennium Development Goals re-invigorated concerns around sustainable health care financing and the adequacy of the financing arrangements in many low-resource settings. Accordingly, this necessitated the institution of user-fees as part of health financing reform in many countries in sub-Saharan Africa. These fees are charges levied at the point of service with the intent of reducing ‘frivolous’ consumption of health services, increasing the quality of services available and at the same time increasing coverage and utilisation of services. Likewise, as a ‘decisive’ policy to cushion the existing challenges facing health care financing in the region, a critical assessment of the assertions of proponents of user fees who use the principle of cost recovery and revenue mobilization to drive the concept of rational utilization, efficiency and equitable distribution of health care services is often exaggerated. As it were, the available evidence suggests that user fees alone will not likely accomplish equity, efficiency, or the sustainability objectives in health services in the region. What is critical is that user fees should be linked to the broader package of financing -such as insurance coverage- and with a view to averting any form of equity danger that may thus arise.

American Journal of Public Health Research. 2013, 1(8), 196-202. DOI: 10.12691/ajphr-1-8-1
Pub. Date: September 23, 2013

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