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Sample records for rural kenyan district

  1. Congenital and neonatal malaria in a rural Kenyan district hospital: An eight-year analysis

    PubMed Central

    2010-01-01

    Background Malaria remains a significant burden in sub-Saharan Africa. However, data on burden of congenital and neonatal malaria is scarce and contradictory, with some recent studies reporting a high burden. Using prospectively collected data on neonatal admissions to a rural district hospital in a region of stable malaria endemicity in Kenya, the prevalence of congenital and neonatal malaria was described. Methods From 1st January 2002 to 31st December 2009, admission and discharge information on all neonates admitted to Kilifi District Hospital was collected. At admission, blood was also drawn for routine investigations, which included a full blood count, blood culture and blood slide for malaria parasites. Results Of the 5,114 neonates admitted during the eight-year surveillance period, blood slide for malaria parasites was performed in 4,790 (93.7%). 18 (0.35%) neonates with Plasmodium falciparum malaria parasitaemia, of whom 11 were admitted within the first week of life and thus classified as congenital parasitaemia, were identified. 7/18 (39%) had fever. Parasite densities were low, ≤50 per μl in 14 cases. The presence of parasitaemia was associated with low haemoglobin (Hb) of <10 g/dl (χ2 10.9 P = 0.001). The case fatality rate of those with and without parasitaemia was similar. Plasmodium falciparum parasitaemia was identified as the cause of symptoms in four neonates. Conclusion Congenital and neonatal malaria are rare in this malaria endemic region. Performing a blood slide for malaria parasites among sick neonates in malaria endemic regions is advisable. This study does not support routine treatment with anti-malarial drugs among admitted neonates with or without fever even in a malaria endemic region. PMID:21054891

  2. Removal of deciduous canine tooth buds in Kenyan rural Maasai.

    PubMed

    Hassanali, J; Amwayi, P; Muriithi, A

    1995-04-01

    The removal of deciduous canine tooth buds in early childhood is a practice that has been documented in Kenya and in neighboring countries. This paper describes the occurrence, rationale and method of this practice amongst rural Kenyan Maasai. In a group of 95 children aged between six months and two years, who were examined in 1991/92, 87% were found to have undergone the removal of one or more deciduous canine tooth buds. In an older age group (3-7 years of age), 72% of the 111 children examined exhibited missing mandibular or maxillary deciduous canines. It was found that the actual removal of a deciduous tooth bud is often performed by middle-aged Maasai women who enucleate the developing tooth using a pointed pen-knife. There exists a strong belief among the Maasai that diarrhoea, vomiting and other febrile illnesses of early childhood are caused by the gingival swelling over the canine region, and which is thought to contain 'worms' or 'nylon' teeth. The immediate and long-term hazards of this practice include profuse bleeding, infection and damage to the developing permanent canines. A multi-disciplinary approach involving social anthropologists in addition to dental and medical personnel, is recommend in order to discourage this harmful operation that appears to be on the increase. PMID:7621751

  3. Industrialization Stresses, Alcohol Abuse & Substance Dependence: Differential Gender Effects in a Kenyan Rural Farming Community

    ERIC Educational Resources Information Center

    Walt, Lisa C.; Kinoti, Elias; Jason, Leonard A.

    2013-01-01

    Developing countries' industrialization and urbanization attempts have been linked to psychological distress and alcohol abuse. We used Hobfoll's COR theory to examine the relationship between gender, perceived resource loss (an indicator of industrialization stress), and alcohol abuse and dependence in a sample of Kenyan rural village men and…

  4. Integrated Literacies in a Rural Kenyan Girls' Secondary School Journalism Club

    ERIC Educational Resources Information Center

    Kendrick, Maureen; Early, Margaret; Chemjor, Walter

    2013-01-01

    Our purpose in this paper is to foreground contextual issues in studies of situated writing practices. During a year-long case study in a rural Kenyan secondary school, we applied a number of ethnographic techniques to document how 32 girls (aged 14-18 years) used local cultural and digital resources (i.e., donated digital cameras, voice…

  5. Routine Paediatric Sickle Cell Disease (SCD) Outpatient Care in a Rural Kenyan Hospital: Utilization and Costs

    PubMed Central

    Amendah, Djesika D.; Mukamah, George; Komba, Albert; Ndila, Carolyne; Williams, Thomas N.

    2013-01-01

    Background More than 70% of children with sickle cell disease (SCD) are born in sub-Saharan Africa where the prevalence at birth of this disease reaches 2% or higher in some selected areas. There is a dearth of knowledge on comprehensive care received by children with SCD in sub-Saharan Africa and its associated cost. Such knowledge is important for setting prevention and treatment priorities at national and international levels. This study focuses on routine care for children with SCD in an outpatient clinic of the Kilifi District Hospital, located in a rural area on the coast of Kenya. Objective To estimate the per-patient costs for routine SCD outpatient care at a rural Kenyan hospital. Methods We collected routine administrative and primary cost data from the SCD outpatient clinic and supporting departments at Kilifi District Hospital, Kenya. Costs were estimated by evaluating inputs - equipment, medication, supplies, building use, utility, and personnel - to reflect the cost of offering this service within an existing healthcare facility. Annual economic costs were similarly calculated based on input costs, prorated lifetime of equipment and appropriate discount rate. Sensitivity analyses evaluated these costs under different pay scales and different discount rate. Results We estimated that the annual economic cost per patient attending the SCD clinic was USD 138 in 2010 with a range of USD 94 to USD 229. Conclusion This study supplies the first published estimate of the cost of routine outpatient care for children born with SCD in sub-Saharan Africa. Our study provides policy makers with an indication of the potential future costs of maintaining specialist outpatient clinics for children living with SCD in similar contexts. PMID:23593408

  6. Unique Rural District Politics

    ERIC Educational Resources Information Center

    Farmer, Tod Allen

    2009-01-01

    The politics of rural educational leadership are both intense and concentrated. Rural educational leaders need to be savvy and politically skilled if they are to inspire educational stakeholders and accomplish organizational objectives. The local school system is an organization with a political culture that can be characterized as a competitive…

  7. Increasing Coverage and Decreasing Inequity in Insecticide-Treated Bed Net Use among Rural Kenyan Children

    PubMed Central

    Noor, Abdisalan M; Amin, Abdinasir A; Akhwale, Willis S; Snow, Robert W

    2007-01-01

    Background Inexpensive and efficacious interventions that avert childhood deaths in sub-Saharan Africa have failed to reach effective coverage, especially among the poorest rural sectors. One particular example is insecticide-treated bed nets (ITNs). In this study, we present repeat observations of ITN coverage among rural Kenyan homesteads exposed at different times to a range of delivery models, and assess changes in coverage across socioeconomic groups. Methods and Findings We undertook a study of annual changes in ITN coverage among a cohort of 3,700 children aged 0–4 y in four districts of Kenya (Bondo, Greater Kisii, Kwale, and Makueni) annually between 2004 and 2006. Cross-sectional surveys of ITN coverage were undertaken coincidentally with the incremental availability of commercial sector nets (2004), the introduction of heavily subsidized nets through clinics (2005), and the introduction of free mass distributed ITNs (2006). The changing prevalence of ITN coverage was examined with special reference to the degree of equity in each delivery approach. ITN coverage was only 7.1% in 2004 when the predominant source of nets was the commercial retail sector. By the end of 2005, following the expansion of heavily subsidized clinic distribution system, ITN coverage rose to 23.5%. In 2006 a large-scale mass distribution of ITNs was mounted providing nets free of charge to children, resulting in a dramatic increase in ITN coverage to 67.3%. With each subsequent survey socioeconomic inequity in net coverage sequentially decreased: 2004 (most poor [2.9%] versus least poor [15.6%]; concentration index 0.281); 2005 (most poor [17.5%] versus least poor [37.9%]; concentration index 0.131), and 2006 with near-perfect equality (most poor [66.3%] versus least poor [66.6%]; concentration index 0.000). The free mass distribution method achieved highest coverage among the poorest children, the highly subsidised clinic nets programme was marginally in favour of the least poor

  8. School Dropouts in Rural Colorado School Districts

    ERIC Educational Resources Information Center

    Tombari, Martin; Andrews, Alex; Gallinati, Tina

    2009-01-01

    Dropouts from rural school districts have not received the same scrutiny as given to those from urban ones. The reasons behind this lack of knowledge about the experience of rural school districts with dropouts are unclear. The purpose of the present study was to begin to close this knowledge gap. A first major study of rural dropouts in the…

  9. Localizing HIV/AIDS discourse in a rural Kenyan community.

    PubMed

    Banda, Felix; Oketch, Omondi

    2011-01-01

    This paper examines the effectiveness of multimodal texts used in HIV/AIDS campaigns in rural western Kenya using multimodal discourse analysis (Kress and Van Leeuwen, 2006; Martin and Rose, 2004). Twenty HIV/AIDS documents (posters, billboards and brochures) are analysed together with interview data (20 unstructured one-on-one interviews and six focus groups) from the target group to explore the effectiveness of the multimodal texts in engaging the target rural audience in meaningful interaction towards behavioural change. It is concluded that in some cases the HIV/AIDS messages are misinterpreted or lost as the multimodal texts used are unfamiliar and contradictory to the everyday life experiences of the rural folk. The paper suggests localization of HIV/AIDS discourse through use of local modes of communication and resources. PMID:21574281

  10. Industrialization Stresses, Alcohol Abuse & Substance Dependence: Differential Gender Effects in a Kenyan Rural Farming Community

    PubMed Central

    Walt, Lisa C.; Kinoti, Elias; Jason, Leonard A.

    2014-01-01

    Developing countries’ industrialization and urbanization attempts have been linked to psychological distress and alcohol abuse. We used Hobfoll’s COR theory to examine the relationship between gender, perceived resource loss (an indicator of industrialization stress), and alcohol abuse and dependence in a sample of Kenyan rural village men and women (N = 186). Regression analyses indicated that both gender and COR loss predicted alcohol abuse and dependence. Additionally, results suggested that gender moderated the relationship between COR loss and alcohol dependence; such that higher COR loss scores predicted higher alcohol dependence for men, but COR loss scores did not predict alcohol dependence for women. Thus, we suggest that gender differences in substance abuse may be due less to actual differences in resource loss, but rather to gender differences in the response to resource loss. Limitations and opportunities for future research are discussed. PMID:24489525

  11. Rural Districts Bolster Choices with Online Learning

    ERIC Educational Resources Information Center

    Brown, Don

    2012-01-01

    All schools can benefit from giving students the option of online learning, but for many rural schools, online learning is a lifeline. In the past two years, Lane Education Service District in Oregon, USA, has developed online resources for 14 Lane County school districts, which vary in size from 170 students to as many as 17,000. Many of the…

  12. A strategy to increase adoption of locally-produced, ceramic cookstoves in rural Kenyan households

    PubMed Central

    2012-01-01

    Background Exposure to household air pollutants released during cooking has been linked to numerous adverse health outcomes among residents of rural areas in low-income countries. Improved cookstoves are one of few available interventions, but achieving equity in cookstove access has been challenging. Therefore, innovative approaches are needed. To evaluate a project designed to motivate adoption of locally-produced, ceramic cookstoves (upesi jiko) in an impoverished, rural African population, we assessed the perceived benefits of the cookstoves (in monetary and time-savings terms), the rate of cookstove adoption, and the equity of adoption. Methods The project was conducted in 60 rural Kenyan villages in 2008 and 2009. Baseline (n = 1250) and follow-up (n = 293) surveys and a stove-tracking database were analyzed. Results At baseline, nearly all respondents used wood (95%) and firepits (99%) for cooking; 98% desired smoke reductions. Households with upesi jiko subsequently spent <100 Kenyan Shillings/week on firewood more often (40%) than households without upesi jiko (20%) (p = 0.0002). There were no significant differences in the presence of children <2 years of age in households using upesi jiko (48%) or three-stone stoves (49%) (p = 0.88); children 2–5 years of age were less common in households using upesi jiko versus three-stone stoves (46% and 69%, respectively) (p = 0.0001). Vendors installed 1,124 upesi jiko in 757 multi-family households in 18 months; 68% of these transactions involved incentives for vendors and purchasers. Relatively few (<10%) upesi jiko were installed in households of women in the youngest age quartile (<22 years) or among households in the poorest quintile. Conclusions Our strategy of training of local vendors, appropriate incentives, and product integration effectively accelerated cookstove adoption into a large number of households. The strategy also created opportunities to reinforce health messages

  13. Impact of biogas digesters on cookhouse volatile organic compound exposure for rural Kenyan farmwomen.

    PubMed

    Dohoo, Carolyn; Read Guernsey, Judith; Gibson, Mark D; VanLeeuwen, John

    2015-01-01

    Women living on rural Kenyan smallholder dairy farms burn wood as biofuel in family cookhouses. Unventilated biofuel combustion produces harmful levels of respirable particles and volatile organic compound (VOC) emissions in indoor environments. Biogas digesters, which can generate high methane-content biogas from livestock manure composting were recently installed on 31 farms. The study objectives were to compare VOC exposure profiles for women cooking on farms with and without biogas digesters, and to compare seasonal variations in VOC exposures for those women cooking with biogas. Participants (n=31 biogas farms, n=31 referent farms) wore passive thermal desorption VOC sampling tubes and recorded cookhouse fuel use on time activity sheets for 7 days. Women using biogas spent significantly less time (mean=509 min/week) exposed to cookhouse wood smoke compared with the referent group (mean=1122 min/week) (P<0.01). Total VOC exposure did not differ between farm groups (P=0.14), though concentrations of trans-1,3-dichloropropene, bromoform, and 1,4-dichlorobenzene in biogas cookhouses were significantly lower than in referent cookhouses, even after Bonferroni correction. The composition of VOC species was also significantly different, reflecting the different fuel sources. Biogas digester technologies have great potential for reducing exposure to wood smoke VOCs in low-income countries. PMID:23899962

  14. Zinc, iron and calcium are major limiting nutrients in the complementary diets of rural Kenyan children.

    PubMed

    Ferguson, Elaine; Chege, Peter; Kimiywe, Judith; Wiesmann, Doris; Hotz, Christine

    2015-12-01

    Poor quality infant and young child (IYC) diets contribute to chronic under-nutrition. To design effective IYC nutrition interventions, an understanding of the extent to which realistic food-based strategies can improve dietary adequacy is required. We collected 24-h dietary recalls from children 6-23 months of age (n = 401) in two rural agro-ecological zones of Kenya to assess the nutrient adequacy of their diets. Linear programming analysis (LPA) was used to identify realistic food-based recommendations (FBRs) and to determine the extent to which they could ensure intake adequacy for 12 nutrients. Mean nutrient densities of the IYC diets were below the desired level for four to nine of the 10 nutrients analysed, depending on the age group. Mean dietary diversity scores ranged from 2.1 ± 1.0 among children 6-8 months old in Kitui County to 3.7 ± 1.1 food groups among children 12-23 months old in Vihiga County. LPA confirmed that dietary adequacy for iron, zinc and calcium will be difficult to ensure using only local foods as consumed. FBRs for breastfed children that promote the daily consumption of cows'/goats' milk (added to porridges), fortified cereals, green leafy vegetables, legumes, and meat, fish or eggs, 3-5 times per week can ensure dietary adequacy for nine and seven of 12 nutrients for children 6-11 and 12-23 months old, respectively. For these rural Kenyan children, even though dietary adequacy could be improved via realistic changes in habitual food consumption practices, alternative interventions are needed to ensure dietary adequacy at the population level. PMID:26778799

  15. Preschool Guidelines: Rural Model (Trimble Local School District).

    ERIC Educational Resources Information Center

    Ohio State Dept. of Education, Columbus. Div. of Educational Services.

    The purpose of this handbook is to guide rural school districts intending to establish a preschool program. The program described was established in the Trimble Local School District in the rural Appalachian area of northern Athens County, the third poorest district in Ohio. Contents concern: (1) the district's beliefs about children; (2)…

  16. Including Rural Districts in Inclusive Staff Development.

    ERIC Educational Resources Information Center

    Pfluger, Loretta; Hendricks, Jenny

    Teaching students who receive special education services in integrated settings requires intensive staff development and on-going training. Region 16 Education Service Center in the Texas panhandle serves 65 rural school districts covering 25,000 square miles and 80,000 students. In 1996, with direction and funding from the state legislature,…

  17. Hamilton County: A Rural School District Profile.

    ERIC Educational Resources Information Center

    Harned, Catherine

    Using state education agency, census, industry employment and occupational information data, this paper provides a detailed picture of a rural school district in Southern Illinois. Mining and agriculture are the major industries in Hamilton County. The major mining employer closed in February 1988, and the drought of 1988 is likely to adversely…

  18. An exploration of rural and urban Kenyan women's knowledge and attitudes regarding breast cancer and breast cancer early detection measures.

    PubMed

    Muthoni, Ann; Miller, Ann Neville

    2010-09-01

    Many women in Kenya with breast cancer symptoms do not seek medical attention until their cancer is very advanced, leading to high mortality rates and a heavy cancer burden on the nation. In this study we employed eight focus groups with low- and middle-income rural and urban Kenyan women to explore their knowledge, attitudes, and behaviors concerning breast cancer and its early detection measures. Topics for discussion were derived from the components of the Health Belief Model (HBM). Findings revealed a huge divide between urban middle-income women and all other groups with respect to knowledge of breast cancer and early detection measures. In addition, women viewed breast cancer as a highly severe disease. Perceived benefits of early detection measures centered around preparing themselves for what was assumed to be inevitable death. PMID:20677038

  19. Recruiting and Interviewing in Rural School Districts: Protocol or Potluck

    ERIC Educational Resources Information Center

    Nichols, Joe

    2004-01-01

    Through administrator and teacher surveys and interviews, this study examined recruiting and interviewing practices of eighty-three rural school districts located in, and between, the rural Ozark Plateau and Mississippi River Delta. Survey results indicated that districts with smaller student populations were far less likely to have an identified…

  20. Satellite Receiving Station Handbook for Rural School Districts.

    ERIC Educational Resources Information Center

    Adams, James C.; And Others

    This handbook gives the historical background of a 2-year project conducted in a rural Wisconsin school district, outlining the planning and actual construction of a high school satellite receiving station. It is written to aid rural school districts in purchasing, installing, and using a satellite receiving station to improve the quality of…

  1. Principal Selection in Rural School Districts: A Process Model.

    ERIC Educational Resources Information Center

    Richardson, M. D.; And Others

    Recent research illustrates the increasingly important role of the school principal. As a result, procedures for selecting principals have also become more critical to rural school districts. School systems, particularly rural school districts, are encouraged to adopt systematic, rational means for selecting administrators. Such procedures will…

  2. Characteristics of Small and Rural School Districts. Statistical Analysis Report.

    ERIC Educational Resources Information Center

    McLaughlin, Donald H.; And Others

    Small rural school districts constitute a major portion of the public elementary and secondary sector of education. Using information from the Common Core of Data, this report focuses on the approximately 4,000 small rural school districts operating since 1986-87; their status in 1993-94; and how they changed each year during that 7-year period,…

  3. Accidental paraffin poisoning in Kenyan children.

    PubMed

    Lang, T; Thuo, N; Akech, S

    2008-06-01

    A serious and common accident in rural Kenyan homesteads is accidental ingestion of paraffin when it has been mistaken for water and offered to a young child. Here we report the incidence, parental practices and outcome of severe paraffin poisoning, requiring admission at Kilifi District Hospital, Kenya. Over a 2-year period, 48 children (0.5% of all admissions) were admitted with kerosene poisoning, constituting 62% of all poisoning cases. All cases were accidental. Ten per cent had induced vomiting. One child (2%) died. We suggest these data support assessment followed by implementation of practical and affordable measures to prevent paraffin poisoning. PMID:18363584

  4. Collaborating with the Community: Lessons from a Rural School District

    ERIC Educational Resources Information Center

    Walker, Anne

    2012-01-01

    This article, based on case study research, highlights how a rural school district in the midwestern United States collaborated with local community organizations to meet the needs of English language learners after the district and community experienced rapid ethnic diversification. In particular, the district EL coordinator spearheaded the…

  5. Economic Support for Education in Rural School Districts. ERIC Digest.

    ERIC Educational Resources Information Center

    Howley, Craig

    This ERIC digest synthesizes research characterizing the economic climate in which rural schools operate and reports on the traditional strategies used to create greater economic support for rural school districts. The benefits of steady urban economic growth have not been shared, generally, by rural areas; this has led to inadequate financial…

  6. Economic Role of School Districts in Rural Communities.

    ERIC Educational Resources Information Center

    Sederberg, Charles H.

    1987-01-01

    Explores secondary economic effects of rural Minnesota school districts, including purchasing power of payrolls, employment, retail stimulus, recapture of taxes, property values, and banking services. Provides nontechnical approach to interpreting how school operations offset costs of rural education. Study can be replicated by rural educators.…

  7. Rural Education: A Case Study of Two Districts in Nepal.

    ERIC Educational Resources Information Center

    Sharma, Madhav P.

    In 1952 Nepal launched a rural development program to improve economic, social, and educational conditions in rural villages, which comprise 91% of the nation's population. This paper examines school characteristics and educational participation in two districts and discusses a national evaluation of the rural education program. Lungruppa village…

  8. Impact of biogas digesters on wood utilisation and self-reported back pain for women living on rural Kenyan smallholder dairy farms.

    PubMed

    Dohoo, Carolyn; VanLeeuwen, John; Read Guernsey, Judith; Critchley, Kim; Gibson, Mark

    2013-01-01

    Women living on rural Kenyan dairy farms spend significant amounts of time collecting wood for cooking. Biogas digesters, which generate biogas for cooking from the anaerobic decomposition of livestock manure, are an alternative fuel source. The objective of this study was to quantify the quality of life and health benefits of installing biogas digesters on rural Kenyan dairy farms with respect to wood utilisation. Women from 62 farms (31 biogas farms and 31 referent farms) participated in interviews to determine reliance on wood and the impact of biogas digesters on this reliance. Self-reported back pain, time spent collecting wood and money spent on wood were significantly lower (p < 0.01) for the biogas group, compared to referent farms. Multivariable linear regression showed that wood consumption increased by 2 lbs/day for each additional family member living on a farm. For an average family of three people, the addition of one cow was associated with increased wood consumption by 1.0 lb/day on biogas farms but by 4.4 lbs/day on referent farms (significant interaction variable - likely due to additional hot water for cleaning milk collection equipment). Biogas digesters represent a potentially important technology that can reduce reliance on wood fuel and improve health for Kenyan dairy farmers. PMID:23305236

  9. Freeing the Hand of the Lord: Securing Constructivist Pedagogy through Professional Development in Kenyan Rural Schools

    ERIC Educational Resources Information Center

    Ngundi, James

    2013-01-01

    This study explores the use of constructivist pedagogy promoting learner-centered teaching in Kenya's rural primary schools. It explores both the school-based as well as bureaucratic hurdles to the success of constructivist pedagogy. Teacher ideologies, issues of diverse cultures and traditional beliefs, the rural context characterized by…

  10. Potential Synergy: Rural School Districts and International Student Programs

    ERIC Educational Resources Information Center

    Casto, Hope G.; Steinhauer, Alexandra; Pollock, Pamela M.

    2012-01-01

    Many rural school districts face declining enrollments. A few districts have taken the unusual path of recruiting international students in order to boost their enrollments. This study examines a community using this strategy and the resulting financial, academic, and social situations for the school, community, and students, both local and…

  11. Latchkey Guidelines: Rural Model (Madison Local School District).

    ERIC Educational Resources Information Center

    Madison Local Schools, Mansfield, OH.

    The Madison Local School District offers guidelines for developing and implementing an independently financed, after-school enrichment program for latchkey children in rural areas. The district, located 40 miles from Cleveland, Ohio, borders on Lake Erie. Sections of the guide concern: (1) program development; (2) establishment of the environment;…

  12. Substance Use in Urban and Rural Texas School Districts

    ERIC Educational Resources Information Center

    Maxwell, Jane Carlisle; Tackett-Gibson, Melissa; Dyer, James

    2006-01-01

    The aim of this study is to compare substance use between urban and rural secondary school districts in Texas between 1998 and 2003. The differences were analyzed using chi-square and analysis of variance. The analysis found that rural schools had students who reported higher rates of use of tobacco, frequent binge drinking, and driving while…

  13. Managing Smallness: Promising Fiscal Practices for Rural School District Administrators.

    ERIC Educational Resources Information Center

    Freitas, Deborah Inman

    Based on a mail survey of over 100 rural school administrators in 34 states, this handbook outlines common problems and successful strategies in the financial management of rural, small school districts. Major problems are related to revenue and cash flow, increasing expenditures, providing quality education programs, and staffing to handle the…

  14. Implementing Comprehensive Parent Services in Small Rural School Districts.

    ERIC Educational Resources Information Center

    Davis, Patricia C.

    In small rural school districts there are significant socioeconomic, cultural, and distance barriers to parent involvement in the education of exceptional children. In Florida, the history of parent involvement in exceptional student education parallels that of organized parent activism generally; rural, isolated, and minority group parents have…

  15. Rural Districts Left Behind? Rural Districts and the Challenges of Administering the Elementary and Secondary Education Act

    ERIC Educational Resources Information Center

    Yettick, Holly; Baker, Robin; Wickersham, Mary; Hupfeld, Kelly

    2014-01-01

    The purpose of this study was to inform the upcoming and overdue reauthorization of the Elementary and Secondary Education Act (ESEA) by exploring whether rural school districts face disadvantages as they attempt to follow the law's provisions and, if so, if the law's rural-specific section ameliorates these disadvantages. The research…

  16. Identifying interventions to help rural Kenyan mothers cope with food insecurity: results of a focused ethnographic study.

    PubMed

    Pelto, Gretel H; Armar-Klemesu, Margaret

    2015-12-01

    essential for child growth and development. This indicates that caregivers in these rural Kenyan communities have adopted the basic biomedical interpretation of the importance of child nutrition as an integral part of their 'knowledge frameworks'. PMID:26778800

  17. Responsiveness to HIV education and VCT services among Kenyan rural women: a community-based survey.

    PubMed

    Karau, Paul Bundi; Winnie, Mueni Saumu; Geoffrey, Muriira; Mwenda, Mukuthuria

    2010-09-01

    Uptake of VCT and other HIV prevention strategies among rural African women is affected by various socio-cultural and economic factors which need elucidation. Our aim was to establish the responsiveness to HIV education among rural women attending three dispensaries in Kenya. This study was designed to assess gender and psycho-social factors that influence HIV dynamics in rural Kenya. This was a cross-sectional questionnaire based study of 1347 women, conducted in October 2009. Socio-economic status as well as knowledge on methods of HIV transmission was assessed. Testing status, knowledge on existing VCT services and willingness to share HIV information with their children was assessed. Majority of the women have heard about VCT services, but significantly few of them have been tested. Those with secondary school education and above are more knowledgeable on methods of HIV transmission, while those with inadequate education are more likely to cite shaking hands, sharing utensils, mosquito bites and hugging as means of transmission (p = 0.001). 90% of educated women are willing to share HIV information with their children, compared to 40% of uneducated women. Marital status is seen to positively influence testing status, but has no significant effect on dissemination of information to children. We conclude that despite the aggressive HIV education and proliferation of VCT services in Kenya, women are not heeding the call to get tested. Education has a positive impact on dissemination of HIV information. Focus needs to shift into increasing acceptability of testing by women in rural Kenya. PMID:21495609

  18. Demand for Public Education: Evidence from a Rural School District

    ERIC Educational Resources Information Center

    Stair, Anthony; Rephann, Terance J.; Heberling, Matt

    2006-01-01

    This study examines the question of how much households are willing to pay for improvements in the quality of local public education in two areas of a rural school district in Pennsylvania. The study uses the contingent valuation technique to obtain micro-data by personal interview on demand for improved public school quality. Estimates of…

  19. Meeting the Prevention Needs of Rural School Districts.

    ERIC Educational Resources Information Center

    Bodensteiner, Michael

    Recent societal changes have forced public education to assume many responsibilities that have been the traditional role of parents and family. The sheer number of pressing social problems, their multifaceted nature, and the lack of resources are particularly problematic for rural school districts. The Southeast Kansas Education Service Center…

  20. Rural School District Reorganization on the Great Plains.

    ERIC Educational Resources Information Center

    Bryant, Miles

    2002-01-01

    Rural school district reorganization and school consolidation are put into perspective by reviewing the large population increases that fueled small-school growth in the Great Plains, 1870-1930. Since the Dust Bowl and Great Depression, population losses, improvements in transportation, and arguments advocating economies of scale and increased…

  1. Use of combined measures from capillary blood to assess iron deficiency in rural Kenyan children.

    PubMed

    Shell-Duncan, Bettina; McDade, Thomas

    2004-02-01

    Community-based surveys of iron deficiency (ID) require simple, accurate methods that can be used in remote areas. The objective of this study was to assess iron status in rural Kenya using "field-friendly" methods for capillary blood, including an improved dried blood spot assay for transferrin receptor (TfR). A single finger stick was used to obtain capillary blood from 275 school-age children. Whole blood was applied directly to filter paper, dried, and later analyzed for TfR, as well as C-reactive protein (CRP), an acute-phase protein that serves as a general marker of inflammation. Capillary blood was also used to measure hemoglobin (Hb) concentration and the ratio of zinc protoporphyrin to heme (ZPP:H). The Hb concentration alone provides the lowest estimate of the prevalence of ID (8.0%). Because ZPP:H is reported to be elevated in the presence of inflammation, we constructed a preliminary diagnostic model based on elevated ZPP:H and normal CRP level, estimating the prevalence of ID at 25.9%. When TfR is added to a multiple criteria model (elevated ZPP:H in the absence of elevated CRP and/or elevated TfR level) the prevalence of ID is estimated to be 31.2%. This study demonstrates the diagnostic utility of combining TfR with other indexes of iron status, enabling the detection of ID in both the presence and absence of infection. Furthermore, this study is the first field application of TfR blood-spot methods, and it demonstrates their feasibility in remote field settings. PMID:14747676

  2. Prevalence of enteropathogens in stools of rural Maasai children under five years of age in the Maasailand region of the Kenyan Rift Valley.

    PubMed

    Joyce, T; McGuigan, K G; Elmore-Meegan, M; Conroy, R M

    1996-01-01

    Stool samples were collected during August 1994 from seventy rural Maasai children under the age of five years who were living in the Maasailand region of the Kenyan Rift Valley. Microbiological analysis was carried out on these samples to identify which intestinal pathogens were present among the infant population of the Maasai. Of the samples studied 54% were pathogen positive. The most common pathogen isolated was Giardia lamblia which was detected in 31% of the samples. Other pathogens that were detected include: Entamoeba histolytica (23%), Enteropathogenic Escherichia coli (13%), Strongyloides stercoralis (4%), Blastocystis hominis (3%) and Cryptosporidium sp (3%). Although all samples were screened for Campylobacter and rotavirus, neither pathogen was detected. Water samples were taken from all the water sources in the study area and analysed microbiologically. Results showed that all the sources were contaminated with the faecal E. coli whose populations ranged from 14 CFU/100 ml to greater than 1800 CFU/100ml. PMID:8625866

  3. Service delivery in Kenyan district hospitals – what can we learn from literature on mid-level managers?

    PubMed Central

    2013-01-01

    Background There is a growing emphasis on the need to tackle inadequate human resources for health (HRH) as an essential part of strengthening health systems; but the focus is mostly on macro-level issues, such as training, recruitment, skill mix and distribution. Few attempts have been made to understand the capability of health workers, their motivation and other structural and organizational aspects of systems that influence workforce performance. We have examined literature on the roles of mid-level managers to help us understand how they might influence service delivery quality in Kenyan hospitals. In the Kenyan hospital settings, these are roles that head of departments who are also clinical or nursing service providers might play. Methods A computerized search strategy was run in Pub Med, Cochrane Library, Directory of Open Access Journals Social Science Research Network, Eldis, Google Scholar and Human Resources for Health web site databases using both free-text and MeSH terms from 1980 to 2011. In addition, citation searching from excluded and included articles was used and relevant unpublished literature systematically identified. Results and discussion A total of 23 articles were finally included in the review from over 7000 titles and abstracts initially identified. The most widely documented roles of mid-level managers were decision-making or problem-solving, strategist or negotiator and communicator. Others included being a therapist or motivator, goal setting or articulation and mentoring or coaching. In addition to these roles, we identified important personal attributes of a good manager, which included interpersonal skills, delegation and accountability, and honesty. The majority of studies included in the review concerned the roles that mid-level managers are expected to play in times of organizational change. Conclusion This review highlights the possible significance of mid-level managers in achieving delivery of high-quality services in Kenyan

  4. Leading Change for the Implementation of Common Core State Standards in Rural School Districts

    ERIC Educational Resources Information Center

    Lopez, Paul; Wise, Donald

    2015-01-01

    Rural school districts across the nation, with their limited resources, face daunting challenges posed by the implementation of the Common Core State Standards. This article presents a recent study of 13 rural school districts in the Central Valley of California and how these districts are responding to those challenges. A total of 352 teachers…

  5. “…still waiting for chloroquine”: the challenge of communicating changes in first-line treatment policy for uncomplicated malaria in a remote Kenyan district

    PubMed Central

    2014-01-01

    Background Widespread parasite resistance to first-line treatment for uncomplicated malaria leads to introduction of new drug interventions. Introducing such interventions is complex and sensitive because of stakeholder interests and public resistance. To enhance take up of such interventions, health policy communication strategies need to deliver accurate and accessible information to empower communities with necessary information and address problems of cultural acceptance of new interventions. Objectives To explore community understanding of policy changes in first-line treatment for uncomplicated malaria in Kenya; to evaluate the potential role of policy communication in influencing responses to changes in first-line treatment policy. Methods Data collection involved qualitative strategies in a remote district in the Kenyan Coast: in-depth interviews (n = 29), focus group discussions (n = 14), informal conversations (n = 11) and patient narratives (n = 8). Constant comparative method was used in the analysis. Being malaria-prone and remotely located, the district offered an ideal area to investigate whether or not and how policy communication about a matter as critical as change of treatment policy reaches vulnerable populations. Results Three years after initial implementation (2009), there was limited knowledge or understanding regarding change of first-line treatment from sulphadoxine-pyrimethamine (SP) to artemether-lumefantrine (AL) for treatment of uncomplicated malaria in the study district. The print and electronic media used to create awareness about the drug change appeared to have had little impact. Although respondents were aware of the existence of AL, the drug was known neither by name nor as the official first-line treatment. Depending on individuals or groups, AL was largely viewed negatively. The weaknesses in communication strategy surrounding the change to AL included poor choice of communication tools, confusing

  6. The Poor Little Rich District: The Effects of Suburbanization on a Rural School and Community

    ERIC Educational Resources Information Center

    Howley, Aimee; Carnes, Marilyn; Eldridge, Anita; Huber, Donna; Lado, Longun Moses; Kotler, Ruth; Turner, Maryalice

    2005-01-01

    Contextualized in relationship to other case studies about rural districts that have experienced population growth and decline as well as in relationship to the small sociological literature on "boom towns," this study considered the dynamics that seem to be interfering with one previously rural and now suburbanizing district's ability to address…

  7. Estimating the Efficiency of Michigan's Rural and Urban Public School Districts

    ERIC Educational Resources Information Center

    Maranowski, Rita

    2012-01-01

    This study examined student achievement in Michigan public school districts to determine if rural school districts are demonstrating greater financial efficiency by producing higher levels of student achievement than school districts in other geographic locations with similar socioeconomics. Three models were developed using multiple regression…

  8. National Television News in Seven Rural Districts. Report 96-2.

    ERIC Educational Resources Information Center

    Nasstrom, Roy; Gierok, Anne

    The implementation, delivery, and impact on students of news programs delivered to schools by Channel One and CNN-Newsroom were examined in seven rural districts in Wisconsin. Investigation covered three districts using CNN and four districts using Channel One within a three-county area. Involved administrators, teachers, and students responded to…

  9. Human Capital Problems in Zimbabwean Rural Schools: A Case Study of Mazowe District

    ERIC Educational Resources Information Center

    Zvavahera, Promise

    2014-01-01

    This study focused on the management of human capital in Zimbabwean rural schools. It was observed that teachers in rural schools preferred urban postings which turned out to have better facilities and incentives. Rural to urban migration of teachers is a cause for concern in Mazowe District. This study was motivated by the high teacher-turnover…

  10. The Kenyan runners.

    PubMed

    Larsen, H B; Sheel, A W

    2015-12-01

    Today the Kenyan dominance in middle- and long-distance running is so profound that it has no equivalence to any other sport in the world. Critical physiological factors for performance in running include maximal oxygen consumption (VO2max), fractional VO2max utilization and running economy (energetic cost of running). Kenyan and non-Kenyan elite runners seem to be able to reach very high, but similar maximal oxygen uptake levels just as there is some indication that untrained Kenyans and non-Kenyans have a similar VO2max. In addition, the fractional utilization of VO2max seems to be very high but similar in Kenyan and European runners. Similarly, no differences in the proportion of slow muscle fibers have been observed when comparing Kenyan elite runners with their Caucasian counterparts. In contrast, the oxygen cost of running at a given running velocity has been found to be lower in Kenyan elite runners relative to other elite runners and there is some indication that this is due to differences in body dimensions. Pulmonary system limitations have been observed in Kenyan runners in the form of exercise-induced arterial hypoxemia, expiratory flow limitation, and high levels of respiratory muscle work. It appears that Kenyan runners do not possess a pulmonary system that confers a physiological advantage. Additional studies on truly elite Kenyan runners are necessary to understand the underlying physiology which permits extraordinary running performances. PMID:26589124

  11. Intake of micronutrients high in animal-source foods is associated with better growth in rural Kenyan school children.

    PubMed

    Grillenberger, Monika; Neumann, Charlotte G; Murphy, Suzanne P; Bwibo, Nimrod O; Weiss, Robert E; Jiang, Luohua; Hautvast, Joseph G A J; West, Clive E

    2006-02-01

    Observational studies have shown that children in developing countries consuming diets containing high amounts of bioavailable nutrients, such as those found in animal-source foods, grow better. The present study investigated which specific nutrients from the diet of Kenyan school children predicted their growth. The children (n 544, median age 7 years) participated in a 2-year long food supplementation study with animal-source foods. Height gain during the intervention period was positively predicted by average daily intakes of energy from animal-source foods, haem Fe, preformed vitamin A, Ca and vitamin B12. Weight gain was positively predicted by average daily intakes of energy from animal-source foods, haem Fe, preformed vitamin A, Ca and vitamin B12. Gain in mid-upper-arm muscle area was positively predicted by average daily intakes of energy from animal-source foods and vitamin B12. Gain in mid-upper-arm fat area was positively predicted by average daily intakes of energy from animal-source foods. Gain in subscapular skinfold thickness was not predicted by any of the nutrient intakes. Negative predictors of growth were total energy and nutrients that are contained in high amounts in plant foods. The study shows that growth was positively predicted by energy and nutrients that are provided in high amounts and in a bioavailable form in meat and milk, and their inclusion into the diets of children in developing countries should be part of all food-based programmes in order to improve micronutrient status and growth. PMID:16469157

  12. Treatment in Kenyan rural health facilities: projected drug costs using the WHO-UNICEF integrated management of childhood illness (IMCI) guidelines.

    PubMed Central

    Boulanger, L. L.; Lee, L. A.; Odhacha, A.

    1999-01-01

    Guidelines for the integrated management of childhood illness (IMCI) in peripheral health facilities have been developed by WHO and UNICEF to improve the recognition and treatment of common causes of childhood death. To evaluate the impact of the guidelines on treatment costs, we compared the cost of drugs actually prescribed to a sample of 747 sick children aged 2-59 months in rural health facilities in western Kenya with the cost of drugs had the children been managed using the IMCI guidelines. The average cost of drugs actually prescribed per child was US$ 0.44 (1996 US$). Antibiotics were the most costly component, with phenoxymethylpenicillin syrup accounting for 59% of the cost of all the drugs prescribed. Of the 295 prescriptions for phenoxymethylpenicillin syrup, 223 (76%) were for treatment of colds or cough. The cost of drugs that would have been prescribed had the same children been managed with the IMCI guidelines ranged from US$ 0.16 per patient (based on a formulary of larger-dose tablets and a home remedy for cough) to US$ 0.39 per patient (based on a formulary of syrups or paediatric-dose tablets and a commercial cough preparation). Treatment of coughs and colds with antibiotics is not recommended in the Kenyan or in the IMCI guidelines. Compliance with existing treatment guidelines for the management of acute respiratory infections would have halved the cost of the drugs prescribed. The estimated cost of the drugs needed to treat children using the IMCI guidelines was less than the cost of the drugs actually prescribed, but varied considerably depending on the dosage forms and whether a commercial cough preparation was used. PMID:10593034

  13. Decision Points and Considerations for Identifying Rural Districts That Have Closed Student Achievement Gaps. REL 2016-130

    ERIC Educational Resources Information Center

    Culbertson, Michael J.; Billig, Shelley H.

    2016-01-01

    Rural districts have long faced challenges in closing achievement gaps between subgroups of students. This brief report describes key decision points and considerations for decision-makers interested in identifying rural districts that have closed academic achievement gaps. Examining practices in these districts may suggest activities associated…

  14. A Study of Factors that Impact Recruitment and Retention in a Selected Rural School District in South Carolina

    ERIC Educational Resources Information Center

    Gadson, Denise Brooks

    2010-01-01

    Recruiting and retaining highly qualified teachers has been a challenge for many rural school districts. Lower salaries, working conditions, and geographic location are some of the challenges rural districts face when staffing their schools. The challenges of recruiting teachers in rural areas are compounded by competition from larger districts…

  15. Assessing Pre-Intervention Capacity for Change in a High-Need Rural School District.

    ERIC Educational Resources Information Center

    Nilsen, Kristine L.

    A technical assistance project in a rural Virginia school district included the goal of building professional learning communities among the district's teachers. Three instruments that measure various elements of a learning community culture were scheduled to be administered to teachers at the beginning, midpoint, and end of the 4-year project.…

  16. Bringing the Community Along: A Case Study of a School District's Information Technology Rural Development Initiative

    ERIC Educational Resources Information Center

    Schafft, Kai A.; Alter, Theodore R.; Bridger, Jeffrey C.

    2006-01-01

    We draw on interactional community theory to analyze the relationship between information technology and local development through a case study of a geographically isolated and economically disadvantaged rural school district. This district has used state-of-the-art information technology infrastructure in a broad-based community and economic…

  17. An Examination of State Takeover as a School Reform Strategy in a Small Rural School District

    ERIC Educational Resources Information Center

    Brookover, Chester Wayne

    2010-01-01

    The purpose of this qualitative study was to explore state takeover as a school reform strategy in a small rural school district. Since 1988, more than 50 U.S. school districts in 20 states have been subject to some form of state takeover. A number of factors generally contribute to a state takeover, some of which include: poor student…

  18. The Importance of a Small Rural School District to the Community

    ERIC Educational Resources Information Center

    Reynolds, Richard Kent

    2013-01-01

    Hallsburg ISD is a small, rural, K-6 school district struggling to sustain its operations due to reduced funding from the state, decreased enrollment, and a decrease in the local tax base. This Problem in Practice Record of Study examines the sustainability issues associated with this school district and its importance to the community. Key…

  19. Factors That Influence Special Education Teachers' Career Decisions in a Rural School District in Southern Indiana

    ERIC Educational Resources Information Center

    Lemons, Theresa

    2013-01-01

    Attrition of special education teachers is a national problem resulting in lost monetary resources, school climate discontinuity, and lower student achievement. Within a small, rural district in southern Indiana, special education teacher attrition has risen since 2008 and continues to rise. District administrators want to retain teachers to…

  20. Staff Development in Small and Rural School Districts. AASA Small School Series #1.

    ERIC Educational Resources Information Center

    Pelton, Mary Helen White

    Staff development is the small school district's key to survival in the 1980's. Although small rural districts may face problems like isolation and limited resources, they have distinct advantages. Chapter 1 of this guide provides a list of advantages, which include close contact between teachers and administrators, strong ties to the local…

  1. Elementary School and Middle School Principals' Theories of Action in Two Rural School Districts

    ERIC Educational Resources Information Center

    Lisy-Macan, Lynn

    2012-01-01

    This dissertation was designed to answer the following question. What are elementary and middle school principals' theories of action in two rural school districts? Sub-questions included the superintendent-principal relationship and its influence on the principal's theories of action and the extent to which rural context impacts…

  2. Elementary Principals and Their School Districts in Three Categories of Ruralness.

    ERIC Educational Resources Information Center

    Pladson, Janet L.; Lemon, Donald K.

    1982-01-01

    Describes a model of relative ruralness for rural states. Applies model to North Dakota, generating descriptions of principals (age, sex, teachers supervised, salary, contract time, experience, expectations, etc.) and districts (enrollment, assessed valuation, total mills levied, per pupil costs, accredidation levels). Compares principals and…

  3. The Impact of Hotspot-Targeted Interventions on Malaria Transmission in Rachuonyo South District in the Western Kenyan Highlands: A Cluster-Randomized Controlled Trial

    PubMed Central

    Bradley, John; Knight, Philip; Stone, William; Osoti, Victor; Makori, Euniah; Owaga, Chrispin; Odongo, Wycliffe; China, Pauline; Shagari, Shehu; Doumbo, Ogobara K.; Sauerwein, Robert W.; Kariuki, Simon; Drakeley, Chris; Stevenson, Jennifer; Cox, Jonathan

    2016-01-01

    Background Malaria transmission is highly heterogeneous, generating malaria hotspots that can fuel malaria transmission across a wider area. Targeting hotspots may represent an efficacious strategy for reducing malaria transmission. We determined the impact of interventions targeted to serologically defined malaria hotspots on malaria transmission both inside hotspots and in surrounding communities. Methods and Findings Twenty-seven serologically defined malaria hotspots were detected in a survey conducted from 24 June to 31 July 2011 that included 17,503 individuals from 3,213 compounds in a 100-km2 area in Rachuonyo South District, Kenya. In a cluster-randomized trial from 22 March to 15 April 2012, we randomly allocated five clusters to hotspot-targeted interventions with larviciding, distribution of long-lasting insecticide-treated nets, indoor residual spraying, and focal mass drug administration (2,082 individuals in 432 compounds); five control clusters received malaria control following Kenyan national policy (2,468 individuals in 512 compounds). Our primary outcome measure was parasite prevalence in evaluation zones up to 500 m outside hotspots, determined by nested PCR (nPCR) at baseline and 8 wk (16 June–6 July 2012) and 16 wk (21 August–10 September 2012) post-intervention by technicians blinded to the intervention arm. Secondary outcome measures were parasite prevalence inside hotpots, parasite prevalence in the evaluation zone as a function of distance from the hotspot boundary, Anopheles mosquito density, mosquito breeding site productivity, malaria incidence by passive case detection, and the safety and acceptability of the interventions. Intervention coverage exceeded 87% for all interventions. Hotspot-targeted interventions did not result in a change in nPCR parasite prevalence outside hotspot boundaries (p ≥ 0.187). We observed an average reduction in nPCR parasite prevalence of 10.2% (95% CI −1.3 to 21.7%) inside hotspots 8 wk post

  4. Similar Districts with Different Results: Using the Baldrige Scale to Understand Outcome Differences in Rural School Districts in the Lower Rio Grande Valley

    ERIC Educational Resources Information Center

    Gonzalez, Miguel Angel

    2009-01-01

    The research for this study describes the organizational characteristics and the personnel behaviors distinctive to high-achieving rural school districts. A comparison between two rural school districts, one high-achieving and the other low-achieving was completed using a survey instrument. The Baldrige National Quality Program instrument was…

  5. Small Rural School District Consolidation in Texas: An Analysis of Its Impact on Cost and Student Achievement

    ERIC Educational Resources Information Center

    Cooley, Dwight A.; Floyd, Koy A.

    2013-01-01

    Historically, the number of public school districts in the United States has decreased despite a dramatic increase in the number of students enrolled. Although public school district consolidation has impacted districts of all sizes, since the late 1930's smaller rural districts facing dwindling community resources have merged or consolidated with…

  6. Consolidation of Small, Rural Schools in One Southeastern Kentucky District

    ERIC Educational Resources Information Center

    Hyndman, June; Cleveland, Roger; Huffman, Tyler

    2010-01-01

    From 1945 to 1980, school districts across the United States decreased the number of schools through consolidation. With the advent of geographic software, it is possible to map schools across time and analyze patterns of school openings, closings, and consolidation. In this study, one Southeastern Kentucky district was selected as a pilot for…

  7. Guiding Rural Schools and Districts: A Research Agenda

    ERIC Educational Resources Information Center

    Arnold, Michael

    2004-01-01

    Mid-Continent Research for Education and Learning (McREL) has identified a research agenda that connects the challenges that rural schools face in implementing No Child Left Behind (NCLB) provisions. The rural education research agenda crafted by McREL includes nine priority topics: (1) Opportunity to learn; (2) School size and student…

  8. Vista School District Digital Intranet: The Delivery of Advanced Placement Courses to Young Adult Learners in Rural Communities.

    ERIC Educational Resources Information Center

    Power, David; Stevens, Ken; Boone, Wilbert; Barry, Maurice

    In partnership with the Memorial University of Newfoundland, the Vista School District, 1 of 10 districts in Newfoundland, Canada, established the Vista School District Digital Intranet (VSDDI) to deliver Web-based advanced placement courses to rural students. Advanced placement mathematics, physics, biology, and chemistry courses are delivered…

  9. Do Schools in Rural and Nonrural Districts Allocate Resources Differently? An Analysis of Spending and Staffing Patterns in the West Region States. Issues & Answers. REL 2011-No. 099

    ERIC Educational Resources Information Center

    Levin, Jesse; Manship, Karen; Chambers, Jay; Johnson, Jerry; Blankenship, Charles

    2011-01-01

    This report presents the first detailed comparison of resource allocation between rural and nonrural districts in the West Region. Three regional characteristics often associated with rural districts were chosen for the analysis: district enrollment, student population density within a district (students per square mile), and drive time from the…

  10. Working against Ourselves: Decision Making in a Small Rural School District

    ERIC Educational Resources Information Center

    Patterson, Jean A.; Koenigs, Andrew; Mohn, Gordon; Rasmussen, Cheryl

    2006-01-01

    Purpose: The purpose of this paper is to examine decision making and resource allocation in a small, rural district in a Midwestern state of the USA during a time of economic retrenchment. Design/methodology/approach: Qualitative case study methods were used, including focus groups and personal interviews with current and former district…

  11. Meeting the Needs of Rural School Districts in Georgia: One ESA's Story.

    ERIC Educational Resources Information Center

    Nelson, Terry T.

    2003-01-01

    Rural Georgia schools have unique needs arising from inequitable funding and high teacher and administrator turnover. Central Savannah River Area Regional Educational Service Agency, which serves 12 school districts, assists with teacher recruitment and preparation, federal regulations, school improvement planning and implementation, and…

  12. Small Rural School Districts in Nebraska: A Case Study of Challenges and Solutions

    ERIC Educational Resources Information Center

    Montgomery, Michael R.

    2010-01-01

    The purpose of this study was to determine the problems faced by small, rural Nebraska school districts. For this study, 15 possible challenges were identified (a) student enrollment, (b) instructional programs, (c) instructional support services, (d) extra curricular activities, (e) hiring and retaining administrative staff, (f) hiring and…

  13. How Talented Students in a Rural School District Experience School Mathematics

    ERIC Educational Resources Information Center

    Howley, Aimee; Pendarvis, Edwina; Gholson, Melissa

    2005-01-01

    This study examined the mathematics experiences of talented children in an impoverished rural school district located in a coal-mining area of Appalachia. Using interview methods, the researchers explored the children's ideas about the nature of mathematics, their perceptions of the mathematics instruction they received at school, and their…

  14. AIDS Education in Rural Oregon School Districts: Compliance with State Curriculum Guidelines.

    ERIC Educational Resources Information Center

    Hales, Loyde W.; McGrew, Robin R.

    The Oregon State Department of Education mandates age-appropriate curricula for all grade levels on infectious diseases, including AIDS, ARC, HIV, and Hepatitis B. The objectives of this study were: (1) to determine the extent to which AIDS education was occurring in three remote rural Oregon school districts; (2) to examine the focus of the…

  15. Managing Teacher Retention in a Rural School District in South Africa

    ERIC Educational Resources Information Center

    Mafora, Patrick

    2013-01-01

    Retaining quality teachers is a global challenge for schools, particularly those in rural districts. A nation-wide study conducted by the Human Sciences Research Council (HSRC) found that 55 % of teachers in South Africa would leave teaching if they could. Resignation was found to be one of the three largest causes of attrition (Hall et al.…

  16. The Incidence and Impacts of Student Transiency in Upstate New York's Rural School Districts

    ERIC Educational Resources Information Center

    Schafft, Kai A.

    2005-01-01

    Chronic student mobility, and in particular the mobility of students from low-income backgrounds, poses a serious yet underdocumented problem for rural schools. This article combines analyses of state-level school district data with survey and interview data to examine the patterns of low-income student mobility in upstate New York, and to assess…

  17. Improving Immunization Coverage in a Rural School District in Pierce County, Washington

    ERIC Educational Resources Information Center

    Peterson, Robin M.; Cook, Carolyn; Yerxa, Mary E.; Marshall, James H.; Pulos, Elizabeth; Rollosson, Matthew P.

    2012-01-01

    Washington State has some of the highest percentages of school immunization exemptions in the country. We compared school immunization records in a rural school district in Pierce County, Washington, to immunization records in the state immunization information system (IIS) and parent-held records. Correcting school immunization records resulted…

  18. Promoting Interdistrict Relations: The Preferred Policy Option for Improving Education in Rural Small School Districts.

    ERIC Educational Resources Information Center

    Stephens, E. Robert

    1988-01-01

    Establishes a rationale for increasing use of interorganizational arrangements among small, rural school districts. Compares two basic forms of interorganizational relations: cooperation and coordination. Identifies several core propositions to guide policy planners and decision-makers when designing cooperative agreements. Includes 34 references.…

  19. Using Appreciative Inquiry to Create a Sustainable Rural School District and Community

    ERIC Educational Resources Information Center

    Calabrese, Raymond; Hester, Michael; Friesen, Scott; Burkhalter, Kim

    2010-01-01

    Purpose: The purpose of this paper is to document how a doctoral research team applied an action research process to improve communication and collaboration strategies among rural Midwestern school district stakeholders. Design/methodology/approach: An appreciative inquiry (AI) action research methodology framed as a qualitative case study using…

  20. Declining Enrollments and Small Rural Cities and Districts: An Exploratory Analysis.

    ERIC Educational Resources Information Center

    Burlingame, Martin

    Based on case studies of the impact of declining enrollments during the 1976-77 school year in each of 9 rural Illinois school districts, this paper addresses the following: enrollment decline in smaller cities across the nation, with particular emphasis on Illinois; demographic characteristics of the east central region of Illinois, with…

  1. An Engineering Summer Program for Underrepresented Students from Rural School Districts

    ERIC Educational Resources Information Center

    Elam, Matthew E.; Donham, Brent L.; Soloman, Stephanie R.

    2012-01-01

    A two-week summer program designed to promote interest and learning in the Science, Technology, Engineering, and Mathematics (STEM) fields is documented. The program included a week-long engineering emphasis. Students and teachers from ten rural and financially disadvantaged school districts participated in the program. Three middle school and…

  2. Media Magic: Automating a K-12 Library Program in a Rural District.

    ERIC Educational Resources Information Center

    Adams, Helen

    1994-01-01

    Describes the automation process in a library resources center in a small rural school district. Topics discussed include long-range planning; retrospective conversion for an online catalog; library automation software vendors; finances; training; time savings; CD-ROM products; telecomputing; computer literacy skills; professional development…

  3. Rural and Urban School Finance: Districts and Experts Speak Out. Policy Briefs. Report 1, 1995.

    ERIC Educational Resources Information Center

    North Central Regional Educational Lab., Oak Brook, IL.

    This policy brief looks at educational finance from the perspective of educators and policymakers in rural and urban districts in the North Central Regional Educational Laboratory (NCREL) region. The region includes Illinois, Indiana, Iowa, Michigan, Minnesota, Ohio, and Wisconsin. A review of the contributions submitted by regional educators…

  4. The Effect of Accelerated Reader on Reading Scores in a Rural School District

    ERIC Educational Resources Information Center

    Hunter, Teresa A.

    2013-01-01

    In this study, the implementation of Accelerated Reader (AR), a computer-assisted supplemental reading program, was investigated as a research-based instructional strategy to assess whether it aided a high-performing, rural school district in meeting adequate yearly progress goals. The theoretical framework was based on Vygotsky's zone of…

  5. Organizational Practices of High-Achieving Rural School Districts in California's San Joaquin Valley

    ERIC Educational Resources Information Center

    Doerksen, Amanda López; Wise, Donald

    2016-01-01

    For over 25 years, researchers have identified "best practices" used by high-achieving school districts. However, little research exists regarding rural school systems, making it difficult to determine whether the best practices identified are relevant within this context. This study filled a void in research by focusing on the…

  6. Is Bigger Better? A Comparison of Rural School Districts

    ERIC Educational Resources Information Center

    Yan, Wenfan

    2006-01-01

    School district size is important to policymakers and educators who need to determine the most effective way to structure school organization. For more than 40 years, a growing body of research has focused on the relationship between school size and school effectiveness (Monk & Plecki, 1999). Early studies did not address the effect of school size…

  7. Leadership Strategies for Maintaining Success in a Rural School District

    ERIC Educational Resources Information Center

    Freeman, Greta G.; Randolph, Ivan

    2013-01-01

    Success in a PK-12 educational environment begins at the top with school leadership. Due to economic problems, poverty and added responsibilities, leaders in rural communities throughout the United States face sensitive and distinctive challenges. Based on research and years of administrative experience as school and school system leaders, the…

  8. Coaching Protocol Gives Rural District a Common Language for Learning

    ERIC Educational Resources Information Center

    Ringler, Marjorie C.; O'Neal, Debra

    2012-01-01

    Academic language has been referred to as a gatekeeper, something that stands in the way of academic success for native and nonnative speakers alike. In rural eastern North Carolina, many students do double the work because they speak nonstandard dialects, lack the background knowledge for school success, and thereby disengage from the classroom.…

  9. The Impact of Structural Costs on Home Schooling Decisions in Rural and Non-Rural Districts.

    ERIC Educational Resources Information Center

    Thompson, John A.

    This paper presents findings of a study that examined the relationship between structural conditions and parent proclivity to educate their children at home. The term "structural costs" was used to refer to conditions within the district that could be changed by the district. Data were obtained from a survey sent to the departments of education in…

  10. Perinatal mortality in a rural district of south India.

    PubMed

    Chandrashekar, S; Rao, R S; Chakladar, B K; Krishnan, L; Nair, N S

    1998-01-01

    Perinatal mortality is one of the most sensitive indices of maternal and child health. The perinatal mortality rate is an indicator of the extent of pregnancy wastage as well as of the quality and quantity of health care available to the mother and the newborn. A community based prospective study carried out on 13,214 births in South Kanara district between Oct. 1991-Sept. 1992 revealed a perinatal mortality rate (PNMR) of 44.65/1000 births. Among the various factors influencing perinatal mortality, breech deliveries and babies of multiple pregnancies had a very high perinatal mortality rate of 180.81/1000 births (adjusted odd's ratio: 4.90) and 128/1000 births (adjusted odd's ratio: 2.64). The previous bad obstetric history of the mother, parity and sex of the newborn were among the other important factors influencing the PNMR. PMID:10773926

  11. No Child Left Behind and Its Effect on Recruiting and Retaining Special Education Teachers in Rural South Carolina School Districts

    ERIC Educational Resources Information Center

    Martin, Deborah S.

    2010-01-01

    The study examined the No Child Left Behind Act as it relates to the recruiting and retention of special education teachers in rural school districts. The focus of the research was to examine those factors that have influenced teachers to leave the profession or to seek employment in more urban school districts. Data for the study were collected…

  12. Science achievement as an indicator of educational opportunity available in rural K--12 districts in Texas

    NASA Astrophysics Data System (ADS)

    Capehart, Cheryl Louise

    Purpose of the study. This study examined Rural K--12 Texas districts to investigate whether science achievement could serve as a gauge to measure the availability and quality of rigorous educational opportunities in Rural Texas districts. Procedure. A Case II criterion-group design was used; 2 groups of districts were selected based on their 3-year performances on the 8th grade Science Texas Assessment of Academic Skills (TAAS)---the statewide criterion-referenced test. The High Performing Group (HPG) was composed of 30 top performing districts; the Low Performing Group (LPG) was composed of 30 lowest performing districts. Data collection was limited to archived quantitative data from Texas Education Agency's open records. Achievement variables were percent passing (1) Science TASS, (2) Biology End-of-Course (EoC) test and (3) the composite passing all Reading, Writing, and Mathematics TAAS. Academic variables were percent participating in (1) advanced courses, (2) rigorous graduation programs, and (3) college entrance examinations. District quality indicators also included 3 budget variables: (1) average teacher salary, (2) per pupil instructional expenditure, (3) percent allocated for instructional leadership; and 4 staff variables: (1) percent teachers fully certified, (2) percent teachers with advanced degrees, (3) average years teacher experience, (4) average percent non-turnover of teachers. One score per variable was obtained for each district. The HPG and LPG were compared on each variable using the group means, standard deviations, standard errors of the mean, Levene's test for equality of variance, and a t test for equality of means with a 95% confidence level. The Pearson correlation with two-tailed significance calculated the relationship of each independent variable (budget and staff factors) to each dependent variable (performance measures). Science TASS and a Combined Science score (grand mean of Science TASS & Biology EoC passing rates) were

  13. Biomass District Heat System for Interior Rural Alaska Villages

    SciTech Connect

    Wall, William A.; Parker, Charles R.

    2014-09-01

    Alaska Village Initiatives (AVI) from the outset of the project had a goal of developing an integrated village approach to biomass in Rural Alaskan villages. A successful biomass project had to be ecologically, socially/culturally and economically viable and sustainable. Although many agencies were supportive of biomass programs in villages none had the capacity to deal effectively with developing all of the tools necessary to build a complete integrated program. AVI had a sharp learning curve as well. By the end of the project with all the completed tasks, AVI developed the tools and understanding to connect all of the dots of an integrated village based program. These included initially developing a feasibility model that created the capacity to optimize a biomass system in a village. AVI intent was to develop all aspects or components of a fully integrated biomass program for a village. This meant understand the forest resource and developing a sustainable harvest system that included the “right sized” harvest equipment for the scale of the project. Developing a training program for harvesting and managing the forest for regeneration. Making sure the type, quality, and delivery system matched the needs of the type of boiler or boilers to be installed. AVI intended for each biomass program to be of the scale that would create jobs and a sustainable business.

  14. What keeps health professionals working in rural district hospitals in South Africa?

    PubMed Central

    Gunst, Colette; Blitz, Julia; Coetzee, Johan F.

    2015-01-01

    Background The theme of the 2014 Southern African Rural Health Conference was ‘Building resilience in facing rural realities’. Retaining health professionals in South Africa is critical for sustainable health services. Only 12% of doctors and 19% of nurses have been retained in the rural areas. The aim of the workshop was to understand from health practitioners why they continued working in their rural settings. Conference workshop The workshop consisted of 29 doctors, managers, academic family physicians, nurses and clinical associates from Southern Africa, with work experience from three weeks to 13 years, often in deep rural districts. Using the nominal group technique, the following question was explored, ‘What is it that keeps you going to work every day?’ Participants reflected on their work situation and listed and rated the important reasons for continuing to work. Results Five main themes emerged. A shared purpose, emanating from a deep sense of meaning, was the strongest reason for staying and working in a rural setting. Working in a team was second most important, with teamwork being related to attitudes and relationships, support from visiting specialists and opportunities to implement individual clinical skills. A culture of support was third, followed by opportunities for growth and continuing professional development, including teaching by outreaching specialists. The fifth theme was a healthy work-life balance. Conclusion Health practitioners continue to work in rural settings for often deeper reasons relating to a sense of meaning, being part of a team that closely relate to each other and feeling supported. PMID:26245623

  15. Endoparasitic infections in dogs from rural areas in the Lobos District, Buenos Aires province, Argentina.

    PubMed

    Dopchiz, Marcela Cecilia; Lavallén, Carla Mariela; Bongiovanni, Roberto; Gonzalez, Patricia Verónica; Elissondo, Celina; Yannarella, Francisco; Denegri, Guillermo

    2013-01-01

    Dogs are definite hosts for several zoonotic helminthes and protozoan. Rural areas from the Lobos District in the northeast of Buenos Aires province, Argentina, are mainly used for livestock activity, increasing in this way the number of dogs on farms as well as the human risk of parasitic infections. The aims of this research were to evaluate the endoparasitic infections in dogs from farms in the Lobos District and analyze their zoonotic importance as well as several risk practices and habits of the rural population. Forty-two dog fecal samples obtained in 21 farms were analyzed through coproparasitological methods and coproantigen tests, which resulted in an overall parasite prevalence of 69.05% and 80.95% of the parasitized farms. The most frequent parasites were Trichuris vulpis and Eucoleus aerophila (26.19%), Echinococcus granulosus (19.05%), Uncinaria stenocephala and coccids (14.29%). The analysis of epidemiological files showed several habits of the rural population considered as risk factors associated with the presence of fecal samples parasitized and the presence of E. granulosus on the farms. It is clear that people involved with the farms studied were exposed to several helminthes that could cause serious diseases like cystic echinococcosis, which can become an important public health issue and affect the economy worldwide. PMID:23538502

  16. Individual and district-level predictors of alcohol use: cross sectional findings from a rural mental health survey in Australia

    PubMed Central

    2012-01-01

    Background Excessive alcohol use is a significant problem in rural and remote Australia. The factors contributing to patterns of alcohol use have not been adequately explained, yet the geographic variation in rates suggests a potential contribution of district-level factors, such as socio-economic disadvantage, rates of population change, environmental adversity, and remoteness from services/population centres. This paper aims to investigate individual-level and district-level predictors of alcohol use in a sample of rural adults. Methods Using baseline survey data (N = 1,981) from the population-based Australian Rural Mental Health Study of community dwelling residents randomly selected from the Australia electoral roll, hierarchal logistic regression models were fitted for three outcomes: 1) at-risk alcohol use, indicated by Alcohol Use Disorders Identification Test scores ≥8; 2) high alcohol consumption (> 40 drinks per month); and 3) lifetime consequences of alcohol use. Predictor variables included demographic factors, pre-dispositional factors, recent difficulties and support, mental health, rural exposure and district-level contextual factors. Results Gender, age, marital status, and personality made the largest contribution to at-risk alcohol use. Five or more adverse life events in the past 12 months were also independently associated with at-risk alcohol use (Adjusted Odds Ratio [AOR] 3.3, 99%CI 1.2, 8.9). When these individual-level factors were controlled for, at-risk alcohol use was associated with having spent a lower proportion of time living in a rural district (AOR 1.7, 99%CI 1.3, 2.9). Higher alcohol consumption per month was associated with higher district-level socio-economic ranking, indicating less disadvantage (AOR 1.2, 99%CI 1.02, 1.4). Rural exposure and district-level contextual factors were not significantly associated with lifetime consequences of alcohol use. Conclusions Although recent attention has been directed towards the

  17. Infant mortality in a rural health district in Georgia, 1974 to 1981.

    PubMed

    Buehler, J W; McCarthy, B J; Holloway, J T; Sikes, R K

    1986-04-01

    In 1979 the infant mortality rate (IMR) dropped nearly 50% in a rural health district in southeast Georgia, and this lower rate continued during the next two years. For infants born during 1979 to 1981, the IMR was 12.4 as compared with 21.6 for those born from 1974 to 1978. Using linked birth and infant death records to identify shifts in the components of infant mortality in this district, we found that the change in IMR primarily reflected a decrease in neonatal and postneonatal deaths among infants with birth weight greater than or equal to 2,500 gm, rather than a change in the distribution of birth weights. Although the IMR was approximately twofold higher in white than in black infants, a similar relative decline in mortality was observed in both racial groups. For infants weighing greater than or equal to 2,500 gm, approximately half of the lower death rate was due to fewer deaths caused by infections. The decline in mortality in this district was greater than declines in neighboring districts and accompanied efforts to improve services for medically indigent mothers and infants. The findings suggest that in areas with high infant mortality, initial efforts to lower mortality should focus on primary care programs rather than more specialized interventions. PMID:3704703

  18. Psychosocial assessment of lathyrism patients in rural Estie district of South Gondar, northern Ethiopia.

    PubMed

    Getahun, H; Haimanot, R T

    1998-01-01

    Three hundred and thirty three patients in the lathyrism endemic rural Estie district of Northern Ethiopia were interviewed and examined to assess the psychosocial impacts of neurolathyrism. The majority of the affected were in the age group of 11-20 years (43%) followed by 21-30 years (29%). Males were more affected than females (4.8:1). Peak occurrences of neurolathyrism was observed at time of mobilization of the population in villagization and land diversification schemes. Females were affected to lesser extent and at an earlier age than males. Neurolathyrism affected matrimony among the rural farming population where marriage is considered as the most significant social achievement of any young member of the society. Divorce rate due to paralysis was 28%. It also influenced the choice of occupation among the afflicted rural people. Many males went into ecclesiastical professions. A significant number of males also took up occupations which traditionally were considered to be exclusively for women like basketry and embroidery. More females, not withstanding their age, were engaged in cattle-keeping. During the study, the rural communities were made aware of the association of neurolathyrism and consumptions of grass pea seed. It is believed that this step will enable communities to use home-based detoxifying methods and resort to alternate crops during times of food shortage. PMID:10214443

  19. Governing the implementation of Emergency Obstetric Care: experiences of Rural District Health Managers, Tanzania

    PubMed Central

    2014-01-01

    Background Many health policies developed internationally often become adopted at the national level and are implemented locally at the district level. A decentralized district health system led by a district health management team becomes responsible for implementing such policies. This study aimed at exploring the experiences of a district health management team in implementing Emergency Obstetric Care (EmOC) related policies and identifying emerging governance aspects. Methods The study used a qualitative approach in which data was obtained from thirteen individual interviews and one focus group discussion (FGD). Interviews were conducted with members of the district health management team, district health service boards and NGO representatives. The FGD included key informants who were directly involved in the work of implementing EmOC services in the district. Documentary reviews and observation were done to supplement the data. All the materials were analysed using a qualitative content analysis approach. Results Implementation of EmOC was considered to be a process accompanied by achievements and challenges. Achievements included increased institutional delivery, increased number of ambulances, training service providers in emergency obstetric care and building a new rural health centre that provides comprehensive emergency obstetric care. These achievements were associated with good leadership skills of the team together with partnerships that existed between different actors such as the Non-Governmental Organization (NGO), development partners, local politicians and Traditional Birth Attendants (TBAs). Most challenges faced during the implementation of EmOC were related to governance issues at different levels and included delays in disbursement of funds from the central government, shortages of health workers, unclear mechanisms for accountability, lack of incentives to motivate overburdened staffs and lack of guidelines for partnership development

  20. Why Rural Community Day Secondary Schools Students' Performance in Physical Science Examinations Is Poor in Lilongwe Rural West Education District in Malawi

    ERIC Educational Resources Information Center

    Mlangeni, Angstone Noel J. Thembachako; Chiotha, Sosten Staphael

    2015-01-01

    A study was conducted to investigate factors that affect students' poor performance in physical science examinations at Malawi School Certificate of Education and Junior Certificate of Education levels in Community day secondary schools (CDSS) in Lilongwe Rural West Education District in Malawi. Students' performance was collected from…

  1. Learning and Community Transition in the Lakes District Rural Dialogue. Rural Dialogue Summary Report (Burns Lake, British Columbia, Canada, March 29, 2006)

    ERIC Educational Resources Information Center

    Canadian Rural Partnership, 2006

    2006-01-01

    This report is a summary of discussions that took place at the Learning and Community Transition, Lakes District Rural Dialogue, held in Burns Lake, British Columbia, on March 29, 2006. This dialogue emerged further to a meeting of northern federal representatives which was organized to better coordinate federal support for northern B.C.…

  2. Dental caries management at a rural district hospital in northern Rwanda: a neglected disease

    PubMed Central

    Uzabakiriho, B.; Amoroso, C. L.; Mpunga, T.; Odhiambo, J.; Mukashema, P.; Seymour, B. A.; Sindayigaya, J. de D.; Hedt-Gauthier, B. L.

    2015-01-01

    Setting: While some studies have reported the prevalence of dental caries in sub-Saharan Africa, little is known about care-seeking behavior or how dental caries are managed, particularly at rural district hospitals. Objective: To describe the management of patients seeking care for dental caries at Butaro District Hospital (BDH) in rural Rwanda. Design: This cross-sectional descriptive study was conducted in BDH, in northern Rwanda. A sample of 287 patient encounters for dental caries between January and December 2013 was randomly selected and stratified by age group (⩽5 years, 6–21 years and >21 years). We estimated the treatment received with 95% confidence intervals in each age group, and differences between age groups were assessed using Fisher's exact test. Results: Nearly all patients (97.6%) underwent tooth extraction, and this did not vary significantly by age group (P = 0.558). In addition to dental caries, most patients also had chronic pulpitis (74.9%). Conclusion: Caries prevention and care should be prioritized through a developed community program on oral health. We recommend introducing advanced training, equipment and materials for dental caries management other than tooth extraction, and increasing the number of qualified dentists. PMID:26399283

  3. In vitro antimicrobial assay of plants used in traditional medicine in Bukoba Rural district, Tanzania.

    PubMed

    Kisangau, D P; Hosea, K M; Joseph, C C; Lyaruu, H V M

    2007-01-01

    Plants used in traditional medicine in Bukoba Rural district in Tanzania were evaluated for their in vitro antimicrobial activities. Plant materials from eight plant species (Harungana madagascariensis (Lam) Poir., Jatropha curcas L., Lantana trifolia L., Plectranthus barbatus Andr., Pseudospondias microcarpa Engl., Psorospermum febrifugum Spach, Teclea nobilis Del. and Vernonia adoensis [Warp.] SL) were collected based on ethnomedical information provided by traditional herbal practitioners. Results of the study indicate that extracts from the eight plant species were active against at least one or more of the test organisms (Bacillus subtilis, Staphylococcus aureus [gram positive], Escherichia coli, Pseudomonas aeruginosa [gram negative] and Candida albicans [Yeast]). A profile of secondary metabolites (alkaloids, terpenoids, triterpenes, phenolics, tannins, flavonoids, anthraquinones, flavonols/flavones and /or chalcones, sterols and saponins) was obtained for three plant species (Jatropha curcas L., Plectranthus barbatus Andr., and Pseudospondias microcarpa Engl.). The paper discusses the probable therapeutic basis of these traditional plants based on their secondary metabolite profiles and for the first time draws research attention to Bukoba Rural district as a source for plants with potential pharmaceutical applications. PMID:20161920

  4. Prevalence of different species of Culicoides in Bangalore rural and urban districts of South India.

    PubMed

    Archana, M; D'Souza, Placid E; Renuka Prasad, C; Byregowda, S M

    2016-09-01

    A study was conducted to observe the prevalence of Culicoides a biting midge, important pest and prime vector for various viruses, protozoa and filarid worms. In the vicinity of 11 different farms of cattle, buffalo, sheep and goats in Bangalore rural and urban districts the flies were collected by using UV traps (Onderstepoort Veterinary Institute. ARC. LNR) connected with suction fan for the period of 1 year (2012-2013). Around 83,629 Culicoides were collected of which 77,906 (93.16 %) were female and 5,723 (6.84 %) were males and 40,120 (47.97 %) of C. imicola, 39,366 (47.07 %) C. oxystoma, 2,504 (2.99 %) C. actoni, 1,145 (1.37 %) C. peregrinus, 145 (0.17 %) C. huffi, 120 (0.16 %) C. innoxius, 90 (0.11 %) C. palpifer, 67 (0.08 %) C. anopheles, 37 (0.04 %) C. circumscriptus and 25 (0.03 %) were C. arakawae. It was observed that C. imicola and C. oxystoma were the most predominant species prevalent in Bangalore rural and urban districts of Karnataka. PMID:27605753

  5. Prevalence of Gingivitis among Children of Urban and Rural Areas of Bhopal District, India

    PubMed Central

    Reddy, Venugopal; Bhambal, Ajay; Agrawal, Rohit

    2014-01-01

    Background: Gingivitis is inflammation of the soft tissue without apical migration of the junctional epithelium. Redness, oedema and bleeding on probing characterize this condition. Untreated cases may lead to a more complex and destructive entity known as chronic periodontitis. Periodontitis are the main cause of tooth loss. Poor oral health has thus the potential of hampering the quality of life. So the aim of this study was to find the prevalence of gingivitis, among school-going children of urban and rural areas of Bhopal district, India. Materials and Methods: The present descriptive, cross-sectional study was conducted among 12 & 15 y old middle and high school government rural and urban school children of Bhopal district. It was conducted of a period of two months. 1100 Children were examined by using WHO (modified) oral health assessment form, Loe and Silness index was used for recording gingival status. For statistical analysis SPSS version 20 was used. The chi-square test was applied for categorical data. p<0.05 was considered statistically significant. Results: Prevalence of gingivitis was 59% found. 584 (53.09 %) children had mild gingivitis,61(5.5%) children had moderate gingivitis. Conclusion: This indicates the need for community health activities and awareness program. PMID:25584317

  6. Using Community Informants to Estimate Maternal Mortality in a Rural District in Pakistan: A Feasibility Study

    PubMed Central

    Shaikh, Mohammad Saleem; Qomariyah, Siti Nurul; Rashida, Gul; Khan, Mumraiz; Masood, Irfan

    2015-01-01

    Background. We aimed to assess the feasibility of using community-based informants' networks to identify maternal deaths that were followed up through verbal autopsies (MADE-IN MADE-FOR technique) to estimate maternal mortality in a rural district in Pakistan. Methods. We used 4 community networks to identify deaths in women of reproductive age in the past 2 years in Chakwal district, Pakistan. The deaths recorded by the informants were followed up through verbal autopsies. Results. In total 1,143 Lady Health Workers (government employees who provide primary health care), 1577 religious leaders, 20 female lady councilors (elected representatives), and 130 nikah registrars (persons who register marriages) identified 2001 deaths in women of reproductive age. 1424 deaths were followed up with verbal autopsies conducted with the relatives of the deceased. 169 pregnancy-related deaths were identified from all reported deaths. Through the capture-recapture technique probability of capturing pregnancy-related deaths by LHWs was 0.73 and for religious leaders 0.49. Maternal mortality in Chakwal district was estimated at 309 per 100,000 live births. Conclusion. It is feasible and economical to use community informants to identify recent deaths in women of reproductive age and, if followed up through verbal autopsies, obviate the need for conducting large scale surveys. PMID:25741446

  7. Access to Educational Opportunity in Rural Communities: Alternative Patterns of Delivering Vocational Education in Sparsely Populated Areas. Volume 3: The Northwest Multi-District: A Mobile Facilities Center.

    ERIC Educational Resources Information Center

    Peterson, Roland L.; And Others

    Representing the mobile facilities pattern of inter-district cooperation, the Northwest Multi-District case is one of four studies addressing access of rural students to vocational education through inter-school district cooperation. The report identifies essential features of this form of cooperation, details factors facilitating/impeding the…

  8. Urban versus rural: fertility decline in the cities and rural districts of Prussia, 1875 to 1910.

    PubMed

    Galloway, P R; Lee, R D; Hammel, E A

    1998-09-01

    This study examined the level and pace of fertility decline in 54 large cities in Prussia during 1875-1910. Data were obtained from census records for 1875, 1880, 1885, 1890, 1895, 1900, 1905, and 1910. Analysis was based on pooled cross sectional time series methods and theories that structural socioeconomic change was a key factor in the decline of fertility in Prussian cities. During 1875-1910, city population grew from 3.8 to 9.6 million. The general marital fertility rate (GMFR) in the 54 cities declined from 281 to 164 during 1875-1910. Catholicism, female labor force participation (FLFP), manufacturing, mining, banking, and communication were statistically positively related to urban fertility level. Pace of decline was related significantly to language, education, FLFP, income, communications, insurance, population size, infant mortality, and married sex ratio. Population size was related to pace but not level. Education and banking had a stronger impact in rural areas. In the city equation, the variables plus dummies accounted for 90% of the variance. A very important variable explaining change in fertility level in Prussia was Catholicism. The most important variables for explaining fertility change in Prussia were infant mortality rate and insurance. Infant mortality, communications, insurance, and income increased in importance over time. FLFP declined over time, but contributed the most to predicted change in GMFR throughout the period, especially in nontraditional occupations. The analysis explained both rapid and slow urban fertility declines and closely approximated predicted fertility. Prussia differs from present developing country contexts in that the population was largely agrarian but literate. PMID:12158982

  9. Do Schools in Rural and Nonrural Districts Allocate Resources Differently? An Analysis of Spending and Staffing Patterns in the West Region States. Summary. Issues & Answers. REL 2011-No. 099

    ERIC Educational Resources Information Center

    Levin, Jesse; Manship, Karen; Chambers, Jay; Johnson, Jerry; Blankenship, Charles

    2011-01-01

    This report presents the first detailed comparison of resource allocation between rural and nonrural districts in the West Region. Three regional characteristics often associated with rural districts were chosen for the analysis: district enrollment, student population density within a district (students per square mile), and drive time from the…

  10. Systemic Reform in Six Rural Districts: A Case Study of First Reactions to the Kentucky Education Reform Act of 1990.

    ERIC Educational Resources Information Center

    Coe, Pamelia; Kannapel, Patricia

    The Kentucky Education Reform Act (KERA) of 1990 was adopted after the Kentucky Supreme Court declared the state's system of schools unconstitutional. The purpose of this study was to identify the sources of information about KERA and to describe community attitudes toward KERA in rural Kentucky school districts during the first few months the law…

  11. Examining the Effectiveness of a Multi-Sensory Instructional Reading Program in One Rural Midwestern School District

    ERIC Educational Resources Information Center

    Waldvogel, Steven John

    2010-01-01

    Scope and method of study: The purpose of this research study was to examine the effectiveness of an (IMSE) Orton-Gillingham based multi-sensory instructional reading program when incorporated with kindergarten through first grade classroom reading instruction in one rural Midwestern school district. The IMSE supplemental reading program is…

  12. Rural School Districts and the Fight for Funding Adequacy: The Legal Challenge of "CASFG v. State of Georgia"

    ERIC Educational Resources Information Center

    Cornelius, Luke M.; Robinson, Charlotte Bunn

    2006-01-01

    On June 23, 2005, oral arguments were heard in the Fulton County Superior Court in the first round of Georgia's current school finance litigation, "CASFG v. State of Georgia." The hearing was on the state's motion to dismiss the action by a coalition of rural school districts, parents, and students. Four months later Senior Judge Elizabeth Long…

  13. Educational Leadership to Create Authentic Inclusive Schools: The Experiences of Principals in a Canadian Rural School District

    ERIC Educational Resources Information Center

    Irvine, Angela; Lupart, Judy; Loreman, Tim; McGhie-Richmond, Donna

    2010-01-01

    Inclusive education--based on the premise of social justice--advocates equal access to educational opportunities for all students. This research provides insight into the inclusive experiences of school principals in a Canadian rural school district through quantitative and qualitative inquiries. A survey was administered to 16 school…

  14. Integration of Interactive Whiteboards within Classroom Instruction in a Small, Rural School District in the Southeastern United States

    ERIC Educational Resources Information Center

    Stewart, Stacy Denise

    2013-01-01

    The purpose of this study was to identify the extent IWB integration occurs in instruction and its impact on student engagement in a small, rural school district in the southeastern United States. A study was conducted in core subject areas across K-12 grade spans involving 50 teachers using a mixed methods approach. Teachers were observed twice…

  15. Educational Opportunities of Rural Consolidation: Final Report of District-Wide Opinion Survey--Title III, ESEA Project.

    ERIC Educational Resources Information Center

    Olympia Community Unit District 16, Minier, IL.

    In March 1973, a door-to-door District census was directed by the Olympia Title III, Elementary and Secondary Education Act (ESEA) Project Office (Illinois). Assisted by the Olympia Citizens Advisory Council and over 300 volunteers, the ESEA Office obtained population data from the census for the rural area. At the same time, a questionnaire to…

  16. A Study of the Roles and Responsibilities of Superintendent/Principals in Small, Rural School Districts in Northern California

    ERIC Educational Resources Information Center

    Geivett, Morton J., II

    2010-01-01

    Purpose. The purpose of this study was to identify and describe the roles and responsibilities of the superintendent/principal in small, rural school districts in northern California perceived to be the most important by the superintendent/principal. In addition, it was the purpose of this study to identify the challenges of serving as the…

  17. Rural-Urban Differences in Household Treatment-Seeking Behaviour for Suspected Malaria in Children at Bata District, Equatorial Guinea

    PubMed Central

    Romay-Barja, Maria; Jarrin, Inma; Ncogo, Policarpo; Nseng, Gloria; Sagrado, Maria Jose; Santana-Morales, Maria A.; Aparcio, Pilar; Valladares, Basilio; Riloha, Matilde; Benito, Agustin

    2015-01-01

    Background Malaria remains a major cause of morbidity and mortality among children under five years old in Equatorial Guinea. However, little is known about the community management of malaria and treatment-seeking patterns. We aimed to assess symptoms of children with reported malaria and treatment-seeking behaviour of their caretakers in rural and urban areas in the Bata District. Methodology A cross-sectional study was conducted in the district of Bata and 440 houses were selected from 18 rural villages and 26 urban neighbourhoods. Differences between rural and urban caregivers and children with reported malaria were assessed through the chi-squared test for independence of categorical variables and the t-Student or the non-parametric Mann-Whitney test for normally or not-normally distributed continuous variables, respectively. Results Differences between rural and urban households were observed in caregiver treatment-seeking patterns. Fever was the main symptom associated with malaria in both areas. Malaria was treated first at home, particularly in rural areas. The second step was to seek treatment outside the home, mainly at hospital and Health Centre for rural households and at hospital and private clinic for urban ones. Artemether monotherapy was the antimalarial treatment prescribed most often. Households waited for more than 24 hours before seeking treatment outside and delays were longest in rural areas. The total cost of treatment was higher in urban than in rural areas in Bata. Conclusions The delays in seeking treatment, the type of malaria therapy received and the cost of treatment are the principal problems found in Bata District. Important steps for reducing malaria morbidity and mortality in this area are to provide sufficient supplies of effective antimalarial drugs and to improve malaria treatment skills in households and in both public and private sectors. PMID:26284683

  18. Deaths Ascribed to Non-Communicable Diseases among Rural Kenyan Adults Are Proportionately Increasing: Evidence from a Health and Demographic Surveillance System, 2003–2010

    PubMed Central

    Phillips-Howard, Penelope A.; Laserson, Kayla F.; Amek, Nyaguara; Beynon, Caryl M.; Angell, Sonia Y.; Khagayi, Sammy; Byass, Peter; Hamel, Mary J.; van Eijk, Anne M.; Zielinski-Gutierrez, Emily; Slutsker, Laurence; De Cock, Kevin M.; Vulule, John; Odhiambo, Frank O.

    2014-01-01

    Background Non-communicable diseases (NCDs) result in more deaths globally than other causes. Monitoring systems require strengthening to attribute the NCD burden and deaths in low and middle-income countries (LMICs). Data from health and demographic surveillance systems (HDSS) can contribute towards this goal. Methods and Findings Between 2003 and 2010, 15,228 deaths in adults aged 15 years (y) and older were identified retrospectively using the HDSS census and verbal autopsy in rural western Kenya, attributed into broad categories using InterVA-4 computer algorithms; 37% were ascribed to NCDs, 60% to communicable diseases (CDs), 3% to injuries, and <1% maternal causes. Median age at death for NCDs was 66y and 71y for females and males, respectively, with 43% (39% male, 48% female) of NCD deaths occurring prematurely among adults aged below 65y. NCD deaths were mainly attributed to cancers (35%) and cardio-vascular diseases (CVDs; 29%). The proportionate mortality from NCDs rose from 35% in 2003 to 45% in 2010 (χ2 linear trend 93.4; p<0.001). While overall annual mortality rates (MRs) for NCDs fell, cancer-specific MRs rose from 200 to 262 per 100,000 population, mainly due to increasing deaths in adults aged 65y and older, and to respiratory neoplasms in all age groups. The substantial fall in CD MRs resulted in similar MRs for CDs and NCDs among all adult females by 2010. NCD MRs for adults aged 15y to <65y fell from 409 to 183 per 100,000 among females and from 517 to 283 per 100,000 population among males. NCD MRs were higher among males than females aged both below, and at or above, 65y. Conclusions NCDs constitute a significant proportion of deaths in rural western Kenya. Evidence of the increasing contribution of NCDs to overall mortality supports international recommendations to introduce or enhance prevention, screening, diagnosis and treatment programmes in LMICs. PMID:25426945

  19. Better adherence to pre-antiretroviral therapy guidelines after implementing an electronic medical record system in rural Kenyan HIV clinics: a multicenter pre–post study☆

    PubMed Central

    Oluoch, Tom; Kwaro, Daniel; Ssempijja, Victor; Katana, Abraham; Langat, Patrick; Okeyo, Nicky; Abu-Hanna, Ameen; de Keizer, Nicolette

    2016-01-01

    SUMMARY Introduction The monitoring of pre-antiretroviral therapy (pre-ART) is a key indicator of HIV quality of care. This study investigated the association of an electronic medical record system (EMR) with adherence to pre-ART guidelines in rural HIV clinics in Kenya. Methods A retrospective study was carried out to assess the quality of pre-ART care using three indicators: (1) the performance of a baseline CD4 test, (2) time from enrollment in care to first CD4 test, and (3) time from baseline CD4 to second CD4 test. A comparison of these indicators was made pre and post the introduction of an EMR system in 17 rural HIV clinics. Results A total of 18 523 patients were receiving pre-ART care, of whom 38.8% in the paper group had had at least one CD4 test compared to 53.4% in the EMR group (p < 0.001). The adjusted odds of performing a CD4 test in clinics using an EMR was 1.59 (95% confidence interval 1.49–1.69). The median time from enrolment into HIV care to first CD4 test was 1.40 months (interquartile range (IQR) 0.47–4.87) for paper vs. 0.93 months (IQR 0.43–3.37) for EMR. The median time from baseline to first CD4 follow-up was 7.5 months (IQR 5.97–10.73) for paper and 6.53 months (IQR 5.57–7.87) for EMR. Conclusion The use of the EMR system was associated with better compliance to HIV guidelines for pre-ART care. EMRs have a potential positive impact on quality of care for HIV patients in resource-constrained settings. PMID:25281905

  20. The hydrochemistry of groundwater in rural communities within the Tema District, Ghana.

    PubMed

    Fianko, Joseph Richmond; Nartey, Vincent K; Donkor, Augustine

    2010-09-01

    A detailed study has been carried out on groundwater in rural communities in the Tema District of the Greater Accra region of Ghana to establish the hydrochemistry and identify the various sources of contaminants as well assess the physical and chemical quality of the groundwater to ascertain their wholesomeness and the health impacts of the groundwater on the communities. The groundwater was found to vary considerably in terms of chemical and physical properties. Generally, the water was mildly acidic (pH 4.3-7.4), brackish to fresh, and undersaturated with respect to gypsum and halite. The majority of groundwater clustered toward Ca-Mg-SO(4) and Na-Cl facies. About 70% of boreholes sampled have elevated levels of NO(3)(-) -N, Cl(-), and SO(4)(2-) emanating from anthropogenic activities. PMID:19669911

  1. Development of a scalable mental healthcare plan for a rural district in Ethiopia

    PubMed Central

    Fekadu, Abebaw; Hanlon, Charlotte; Medhin, Girmay; Alem, Atalay; Selamu, Medhin; Giorgis, Tedla W.; Shibre, Teshome; Teferra, Solomon; Tegegn, Teketel; Breuer, Erica; Patel, Vikram; Tomlinson, Mark; Thornicroft, Graham; Prince, Martin; Lund, Crick

    2016-01-01

    Background Developing evidence for the implementation and scaling up of mental healthcare in low- and middle-income countries (LMIC) like Ethiopia is an urgent priority. Aims To outline a mental healthcare plan (MHCP), as a scalable template for the implementation of mental healthcare in rural Ethiopia. Method A mixed methods approach was used to develop the MHCP for the three levels of the district health system (community, health facility and healthcare organisation). Results The community packages were community case detection, community reintegration and community inclusion. The facility packages included capacity building, decision support and staff well-being. Organisational packages were programme management, supervision and sustainability. Conclusions The MHCP focused on improving demand and access at the community level, inclusive care at the facility level and sustainability at the organisation level. The MHCP represented an essential framework for the provision of integrated care and may be a useful template for similar LMIC. PMID:26447174

  2. Menstrual Needs and Associations with Sexual and Reproductive Risks in Rural Kenyan Females: A Cross-Sectional Behavioral Survey Linked with HIV Prevalence

    PubMed Central

    Otieno, George; Burmen, Barbara; Otieno, Frederick; Odongo, Frederick; Odour, Clifford; Nyothach, Elizabeth; Amek, Nyanguara; Zielinski-Gutierrez, Emily; Odhiambo, Frank; Zeh, Clement; Kwaro, Daniel; Mills, Lisa A.; Laserson, Kayla F.

    2015-01-01

    Abstract Background: Females in low and middle income countries (LMICs) have difficulty coping with menstrual needs, but few studies have examined the social or health implications of these needs. Methods: Responses from 3418 menstruating females aged 13–29 years were extracted from an HIV and behavioral risks cross-sectional survey conducted in rural western Kenya. We examined sanitary products used, provision of products from sexual partners or from transactional sex, and demographic and sexual exposures. Results: Overall, 75% of females reported using commercial pads and 25% used traditional materials such as cloth or items like paper or tissue, with 10% of girls <15 years old depending on makeshift items. Two-thirds of females with no education relied on traditional items. Having attended secondary school increased the odds of using commercial pads among married (adjusted odds ratios [AOR] 4.8, 95% confidence interval [CI] 3.25–7.12) and single females (AOR 2.17, 95% CI 1.04–4.55). Married females had lower odds of pad use if they reported early (<12 years of age) compared with later (≥18 years) sexual debut (64% vs. 78%, AOR 0.45, 95% CI 0.21–0.97). Two-thirds of pad users received them from sexual partners. Receipt was lower among married females if partners were violent (AOR 0.67, 95% CI 0.53–0.85). Receipt among single females was higher if they had two or more sexual partners in the past year (AOR 2.11, 95% CI 1.04–4.29). Prevalence of engaging in sex for money to buy pads was low (1.3%); however, 10% of 15-year-olds reported this, with girls ≤15 having significantly higher odds compared with females over 15 (AOR 2.84, 95% CI 0.89–9.11). The odds of having transactional sex for pads was higher among females having two or more partners in the past 12 months (AOR 4.86, 95% CI 2.06–11.43). Conclusions: Menstrual needs of impoverished females in rural LMICs settings likely leads to increased physical and sexual harms. Studies are required

  3. Motivation of human resources for health: a case study at rural district level in Tanzania.

    PubMed

    Zinnen, Véronique; Paul, Elisabeth; Mwisongo, Aziza; Nyato, Daniel; Robert, Annie

    2012-01-01

    An increasing number of studies explore the association between financial and non-financial incentives and the retention of health workers in developing countries. This study aims to contribute to empirical evidence on human resource for health motivation factors to assist policy makers in promoting effective and realistic interventions. A cross-sectional survey was conducted in four rural Tanzanian districts to explore staff stability and health workers' motivation. Data were collected using qualitative and quantitative techniques, covering all levels and types of health facilities. Stability of staff was found to be quite high. Public institutions remained very attractive with better job security, salary and retirement benefits. Satisfaction over working conditions was very low owing to inadequate working equipment, work overload, lack of services, difficult environment, favouritism and 'empty promotions'. Positive incentives mentioned were support for career development and supportive supervision. Attracting new staff in rural areas appeared to be more difficult than retaining staff in place. The study concluded that strategies to better motivate health personnel should focus on adequate remuneration, positive working and living environment and supportive management. However, by multiplying health facilities, the latest Tanzanian human resource for health plan could jeopardize current positive results. PMID:22714251

  4. From Attitudes to Practice: Utilising Inclusive Teaching Strategies in Kenyan Primary Schools

    ERIC Educational Resources Information Center

    Elder, Brent C.; Damiani, Michelle L.; Oswago, Benson O.

    2016-01-01

    The purpose of this paper is to provide evidence of Kenyan primary school teachers using inclusive teaching strategies in a rural setting with many known barriers to the development of a sustainable inclusive education system. This qualitative study examines teachers' uses of inclusive teaching strategies in primary schools following a series of…

  5. Measuring health workers’ motivation in rural health facilities: baseline results from three study districts in Zambia

    PubMed Central

    2013-01-01

    Introduction Health worker motivation can potentially affect the provision of health services. Low morale among the workforce can undermine the quality of service provision and drive workers away from the profession. While the presence of high-quality, motivated staff is a key aspect of health system performance, it is also one of the most difficult factors to measure. Methods We assessed health worker motivation as part of the baseline assessment for a health system strengthening intervention in three rural districts in Zambia. The intervention (Better Health Outcomes Through Mentoring and Assessment (BHOMA)) aims to increase health worker motivation through training, mentoring and support. We assessed motivation by examining underlying issues grouped around relevant outcome constructs such as job satisfaction, general motivation, burnout, organization commitment, conscientiousness and timeliness that collectively measure overall levels of motivation. The tools and the concepts have been used in high-income countries and they were recently applied in African settings to measure health worker motivation. Results Female participants had the highest motivation scores (female: mean 78.5 (SD 7.8) vs male: mean (SD 7.0)). By type of worker, nurses had the highest scores while environmental health technicians had the lowest score (77.4 (SD 7.8 vs 73.2 (SD 9.3)). Health workers who had been in post longer also had higher scores (>7 months). Health workers who had received some form of training in the preceding 12 months were more likely to have a higher score; this was also true for those older than 40 years when compared to those less than 40 years of age. The highest score values were noted in conscientiousness and timeliness, with all districts scoring above 80. Conclusions This study evaluated motivation among rural health workers using a simple adapted tool to measure the concept of motivation. Results showed variation in motivation score by sex, type of health

  6. Community involvement in obstetric emergency management in rural areas: a case of Rukungiri district, Western Uganda

    PubMed Central

    2012-01-01

    Background Maternal mortality is a major public health problem worldwide especially in low income countries. Most causes of maternal deaths are due to direct obstetric complications. Maternal mortality ratio remains high in Rukungiri district, western Uganda estimated at 475 per 100,000 live births. The objectives were to identify types of community involvement and examine factors influencing the level of community involvement in the management of obstetric emergencies. Methods We conducted a descriptive study during 2nd to 28th February 2009 in rural Rukungiri district, western Uganda. A total of 448 heads of households, randomly selected from 6/11 (54.5%) of sub-counties, 21/42 (50.0%) parishes and 32/212 (15.1%) villages (clusters), were interviewed. Data were analysed using STATA version 10.0. Results Community pre-emergency support interventions available included community awareness creation (sensitization) while interventions undertaken when emergency had occurred included transportation and referring women to health facility. Community support programmes towards health care (obstetric emergencies) included establishment of community savings and credit schemes, and insurance schemes. The factors associated with community involvement in obstetric emergency management were community members being employed (AOR = 1.91, 95% CI: 1.02 - 3.54) and rating the quality of maternal health care as good (AOR = 2.22, 95% CI: 1.19 - 4.14). Conclusions Types of community involvement in obstetric emergency management include practices and support programmes. Community involvement in obstetric emergency management is influenced by employment status and perceived quality of health care services. Policies to promote community networks and resource mobilization strategies for health care should be implemented. There is need for promotion of community support initiatives including health insurance schemes and self help associations; further community sensitization by empowered

  7. Demographic and financial characteristics of school districts with low and high à la Carte sales in rural Kansas Public Schools.

    PubMed

    Nollen, Nicole L; Kimminau, Kim S; Nazir, Niaman

    2011-06-01

    Reducing à la carte items in schools-foods and beverages sold outside the reimbursable meals program-can have important implications for childhood obesity. However, schools are reluctant to reduce à la carte offerings because of the impact these changes could have on revenue. Some foodservice programs operate with limited à la carte sales, but little is known about these programs. This secondary data analysis compared rural and urban/suburban school districts with low and high à la carte sales. Foodservice financial records (2007-2008) were obtained from the Kansas State Department of Education for all public K-12 school districts (n=302). χ² and t tests were used to examine the independent association of variables to à la carte sales. A multivariate model was then constructed of the factors most strongly associated with low à la carte sales. In rural districts with low à la carte sales, lunch prices and participation were higher, lunch costs and à la carte quality were lower, and fewer free/reduced price lunches were served compared to rural districts with high à la carte sales. Lunch price (odds ratio=1.2; 95% confidence interval, 1.1 to 1.4) and free/reduced price lunch participation (odds ratio=3.0; 95% confidence interval, 1.0 to 9.8) remained in the multivariate model predicting low à la carte sales. No differences were found between urban/suburban districts with low and high à la carte sales. Findings highlight important factors to maintaining low à la carte sales. Schools should consider raising lunch prices and increasing meal participation rates as two potential strategies for reducing the sale of à la carte items without compromising foodservice revenue. PMID:21616201

  8. Hope and despair: community health assistants’ experiences of working in a rural district in Zambia

    PubMed Central

    2014-01-01

    Background In order to address the challenges facing the community-based health workforce in Zambia, the Ministry of Health implemented the national community health assistant strategy in 2010. The strategy aims to address the challenges by creating a new group of workers called community health assistants (CHAs) and integrating them into the health system. The first group started working in August 2012. The objective of this paper is to document their motivation to become a CHA, their experiences of working in a rural district, and how these experiences affected their motivation to work. Methods A phenomenological approach was used to examine CHAs’ experiences. Data collected through in-depth interviews with 12 CHAs in Kapiri Mposhi district and observations were analysed using a thematic analysis approach. Results Personal characteristics such as previous experience and knowledge, passion to serve the community and a desire to improve skills motivated people to become CHAs. Health systems characteristics such as an inclusive work culture in some health posts motivated CHAs to work. Conversely, a non-inclusive work culture created a social structure which constrained CHAs’ ability to learn, to be innovative and to effectively conduct their duties. Further, limited supervision, misconceptions about CHA roles, poor prioritisation of CHA tasks by some supervisors, as well as non- and irregular payment of incentives also adversely affected CHAs’ ability to work effectively. In addition, negative feedback from some colleagues at the health posts affected CHA’s self-confidence and professional outlook. In the community, respect and support provided to CHAs by community members instilled a sense of recognition, appreciation and belonging in CHAs which inspired them to work. On the other hand, limited drug supplies and support from other community-based health workers due to their exclusion from the government payroll inhibited CHAs’ ability to deliver services

  9. Impact and Implications of Litigation on Small Rural School Districts: A Study of Selected Western Pennsylvania Public School Superintendents' Perception and Knowledge of School Law

    ERIC Educational Resources Information Center

    Sinopoli, Henry D.

    2010-01-01

    The need for superintendents to respond correctly to the myriad of legally charged situations is vital to the success of a school district. In small rural school districts, without the benefit of extensive financial resources or large administrative bureaucracies, many of the day-to-day legal challenges are handled solely by the superintendent of…

  10. The Impact of a State Takeover on Academic Achievement, School Performance, and School Leadership in a Rural South Carolina School District

    ERIC Educational Resources Information Center

    Bishop, Janice Zissette

    2009-01-01

    This case study on the impact of a state takeover in one of South Carolina's most rural school districts ("referred to as the County School District") was completed using a quasi-experimental mixed methods design to examine the impact on academic achievement, school performance, and school leadership as a result of the South Carolina Department of…

  11. Providing Psychological Consultative Services to Students with Emotional/Behavioral Disabilities: A Collaborative Effort between Rural School Districts and a University Training Program.

    ERIC Educational Resources Information Center

    Jerez, Ric; Brady, Sharon; Cates, Dennis

    A project of Cameron University increases the availability of psychological services to rural schools in southwestern Oklahoma. Rural districts identified needs for professionals to conduct psychological evaluations, develop and help in the implementation of behavioral intervention plans, and consult with teachers regarding plan implementation and…

  12. Sustainability of donor-funded rural water supply and sanitation projects in Mbire district, Zimbabwe

    NASA Astrophysics Data System (ADS)

    Kwangware, Johnson; Mayo, Aloyce; Hoko, Zvikomborero

    The sustainability of donor-funded rural water supply and sanitation projects was assessed in Mbire district, Zimbabwe in terms of level of community participation, quality of implementation and reliability of the systems. The study was carried out through questionnaires, focus group discussions, interviews and field observations. The results show that the quality of implementation of the projects was deemed to be good and participation of the communities in project ideas initiation and choice of technology was found to be very low. Reliability of the systems was found to be very high with 97% of the boreholes in all the three wards studied being functional. Financial management mechanisms were very poor because water consumers were not willing to pay for operation and maintenance. The projects were classified as potentially sustainable with sustainability index between 5.00 and 6.67. Poor financial management mechanisms for effective borehole maintenance, poor quality of construction and lack of community participation in project planning were found to be potential threats to the sustainability of the projects. Future projects should establish the need for the service and should thus be demand driven to ensure effective participation of the water consumers and enhance project's potential for sustainability.

  13. Awareness regarding oral cancer and oral precancerous lesions among rural population of Belgaum district, India.

    PubMed

    Sankeshwari, Roopali; Ankola, Anil; Hebbal, Mamata; Muttagi, Sidramesh; Rawal, Nilam

    2016-09-01

    Belgaum district of Karnataka state is well known for high production and consumption of tobacco in Southern India. This study aimed to investigate the rural population's awareness of oral cancer, precancerous lesions and their risk factors. Data were collected via face to face interviews using a pretested and validated questionnaire. The questionnaire comprised two parts: part one had questions concerning socio-demographic data and part two consisted of 25 questions pertaining to people's attitudes to and awareness of risk factors for oral cancer and precancerous lesions. One researcher interviewed participants and recorded the responses verbatim. Of the participants, 17% identified all the symptoms of oral cancer and 27.8% identified all the symptoms of oral precancerous lesions. Approximately 90% of the participants had never noticed statutory warnings on tobacco and alcohol products. Awareness was especially poor in people of lower socio-economic status. This study highlights a need for education concerning the risk factors for oral cancer, its clinical manifestations and the impact of adverse habits on long term health. Health education campaigns emphasizing oral cancer need to be integrated with broader public health messages. PMID:25758170

  14. Using photovoice to examine community level barriers affecting maternal health in rural Wakiso district, Uganda.

    PubMed

    Musoke, David; Ekirapa-Kiracho, Elizabeth; Ndejjo, Rawlance; George, Asha

    2015-05-01

    Uganda continues to have poor maternal health indicators including a high maternal mortality ratio. This paper explores community level barriers affecting maternal health in rural Wakiso district, Uganda. Using photovoice, a community-based participatory research approach, over a five-month period, ten young community members aged 18-29 years took photographs and analysed them, developing an understanding of the emerging issues and engaging in community dialogue on them. From the study, known health systems problems including inadequate transport, long distance to health facilities, long waiting times at facilities and poor quality of care were confirmed, but other aspects that needed to be addressed were also established. These included key gender-related determinants of maternal health, such as domestic violence, low contraceptive use and early teenage pregnancy, as well as problems of unclean water, poor sanitation and women's lack of income. Community members appreciated learning about the research findings precisely hence designing and implementing appropriate solutions to the problems identified because they could see photographs from their own local area. Photovoice's strength is in generating evidence by community members in ways that articulate their perspectives, support local action and allow direct communication with stakeholders. PMID:26278841

  15. [Research of the Stormwater Runoff and Pollution Characteristics in Rural Area of Yuhang District, Hangzhou].

    PubMed

    Duan, Sheng-hui; Zhao, Yu; Shan, Bao-qing; Tang, Wen-zhong; Zhang, Wen-qiang; Zhang, Shu-zhen; Lang, Chao

    2015-10-01

    In order to investigate the pollution characteristics of stormwater runoff in the southern developed rural region, the runoff samples were collected from four different underlying surfaces during three storm events in Caoqiao and Pujia Tou, which are two typical villages and are located in Yuhang District of Hangzhou. The content of nutrition (nitrogen and phosphorus) and heavy metals (Mn, Cu, Zn, Ni, Cr, Cd, As, Pb) in the simples were analyzed, and the difference of EMC ( event mean concentration) and pollution load of the contaminants in the runoff on different underlying surfaces were compared. The results showed that the EMC of TSS, COD, NH4(+)-N, TP and TN were 16.19, 21.01, 0.74, 1.39 and 2.39 mg x L(-1) in the Caoqiao, respectively; as to Pujia Tou, they were 3.10, 15.69, 0.90, 0.78 and 3.58 mg x L(-1), respectively. The content of heavy metals was all lower than the national surface water quality of two type water in the runoff. Compared with the quality standards for surface water, the EMC of TP was 9 times and 3. 5 times higher and TN was 1. 8 times and 1. 2 times higher in two areas. Besides, the pollution loads of TSS and COD were the highest in farmland. PMID:26841601

  16. Examining the relationship between school district size and science achievement in Texas including rural school administrator perceptions of challenges and solutions

    NASA Astrophysics Data System (ADS)

    Mann, Matthew James

    Rural and small schools have almost one-third of all public school enrollment in America, yet typically have the fewest financial and research based resources. Educational models have been developed with either the urban or suburban school in mind, and the rural school is often left with no other alternative except this paradigm. Rural based educational resources are rare and the ability to access these resources for rural school districts almost non-existent. Federal and state based education agencies provide some rural educational based programs, but have had virtually no success in answering rural school issues. With federal and state interest in science initiatives, the challenge that rural schools face weigh in. To align with that focus, this study examined Texas middle school student achievement in science and its relationship with school district enrollment size. This study involved a sequential transformative mixed methodology with the quantitative phase driving the second qualitative portion. The quantitative research was a non-experimental causal-comparative study conducted to determine whether there is a significant difference between student achievement on the 2010 Texas Assessment of Knowledge and Skills 8 th grade science results and school district enrollment size. The school districts were distributed into four categories by size including: a) small districts (32-550); b) medium districts (551-1500); c) large districts (1501-6000); and d) mega-sized districts (6001-202,773). A one-way analysis of variance (ANOVA) was conducted to compare the district averages from the 2010 TAKS 8th grade science assessment results and the four district enrollment groups. The second phase of the study was qualitative utilizing constructivism and critical theory to identify the issues facing rural and small school administrators concerning science based curriculum and development. These themes and issues were sought through a case study method and through use of semi

  17. Cost Evaluation of Reproductive and Primary Health Care Mobile Service Delivery for Women in Two Rural Districts in South Africa

    PubMed Central

    Schnippel, Kathryn; Lince-Deroche, Naomi; van den Handel, Theo; Molefi, Seithati; Bruce, Suann; Firnhaber, Cynthia

    2015-01-01

    Background Cervical cancer screening is a critical health service that is often unavailable to women in under-resourced settings. In order to expand access to this and other reproductive and primary health care services, a South African non-governmental organization established a van-based mobile clinic in two rural districts in South Africa. To inform policy and budgeting, we conducted a cost evaluation of this service delivery model. Methods The evaluation was retrospective (October 2012–September 2013 for one district and April–September 2013 for the second district) and conducted from a provider cost perspective. Services evaluated included cervical cancer screening, HIV counselling and testing, syndromic management of sexually transmitted infections (STIs), breast exams, provision of condoms, contraceptives, and general health education. Fixed costs, including vehicle purchase and conversion, equipment, operating costs and mobile clinic staffing, were collected from program records and public sector pricing information. The number of women accessing different services was multiplied by ingredients-based variable costs, reflecting the consumables required. All costs are reported in 2013 USD. Results Fixed costs accounted for most of the total annual costs of the mobile clinics (85% and 94% for the two districts); the largest contributor to annual fixed costs was staff salaries. Average costs per patient were driven by the total number of patients seen, at $46.09 and $76.03 for the two districts. Variable costs for Pap smears were higher than for other services provided, and some services, such as breast exams and STI and tuberculosis symptoms screening, had no marginal cost. Conclusions Staffing costs are the largest component of providing mobile health services to rural communities. Yet, in remote areas where patient volumes do not exceed nursing staff capacity, incorporating multiple services within a cervical cancer screening program is an approach to

  18. Factors Influencing Teacher Job Satisfaction and Their Alignment with Current District Practices in a Rural School District

    ERIC Educational Resources Information Center

    Wallace, Taneal Marie

    2010-01-01

    School districts' decisions across the country are influencing the satisfaction level of teachers, in both positive and negative ways. With statistics reporting as high as fifty percent of teachers leaving the profession in the first five years of experience (Ingersoll, 2003), determining the reasons for teacher dissatisfaction are important in…

  19. Tracing the Development of a Rural University-District Partnership: Encouraging District Voice and Challenging Assumptions Leadership

    ERIC Educational Resources Information Center

    Myran, Steve; Sanzo, Karen L.; Clayton, Jennifer

    2011-01-01

    The increase in accountability on both preK-12 districts and institutes of higher education has heightened the demands for partnerships between the two. Such programs have the ability to provide contextually focused, meaningful experiences by combining the theory and research knowledge of university faculty with the practical experience of…

  20. Dietary Patterns and Household Food Insecurity in Rural Populations of Kilosa District, Tanzania

    PubMed Central

    Ntwenya, Julius Edward; Kinabo, Joyce; Msuya, John; Mamiro, Peter; Majili, Zahara Saidi

    2015-01-01

    Introduction Few studies have investigated the relationship between dietary pattern and household food insecurity. The objective of the present analysis was to describe the food consumption patterns and to relate these with the prevalence of food insecurity in the context of a rural community. Methodology Three hundred and seven (307) randomly selected households in Kilosa district participated in the study. Data were collected during the rainy season (February–May) and post harvest season (September–October) in the year 2011. Food consumption pattern was determined using a 24-h dietary recall method. Food insecurity data were based on the 30 day recall experience to food insecurity in the household. Factor analysis method using Principal Components extraction function was used to derive the dietary patterns and correlation analysis was used to establish the existing relationship between household food insecurity and dietary patterns factor score. Results Four food consumption patterns namely (I) Meat and milk; (II) Pulses, legumes, nuts and cooking oils; (III) fish (and other sea foods), roots and tubers; (IV) Cereals, vegetables and fruits consumption patterns were identified during harvest season. Dietary patterns identified during the rainy season were as follows: (I) Fruits, cooking oils, fats, roots and tubers (II) Eggs, meat, milk and milk products (III) Fish, other sea foods, vegetables, roots and tubers and (IV) Pulses, legumes, nuts, cereals and vegetables. Household food insecurity was 80% and 69% during rainy and harvest–seasons, respectively (P = 0.01). Household food insecurity access scale score was negatively correlated with the factor scores on household dietary diversity. Conclusion Food consumption patterns and food insecurity varied by seasons with worst scenarios most prevalent during the rainy season. The risk for inadequate dietary diversity was higher among food insecure households compared to food secure households. Effort geared at

  1. Factors contributing to the low uptake of medical male circumcision in Mutare Rural District, Zimbabwe

    PubMed Central

    Chiringa, Irene O.; Mashau, Ntsieni S.

    2016-01-01

    Background Medical male circumcision (MMC) has become a significant dimension of HIV prevention interventions, after the results of three randomised controlled trials in Uganda, South Africa and Kenya demonstrated that circumcision has a protective effect against contracting HIV of up to 60%. Following recommendations by the World Health Organization, Zimbabwe in 2009 adopted voluntary MMC as an additional HIV prevention strategy to the existing ABC behaviour change model. Purpose The purpose of this study is thus to investigate the factors contributing to the low uptake of MMC. Methods The study was a quantitative cross-sectional survey conducted in Mutare rural district, Zimbabwe. Questionnaires with open- and closed-ended questions were administered to the eligible respondents. The target population were male participants aged 15–29 who met the inclusion criteria. The households were systematically selected with a sample size of 234. Statistical Package for the Social Sciences was used to analyse the data. Results Socioculturally, circumcised men are viewed as worthless (37%), shameful (30%) and are tainted as promiscuous (20%), psychological factors reported were infection and delayed healing (39%), being ashamed and dehumanised (58%), stigmatised and discriminated (40.2%) and fear of having an erection during treatment period (89.7%) whilst socio-economic factors were not having time, as it will take their time from work (58%) and complications may arise leading to spending money on treatment (84%). Conclusion Knowledge deficits regarding male medical circumcision lead to low uptake, education on male medical circumcision and its benefits. Comprehensive sexual health education should target men and dispel negative attitudes related to the use of health services. PMID:27380850

  2. Factors affecting the utilisation of improved ventilated latrines among communities in Mtwara Rural District, Tanzania

    PubMed Central

    Kema, Koronel; Semali, Innocent; Mkuwa, Serafina; Kagonji, Ignatio; Temu, Florence; Ilako, Festus; Mkuye, Martin

    2012-01-01

    Introduction The Tanzania government, working in partnership with other stakeholders implemented a community-based project aimed at increasing access to clean and safe water basic sanitation and promotion of personal hygiene in Mtwara Rural District. Mid-term evaluation revealed that progress had been made towards improved ventilated latrines; however, there was no adequate information on utilisation of these latrines and associated factors. This study was therefore conducted to establish the factors influencing the utilisation of these latrines. Methods A cross-sectional study was conducted among 375 randomly selected households using a pre-tested questionnaire to determine whether the households owned improved ventilated latrines and how they utilised them. Resuls About half (50.5%) of the households had an improved ventilated latrine and households with earnings of more than 50,000 Tanzanian Shillings were two times more likely to own an improved latrine than those that earned less (AOR 2.1, 95% CI=1.1-4.0, p= 0.034). The likelihood of owning an improved latrine was reduced by more than 60 percent for female-headed households (AOR=0.38; 95% CI=0.20-0.71; p=0.002). Furthermore, it was established that all members of a household were more likely to use a latrine if it was an improved ventilated latrine (AOR=2.4; 95% CI=1.1-5.1; p= 0.024). Conclusion Findings suggest adoption of strategies to improve the wellbeing of households and deploying those who had acquired improved ventilated latrines as resource persons to help train others. Furthermore, efforts are needed to increase access to soft loans for disadvantaged members and increasing community participation. PMID:23467697

  3. A Demographic Study of Rural, Small School Districts in Four Appalachian States. Occasional Paper 025.

    ERIC Educational Resources Information Center

    Meehan, Merrill L.; DeYoung, Alan

    Data gathered from a review of the literature, state department of education personnel, and directories of school districts are used to report on small school districts in Kentucky, Tennessee, Virginia and West Virginia. Enrollment size of school districts, expenditures per pupil, transportation costs per pupil, and student density were computed…

  4. Rural School District Enrollment and Building Capacity: Projections for the Next 10 Years

    ERIC Educational Resources Information Center

    Yan, Wenfan

    2009-01-01

    Given the shifting population trends across the U.S. and Pennsylvania, it is important for policy makers and school districts to know what to expect, in terms of school district enrollment and facility needs, in the coming years. This research was conducted to provide a perspective on the potential building needs of school districts over the next…

  5. Challenges faced by professional nurses when implementing the Expanded Programme on Immunisation at rural clinics in Capricorn District, Limpopo

    PubMed Central

    Tladi, Flora M.

    2016-01-01

    Background Immunisation is the cornerstone of primary healthcare. Apart from the provision of safe water, immunisation remains the most cost-effective public health intervention currently available. Immunisation prevents infectious conditions that are debilitating, fatal and have the potential to cause huge public health burdens, both financially and socially, in South Africa. Aim To determine the challenges faced by professional nurses when implementing the Expanded Programme on Immunisation (EPI) at rural clinics in Capricorn District, Limpopo Province, South Africa. Setting The study was conducted in selected primary healthcare clinics of Capricorn District, Limpopo Province. Methods A qualitative explorative descriptive contextual research design was used to gather data related to the challenges faced by professional nurses when implementing EPI at rural clinics in Capricorn District. Results The findings revealed that professional nurses had knowledge of the programme, but that they experienced several challenges during implementation of EPI that included staff shortages and problems related to maintenance of the vaccines’ potency. Conclusions The Department of Health as well as the nursing administration should monitor policies and guidelines, and especially maintenance of a cold chain for vaccines, to ensure that they are practised throughout Limpopo Province. The problem of staff shortages also needs to be addressed so that the EPI can achieve its targeted objectives. PMID:27380844

  6. Human Resource Management in Small Rural Districts: The Administrator's Role in Recruitment, Hiring and Staff Development

    ERIC Educational Resources Information Center

    Townsell, Rhodena

    2007-01-01

    The purpose of this article is to review the rural area administrator's role in the areas of teacher recruitment, hiring and staff development. State and Regional Policies reveal that these areas are chief among the concerns of rural school leaders (Johnson, 2005). The rural school administrator's role often requires him/her to become involved in…

  7. Rural-Urban Inequity in Unmet Obstetric Needs and Functionality of Emergency Obstetric Care Services in a Zambian District

    PubMed Central

    Ng’anjo Phiri, Selia; Fylkesnes, Knut; Moland, Karen Marie; Byskov, Jens; Kiserud, Torvid

    2016-01-01

    Background Zambia has a high maternal mortality ratio, 398/100,000 live births. Few pregnant women access emergency obstetric care services to handle complications at childbirth. We aimed to assess the deficit in life-saving obstetric services in the rural and urban areas of Kapiri Mposhi district. Method A cross-sectional survey was conducted in 2011 as part of the ‘Response to Accountable priority setting for Trust in health systems’ (REACT) project. Data on all childbirths that occurred in emergency obstetric care facilities in 2010 were obtained retrospectively. Sources of information included registers from maternity ward admission, delivery and operation theatre, and case records. Data included age, parity, mode of delivery, obstetric complications, and outcome of mother and the newborn. An approach using estimated major obstetric interventions expected but not done in health facilities was used to assess deficit of life-saving interventions in urban and rural areas. Results A total of 2114 urban and 1226 rural childbirths occurring in emergency obstetric care facilities (excluding abortions) were analysed. Facility childbirth constituted 81% of expected births in urban and 16% in rural areas. Based on the reference estimate that 1.4% of childbearing women were expected to need major obstetric intervention, unmet obstetric need was 77 of 106 women, thus 73% (95% CI 71–75%) in rural areas whereas urban areas had no deficit. Major obstetric interventions for absolute maternal indications were higher in urban 2.1% (95% CI 1.60–2.71%) than in rural areas 0.4% (95% CI 0.27–0.55%), with an urban to rural rate ratio of 5.5 (95% CI 3.55–8.76). Conclusions Women in rural areas had deficient obstetric care. The likelihood of under-going a life-saving intervention was 5.5 times higher for women in urban than rural areas. Targeting rural women with life-saving services could substantially reduce this inequity and preventable deaths. PMID:26824599

  8. Nursing Personnel Planning for Rural Hospitals in Burdwan District, West Bengal, India, Using Workload Indicators of Staffing Needs

    PubMed Central

    Roy, Rabindra Nath; Dasgupta, Samir; Bhattacharyya, Krishna Das; Misra, Raghu Nath; Roy, Sima; Saha, Indranil

    2014-01-01

    ABSTRACT Lack of appropriate human resources planning is an important factor in the inefficient use of the public health facilities. Workforce projections can be improved by using objective methods of staffing needs based on the workload and actual work undertaken by workers, a guideline developed by Peter J. Shipp in collaboration with WHO—Workload Indicators of Staffing Need (WISN). A cross-sectional study was carried out to estimate the nursing stuff requirement for the rural hospitals and provide a quantitative description of imbalances, if there is any, in the allocation at the district level during 2011. The average WISN turns out to be 0.35 for entire district, which means only 35% of the required nurses is available or 65% understaffed. So, there is an urgent need for more allocations and deployment of staff so that workload can be tackled and evenly distributed among all nursing personnel. PMID:25895199

  9. Nursing personnel planning for rural hospitals in Burdwan District, West Bengal, India, using workload indicators of staffing needs.

    PubMed

    Shivam, Swapnil; Roy, Rabindra Nath; Dasgupta, Samir; Das Bhattacharyya, Krishna; Misra, Raghu Nath; Roy, Sima; Indranil, Saha

    2014-12-01

    Lack of appropriate human resources planning is an important factor in the inefficient use of the public health facilities. Workforce projections can be improved by using objective methods of staffing needs based on the workload and actual work undertaken by workers, a guideline developed by Peter J. Shipp in collaboration with WHO-Workload Indicators of Staffing Need (WISN). A cross-sectional study was carried out to estimate the nursing stuff requirement for the rural hospitals and provide a quantitative description of imbalances, if there is any, in the allocation at the district level during 2011. The average WISN turns out to be 0.35 for entire district, which means only 35% of the required nurses is available or 65% understaffed. So, there is an urgent need for more allocations and deployment of staff so that workload can be tackled and evenly distributed among all nursing personnel. PMID:25895199

  10. Preliminary observations on accessibility and utilisation of water in selected villages in Dodoma Rural and Bagamoyo Districts, Tanzania

    NASA Astrophysics Data System (ADS)

    Kusiluka, L. J. M.; Mlozi, M. R. S.; Munishi, P. K. T.; Karimuribo, E. D.; Luoga, E. J.; Mdegela, R. H.; Kambarage, D. M.

    A study was carried out to establish the availability and utilisation of water in eight villages in Dodoma Rural and Bagamoyo districts, Tanzania. A total of 128 respondents were interviewed, involving 64 people in each district. The study revealed that the main sources of water for domestic and animal uses in Dodoma district were wells and dams, while in Bagamoyo district; the main sources were dams and ponds. Nine percent of the respondents reported water to be ‘readily available’, whereas 50% and 41% reported water to be ‘not easily available’ and ‘problematic’, respectively. Distances travelled to the nearest water source were in the range of 0.5-2.0, 0.25-15.00 and 0.5-14.40 km for the respondents who reported water as “readily available”, “not easily available” and “problematic”, respectively and, the corresponding time taken to the nearest water source was 0.17-2.00; 0.10-6.00 and 0.17-5.00 hours for the three categories of respondents respectively. More than two-thirds of the respondents reported that water sources were shared between households and also 71.9% reported sharing of water sources with animals, particularly cattle, sheep and goats. The proportions of respondents that reported occurrence of enteric or diarrhoeic cases amongst household members within the past three months before the study were 35.9% and 37.5% in Dodoma and Bagamoyo districts, respectively. All respondents in Dodoma district had latrines whereas 84% in Bagamoyo district had these facilities. All except one of the respondents who had no latrines in Bagamoyo district were based in Chamakweza, a village dominated by a Maasai pastoral community. Interestingly, a significantly higher proportion of diarrhoeic cases were reported in this village compared to the other three villages in Bagamoyo district ( p = 0.029). These findings show that availability of safe water is a serious problem in the study areas and that this may have serious consequences on public

  11. Knowledge regarding family planning methods among rural women of Faridkot district of Punjab.

    PubMed

    Kaur, H P

    1991-07-01

    A researcher analyzed data on 60 married women of reproductive age living in the villages of Kaoni and Assa Buttar in Faridkot District, Punjab state, India, to determine their knowledge levels of various aspects of family planning methods. 80% of the women could neither read nor write. About half lived in an extended family, while the rest lived in a nuclear family. All the women knew about family planning. The women considered the purpose of family planning to be limiting family size (80%), spacing children (53.3%), and preventing conception of children (33.3%). Indeed 40% used a family planning method to space their children, 33.3% to limit family size, and 26.7% to cease childbearing. The leading known methods included the copper T IUD (100%), tubectomy (93.3%), vasectomy (86.6%), and condom (86.6%). 60% of the women and 13.2% of their husbands used a contraceptive. The major methods ever used were tubectomy (46.6%), condom (26.6%), the loop IUD (13.6%), oral contraceptives (13.3%), and the copper T IUD (13.3%). Friends and relatives constituted the most frequently reported knowledge sources for all family planning methods except jelly, cream, and diaphragm which none of the women knew about. Husbands tended to be the leading information source about condoms. Authorities were not major contributors to these rural women's family planning knowledge. All the women trusted family planning and believed it to be good for their health. 86.6% thought it was also good for their children's health and that it allowed parents to provide a better life for their children. The main reasons for stopping family planning use were 1) wanted a child (20%), 2) physical discomfort (13.3%), and 3) method failure (6.6%). The leading reasons for not using a family planning method at all included 1) wanted a child (20%) 2) unhappy marriage (13.3%), and 3) high cost (6.6%). PMID:12286548

  12. A Student-Led Global Health Education Initiative: Reflections on the Kenyan Village Medical Education Program

    PubMed Central

    John, Christopher; Asquith, Heidi; Wren, Tom; Mercuri, Stephanie; Brownlow, Sian

    2016-01-01

    The Kenyan Village Medical Education Program is a student-led global health initiative that seeks to improve health outcomes in rural Kenya through culturally appropriate health education. The month-long program, which is organised by the Melbourne University Health Initiative (Australia), is conducted each January in southern rural Kenya. Significance for public health The Kenyan Village Medical Education (KVME) Program is a student-led global health initiative that involves exploring well-established strategies for the prevention of disease through workshops that are conducted in southern rural Kenya. These workshops are tailored to the unique needs and circumstances of rural Kenyan communities, and are delivered to community leaders, as well as to adults and children within the wider community. Aside from the KVME Program’s emphasis on reducing the burden of preventable disease through health education, the positive impact of the KVME Program on the Program’s student volunteers also deserves consideration. Throughout the month-long KVME Program, student volunteers are presented with opportunities to develop their understanding of cultural competency, the social and economic determinants of health, as well as the unique challenges associated with working in resource-poor communities. Importantly, the KVME Program also represents an avenue through which global health leadership can be fostered amongst student volunteers. PMID:27190974

  13. A Student-Led Global Health Education Initiative: Reflections on the Kenyan Village Medical Education Program.

    PubMed

    John, Christopher; Asquith, Heidi; Wren, Tom; Mercuri, Stephanie; Brownlow, Sian

    2016-04-26

    The Kenyan Village Medical Education Program is a student-led global health initiative that seeks to improve health outcomes in rural Kenya through culturally appropriate health education. The month-long program, which is organised by the Melbourne University Health Initiative (Australia), is conducted each January in southern rural Kenya. Significance for public healthThe Kenyan Village Medical Education (KVME) Program is a student-led global health initiative that involves exploring well-established strategies for the prevention of disease through workshops that are conducted in southern rural Kenya. These workshops are tailored to the unique needs and circumstances of rural Kenyan communities, and are delivered to community leaders, as well as to adults and children within the wider community. Aside from the KVME Program's emphasis on reducing the burden of preventable disease through health education, the positive impact of the KVME Program on the Program's student volunteers also deserves consideration. Throughout the month-long KVME Program, student volunteers are presented with opportunities to develop their understanding of cultural competency, the social and economic determinants of health, as well as the unique challenges associated with working in resource-poor communities. Importantly, the KVME Program also represents an avenue through which global health leadership can be fostered amongst student volunteers. PMID:27190974

  14. "It Is Two-Way Traffic": Teachers' Tensions in the Implementation of the Kenyan Language-in-Education Policy

    ERIC Educational Resources Information Center

    Jones, Jennifer M.; Barkhuizen, Gary

    2011-01-01

    This article reports on an ethnographic study which investigated the implementation of the Kenyan language-in-education policy in a school in rural Western Kenya. The study reveals the complexity of policy implementation in a multilingual and multiethnic context where language shift and civil unrest are occurring, and where there is pressure to…

  15. LONG-TERM STUDY OF EDUCATIONAL EFFECTIVENESS OF NEWLY FORMED CENTRALIZED SCHOOL DISTRICTS IN RURAL AREAS.

    ERIC Educational Resources Information Center

    KREITLOW, B.W.

    THE BASIC PURPOSES OF THIS STUDY WERE--(1) TO ASCERTAIN WHETHER OR NOT SCHOOL DISTRICT REORGANIZATION IS WORTHWHILE IN TERMS OF TIME, EFFORT, AND EXPENDITURE OF FUNDS, AND (2) TO DETERMINE THE EFFECTS OF SUCH SCHOOL DISTRICT REORGANIZATIONS ON THE EDUCATIONAL OUTCOMES OF THE SCHOOL. THE SAMPLING CONSISTED OF 10 WISCONSIN COMMUNITIES--5 WITH…

  16. Improving the Small Rural or Remote School: The Role of the District

    ERIC Educational Resources Information Center

    Clarke, Simon; Wildy, Helen

    2011-01-01

    There is a robust body of work highlighting distinctive challenges encountered by leaders of small schools in pursuit of school improvement but this work has focused on the school as the unit of change and neglects the role of the district. As the district potentially influences what principals know and how they use their knowledge, this article…

  17. [State of neurological medical services in the suburbs of Tokyo: the difference between urban and rural districts].

    PubMed

    Ohashi, Takashi

    2010-11-01

    In Chiba, the number of doctors and hospital beds remain quite insufficient for the current population. The number of neurologists is also insufficient. However, the situation differs between urban regions and rural districts. In rural districts, few neurologists provide medical care for patients living in a large area. On the other hand, in urban regions, the number of neurologists is insufficient because they have to take care of too many patients, most of whom can be dealt with by family doctors. Therefore, we need to take measures to reduce burden on neurologists. It is important to clarify the role of each hospital employee, thereby allowing neurologists to devote themselves to their main duties. The establishment of clinical pathways is one helpful way to promote a team approach in medical care, while trying to improve the efficiency of duties and thus improve the overall medical quality. It is also important to improve the understanding of local residents through education and information programs. By promoting regional medical liaison, we can increase effective medical care that is performed by family doctors. PMID:21921566

  18. Female High School Principals in Rural Midwestern School Districts: Their Lived Experiences in Leadership

    ERIC Educational Resources Information Center

    Bartling, Ellen M.

    2013-01-01

    This study was explored the leadership experiences of female principals of rural high schools in a Midwestern state. The study sought to describe the leadership styles used by these principals to make changes within their schools. Qualitative methodology was used, and four female rural high school principals were interviewed during a series of…

  19. How Has the Free Obstetric Care Policy Impacted Unmet Obstetric Need in a Rural Health District in Guinea?

    PubMed Central

    Delamou, Alexandre; Dubourg, Dominique; Beavogui, Abdoul Habib; Delvaux, Thérèse; Kolié, Jacques Seraphin; Barry, Thierno Hamidou; Camara, Bienvenu Salim; Edginton, Mary; Hinderaker, Sven; De Brouwere, Vincent

    2015-01-01

    Introduction In 2010, the Ministry of Health (MoH) of Guinea introduced a free emergency obstetric care policy in all the public health facilities of the country. This included antenatal checks, normal delivery and Caesarean section. Objective This study aims at assessing the changes in coverage of obstetric care according to the Unmet Obstetric Need concept before (2008) and after (2012) the implementation of the free emergency obstetric care policy in a rural health district in Guinea. Methods We carried out a descriptive cross-sectional study involving the retrospective review of routine programme data during the period April to June 2014. Results No statistical difference was observed in women’s sociodemographic characteristics and indications (absolute maternal indications versus non-absolute maternal indications) before and after the implementation of the policy. Compared to referrals from health centers of patients, direct admissions at hospital significantly increased from 49% to 66% between 2008 and 2012 (p = 0.001). In rural areas, this increase concerned all maternal complications regardless of their severity, while in urban areas it mainly affected very severe complications. Compared to 2008, there were significantly more Major Obstetric Interventions for Maternal Absolute Indications in 2012 (p<0.001). Maternal deaths decreased between 2008 and 2012 from 1.5% to 1.1% while neonatal death increased from 12% in 2008 to 15% in 2012. Conclusion The implementation of the free obstetric care policy led to a significant decrease in unmet obstetric need between 2008 and 2012 in the health district of Kissidougou. However, more research is needed to allow comparisons with other health districts in the country and to analyse the trends. PMID:26047472

  20. Impact of Lean on patient cycle and waiting times at a rural district hospital in KwaZulu-Natal

    PubMed Central

    Naidoo, Logandran

    2016-01-01

    Background Prolonged waiting time is a source of patient dissatisfaction with health care and is negatively associated with patient satisfaction. Prolonged waiting times in many district hospitals result in many dissatisfied patients, overworked and frustrated staff, and poor quality of care because of the perceived increased workload. Aim The aim of the study was to determine the impact of Lean principles techniques, and tools on the operational efficiency in the outpatient department (OPD) of a rural district hospital. Setting The study was conducted at the Catherine Booth Hospital (CBH) – a rural district hospital in KwaZulu-Natal, South Africa. Methods This was an action research study with pre-, intermediate-, and post-implementation assessments. Cycle and waiting times were measured by direct observation on two occasions before, approximately two-weekly during, and on two occasions after Lean implementation. A standardised data collection tool was completed by the researcher at each of the six key service nodes in the OPD to capture the waiting times and cycle times. Results All six service nodes showed a reduction in cycle times and waiting times between the baseline assessment and post-Lean implementation measurement. Significant reduction was achieved in cycle times (27%; p < 0.05) and waiting times (from 11.93 to 10 min; p = 0.03) at the Investigations node. Although the target reduction was not achieved for the Consulting Room node, there was a significant reduction in waiting times from 80.95 to 74.43 min, (p < 0.001). The average efficiency increased from 16.35% (baseline) to 20.13% (post-intervention). Conclusion The application of Lean principles, tools and techniques provides hospital managers with an evidence-based management approach to resolving problems and improving quality indicators. PMID:27543283

  1. Willingness to join community-based health insurance among rural households of Debub Bench District, Bench Maji Zone, Southwest Ethiopia

    PubMed Central

    2014-01-01

    Background Even though Ethiopia bears high burden of diseases, utilization of modern health care services is limited. One of the reasons for low utilization of healthcare services is the user-fee charges. Moving away from out-of-pocket charges for healthcare at the time of use is an important step towards averting the financial hardship associated with paying for health service. Prepaid plans for health are not accustomed in Ethiopia. Therefore, social and community based health insurance schemes were introduced since 2010. In this study, willingness of rural households in Debub Bench District, to join community based health insurance was assessed. Method Cross-sectional community based study was conducted in Debub Bench District in March 2013 using a pretested structured questionnaire. Two stage sampling technique was used to select 845 households as study units which were allocated to the kebeles proportionately. The sampled households were selected using simple random sampling technique. Data were entered into EPIDATA 3.0 and analyzed with SPSS version 20. Result Among 845 sampled households, 808 were interviewed (95.6% response rate). About 78% of the respondents were willing to join the scheme. Most of demographic, socioeconomic variables and social capital were found to be significantly associated with willingness to join community based health insurance. Conclusion If the scheme is initiated in the district, majority of the households will enroll in the community based health insurance. Farmers, the married households, Bench ethnic groups and illiterate, the dominant segments of the population, are more likely to enroll the schemes. Therefore initiation of the scheme is beneficial in the district. PMID:24920538

  2. Undiagnosed hypertension in a rural district in Bangladesh: The Bangladesh Population-based Diabetes and Eye Study (BPDES).

    PubMed

    Islam, F M A; Bhuiyan, A; Chakrabarti, R; Rahman, M A; Kanagasingam, Y; Hiller, J E

    2016-04-01

    Hypertension is mainly asymptomatic and remains undiagnosed until the disease progresses. The objective of the study was to determine the prevalence of and risk factors for hypertension in rural Bangladesh. Using a population-based cluster random sampling strategy, 3096 adults aged ⩾30 years were recruited from a rural district in Bangladesh. Data collected included two blood pressure (BP) measurements, fasting blood glucose, socio-demographic and anthropometric measurements. Hypertension was defined as systolic BP (SBP) ⩾140 mm Hg or diastolic BP (DBP) ⩾90 mm Hg or self-reported diagnosed hypertension. Logistic regression techniques were used for data analyses. The crude prevalence of hypertension was 40% (95% confidence interval (CI) 38-42%) of which 82% were previously undiagnosed. People from lower socio-economic status (SES) had a significantly higher percentage of undiagnosed hypertension compared with people with higher SES (P<0.001). There was no significant gender difference in severity of hypertension. Males with higher education level compared with no education had a higher prevalence of hypertension (odds ratio 2.34, 95% CI 1.49-3.69). Older age and waist circumference in both genders, and diabetes, lack of physical activity in females were found to be associated with higher prevalence of hypertension. Our research suggests the prevalence of undiagnosed hypertension was higher in the rural area in Bangladesh than that reported from the rural area in neighbouring India and China. Lower SES was associated with a higher risk of undiagnosed hypertension. Public health programs at the grass-roots level must emphasise the provision of primary care and preventive services in managing this non-communicable disease. PMID:26108363

  3. Factors That Influence School Board Actions to Support Student Achievement: A Multi-Case Study of High-Achieving Rural School Districts

    ERIC Educational Resources Information Center

    Timm, Colleen A.

    2012-01-01

    The purpose of this study is to examine the factors that influence the actions taken by school boards that advance student achievement in high-achieving rural public school districts. Much of what is discussed in the literature on school improvement efforts is centered on the work carried out by school personnel at the school level. What is…

  4. The Impact of Cooperative and Traditional Learning on the Academic Achievement of Third Grade Students in Selected Rural School Districts in Northeast, South Carolina

    ERIC Educational Resources Information Center

    Johnson, Shawn Lamont L.

    2013-01-01

    This study examined the impact that cooperative learning and traditional learning have on the academic performance of elementary school students in rural school districts. Cooperative learning is considered a typical model that can maximize the effectiveness of constructivism. Slavin (1991, p. 71) completed a synthesis of research on cooperative…

  5. A Descriptive Study of Superintendents' and School Board Members' Perceptions of the Superintendent's Leadership in Rural Districts in Three Mid-Atlantic States

    ERIC Educational Resources Information Center

    Wilson, Janet S.

    2011-01-01

    The purpose of this study was to ascertain if perceptual differences exist between superintendents and board members regarding superintendents' leadership behaviors in rural school districts. Transformational leadership is considered necessary for organizations to move forward in the 21st century. This research sought to determine if…

  6. A Comparative Study on Nutritional Status and Body Composition of Urban and Rural Schoolchildren from Brandsen District (Argentina)

    PubMed Central

    Cesani, Maria Florencia; Garraza, Mariela; Bergel Sanchís, María Laura; Luis, María Antonia; Torres, María Fernanda; Quintero, Fabián Aníbal; Oyhenart, Evelia Edith

    2013-01-01

    The purpose of this study was to analyze whether nutritional status and body composition varies according to the environment of residence (urban or rural) of children in the Brandsen district (Argentina). Weight, height, arm circumference and tricipital and subscapular skinfolds were performed in 1368 schoolchildren aged 3 to 14. NHANES III reference was used to estimate nutritional status -underweight, stunting, wasting, overweight, and obesity- and to evaluate body composition -deficit and excess of adipose (DA, EA) and muscular (DM, EM) tissues of the arm-. Central fat distribution (CFD) was estimated using the subscapular-tricipital index. A structured questionnaire was implemented to evaluate socio-environmental characteristics. Nutritional categories based on body size and body composition were compared between urban and rural areas of residence using Chi-squared tests (χ2). The results indicated for the total sample: 1.1% underweight, 6.9% stunting, 0.4% wasting, 12.1% overweight, 9.7% obesity, 22.0% DM, 2.5% EM, 0.1% DA, 17.6% EA, and 8.5% CFD. Significant differences between urban and rural areas were found only for CFD. The socio-environmental analysis showed that while access to public services and housing quality was significantly better in the urban area, a considerable number of city households lived under deficient conditions, lacked health insurance and had low socioeconomic level. Fifty-three percent of the undernourished children had DM without urban-rural significant differences, and none of them showed DA. In the overweight plus obesity group, 62.8% presented EA, 6.4% EM, 4.7% DM, and 22.8% CFD. The highest percentages of DM and CFD were recorded in rural areas (p = 0.00). We conclude that the child population shows the “double burden” of malnutrition. The environment of residence does not promote any differentiation in the nutritional status. Nevertheless, the increment of central adiposity and, in some cases of muscle deficit in rural

  7. Professional Quality of Life and Associated Factors Among Ugandan Midwives Working in Mubende and Mityana Rural Districts.

    PubMed

    Muliira, Rhoda Suubi; Ssendikadiwa, Vito Bosco

    2016-03-01

    Objective To explore the professional quality of life and associated factors among Ugandan midwives working in Mubende and Mityana rural district to recommend interventions to improve professional well-being and outcomes of midwifery care. Background Professional quality of life of midwives working in rural areas may be influenced by several personal and work setting factors of care professionals often impacting the quality and outcomes of patient care. Methods A cross-sectional study design was used to collect data from 224 midwives working in two rural districts of Uganda. Findings The majority of participants were female (80 %), with an associate degree in midwifery (92 %). The mean age and years of experience were 34 ± 6.3 and 4 ± 2.1 years, respectively. The mean scores on the professional quality of life scale showed average compassionate satisfaction (19 ± 4.88), burnout (36.9 ± 6.22) and secondary traumatic stress (22.9 ± 6.69). The midwives' compassion satisfaction was related to psychological well-being (p < 0.01) and job satisfaction (p < 0.01). Conversely, their burnout levels and secondary traumatic stress were associated with education level (p < 0.01), marital status (p < 0.01), involvement in non-midwifery health care activities (p < 0.01), and physical well-being (p < 0.01). Conclusion and Implication to practice Midwives working in rural areas of resourcepoor countries have moderate professional quality of life and tend to experience moderate to high levels of burnout, secondary traumatic stress and compassion satisfaction in their professional work. Therefore, employers need to provide deliberate work based services such as counselling, debriefing, training and social support to enhance midwives professional quality of life and quality of midwifery care and practice. PMID:26525560

  8. [Attitude to the special education student with reference to social integration in early adulthood--studies in a rural district].

    PubMed

    Kurth, E; Nissler, R

    1988-02-01

    This paper deals with cognition of attitudes to pupils from a special school for mentally retarded children in a rural district on the base of using polarity profiles. Although children from Secondary Schools and adults have little understanding of the retarded children's handicaps, they do not appear to hold one-sided stereotyped opinions and in the areas of social behavior and ways of working positive attributes of the personality are emphasized. In comparison with this results recorded self-assessments of former pupils of special schools, together with the assessments of others, in real working situations show a satisfactory level of integration, although after initial difficulties. Opportunities for advice and care are considered necessary, even after pupils have left school. PMID:3375385

  9. Tuberculosis in developing countries: conditions for successful use of a decentralized approach in a rural health district

    PubMed Central

    Méda, Ziemlé Clément; Huang, Chung-Chien; Sombié, Issiaka; Konaté, Lassina; Somda, Paulin Küssome; Djibougou, Arthur Diakourga; Sanou, Moussa

    2014-01-01

    -density rate based on positive smears were 16.11% (11.00% in 2005) and 10.42 per 100,000 inhabitants per year (6.88 per 100,000 inhabitants in 2005), respectively. There were 29 patients positive for TB: 41.37% of these had cough lasting 10 to 15 days, 10.34% were also positive for HIV, and 68.97% were from rural areas. Health workers and patients reported satisfaction with the intervention. It was found that implementing a decentralized approach to TB prevention in rural areas is plausible and effective under some conditions: considering that health district system is functional; carefully designing the intervention for TB case management; setting up and implementing of decentralized approach including strong monitoring; and taking into account the all financing, community and volunteer involvement, evaluation of the cost savings from integrating specific donor funding, and being supported by regional and central levels including National TB program. Conclusion The study has shown that TB detection rate can be increased by implementing a decentralized approach to primary care. When carefully implemented, a decentralized approach is a suitable approach to TB and HIV prevention in rural and inaccessible settings. PMID:25396024

  10. Impact of HIV comprehensive care and treatment on serostatus disclosure among Cameroonian patients in rural district hospitals.

    PubMed

    Suzan-Monti, Marie; Kouanfack, Charles; Boyer, Sylvie; Blanche, Jérôme; Bonono, Renée-Cécile; Delaporte, Eric; Carrieri, Patrizia M; Moatti, Jean-Paul; Laurent, Christian; Spire, Bruno

    2013-01-01

    This work aimed to analyze the rate of disclosure to relatives and friends over time and to identify factors affecting disclosure among seropositive adults initiating antiretroviral therapy (ART) in rural district hospitals in the context of decentralized, integrated HIV care and task-shifting to nurses in Cameroon. Stratall was a 24-month, randomized, open-label trial comparing the effectiveness of clinical monitoring alone with laboratory plus clinical monitoring on treatment outcomes. It enrolled 459 HIV-infected ART-naive adults in 9 rural district hospitals in Cameroon. Participants in both groups were sometimes visited by nurses instead of physicians. Patients with complete data both at enrolment (M0) and at least at one follow-up visit were included in the present analysis. A mixed Poisson regression was used to estimate predictors of the evolution of disclosure index over 24 months (M24).The study population included 385 patients, accounting for 1733 face-to-face interviews at follow-up visits from M0 to M24. The median [IQR] number of categories of relatives and friends to whom patients had disclosed was 2 [1]-[3] and 3 [2]-[5] at M0 and M24 (p-trend<0.001), respectively. After multiple adjustments, factors associated with disclosure to a higher number of categories of relatives and friends were as follows: having revealed one's status to one's main partner, time on ART, HIV diagnosis during hospitalization, knowledge on ART and positive ratio of follow-up nurse-led to physician-led visits measuring task-shifting. ART delivered in the context of decentralized, integrated HIV care including task-shifting was associated with increased HIV serological status disclosure. PMID:23383117

  11. Dental Caries and Their Treatment Needs in 3-5 Year Old Preschool Children in a Rural District of India

    PubMed Central

    Gupta, Devanand; Momin, Rizwan K; Mathur, Ayush; Srinivas, Kavuri Teja; Jain, Ankita; Dommaraju, Neelima; Dalai, Deepak Ranjan; Gupta, Rajendra Kumar

    2015-01-01

    Background: Dental problems in the preschool children are neglected by their parents as the deciduous teeth are going to shed off, and hence considered to be of no importance and more of economic burden if attended to them. Aims: This study was to determine the caries prevalence in preschool children (3-5-year-old) of rural Moradabad district, to analyze the specific pattern of dental caries experience in this population and to assess the treatment needs among them. Material and Methods: Children within the age group of 3-5 years attending Anganwadi centers of rural Moradabad district were included in the study. Caries diagnosis was based on decayed, extracted, filled surface (defs) and the treatment needs were recorded using World Health Organization (WHO) oral health assessment form 1997. Results: Out of 1,500 children examined, 48.7% males and 52.6% females did not require any treatment. The mean decayed, extracted, filled teeth (deft) value was found to be significantly high in 5-year-old participants when compared to 3-year-old participants (P < 0.01). Majority of the children required one surface filling followed by two surface fillings, caries arresting sealant care, extraction, crown bridge element, pulp care, and space maintainer. Conclusion: The most common pattern was pit and fissure, then maxillary anterior pattern, posterior proximal pattern, and posterior buccal lingual smooth surface pattern. The mean deft value was higher in males as compared to females. There is a greater need for oral health education among parents and teachers. PMID:25973401

  12. The incidence of antibody to infectious bovine rhinotracheitis virus in Kenyan cattle.

    PubMed

    Jessett, D M; Rampton, C S

    1975-03-01

    A total of 3204 cattle sera, collected between 1966 and 1974, from all seven provinces and 34 of the 42 districts of Kenya were screened in a neutralisation test for antibody to infectious bovine rhinotracheitis virus (IBRV). Antibody to IBRV was found in some sera from all the districts, with cattle over two years old showing the highest incidence. A small number of goat sera also showed some antibody. From the results obtained it is concluded that IBRV infection is widespread in Kenyan cattle. PMID:165572

  13. The Local-Federal Interface in Rural School Improvement: River District, Wyoming.

    ERIC Educational Resources Information Center

    Messerschmidt, Donald A.

    When the Experimental Schools (ES) program began in 1972, schools in conservative and traditional River District, Wyoming, had just undergone a controversial consolidation. The ES program was perceived by new administrators as a source of necessary unity, useful outside help, and financial incentives. School trustees were "favorable but guarded"…

  14. Evaluation of a Shared Services Compact in Two Rural Ohio School Districts

    ERIC Educational Resources Information Center

    Dziczkowski, Jennifer E.

    2011-01-01

    School funding adequacy is a topic that has received increased attention throughout the United States since the late 1990s. Current economic conditions, deficit spending, and burgeoning health care costs have caused school districts to compete with state governments for scarce monetary resources. Ohio is one such state. In December of 2008, the…

  15. Community knowledge and acceptance of larviciding for malaria control in a rural district of east-central Tanzania.

    PubMed

    Mboera, Leonard E G; Kramer, Randall A; Miranda, Marie Lynn; Kilima, Stella P; Shayo, Elizabeth H; Lesser, Adriane

    2014-05-01

    The use of microbial larvicides, a form of larval source management, is a less commonly used malaria control intervention that nonetheless has significant potential as a component of an integrated vector management strategy. We evaluated community acceptability of larviciding in a rural district in east-central Tanzania using data from 962 household surveys, 12 focus group discussions, and 24 in-depth interviews. Most survey respondents trusted in the safety (73.1%) and efficacy of larviciding, both with regards to mosquito control (92.3%) and to reduce malaria infection risk (91.9%). Probing these perceptions using a Likert scale provides a more detailed picture. Focus group participants and key informants were also receptive to larviciding, but stressed the importance of sensitization before its implementation. Overall, 73.4% of survey respondents expressed a willingness to make a nominal household contribution to a larviciding program, a proportion which decreased as the proposed contribution increased. The lower-bound mean willingness to pay is estimated at 2,934 Tanzanian Shillings (approximately US$1.76) per three month period. We present a multivariate probit regression analysis examining factors associated with willingness to pay. Overall, our findings point to a receptive environment in a rural setting in Tanzania for the use of microbial larvicides in malaria control. PMID:24830448

  16. A knowledge, attitude and practices (KAP) study on dengue among selected rural communities in the Kuala Kangsar district.

    PubMed

    Hairi, Farizah; Ong, Cyril-H S; Suhaimi, Anwar; Tsung, Teoh-Wei; bin Anis Ahmad, Mohd Azhar; Sundaraj, Charlotte; Soe, Myint Myint

    2003-01-01

    A cross-sectional survey was conducted to assess the level of knowledge, attitude and practices concerning dengue and its vector Aedes mosquito among selected rural communities in the Kuala Kangsar district from 16-25th June, 2002. It was found that the knowledge of the community was good. Out of the 200 respondents, 82.0% cited that their main source of information on dengue was from television/radio. The respondents' attitude was found to be good and most of them were supportive of Aedes control measures. There is a significant association found between knowledge of dengue and attitude towards Aedes control (p = 0.047). It was also found that good knowledge does not necessarily lead to good practice. This is most likely due to certain practices like water storage for domestic use, which is deeply ingrained in the community. Mass media is an important means of conveying health messages to the public even among the rural population, thus research and development of educational strategies designed to improve behaviour and practice of effective control measures among the villagers are recommended. PMID:14620496

  17. Promoting safer sexual practices among young adults: a survey of health workers in Moshi Rural District, Tanzania.

    PubMed

    Ngomuo, E T; Klepp, K I; Rise, J; Mnyika, K S

    1995-01-01

    As part of the national effort to prevent further spread of HIV/AIDS, rural health workers in Tanzania are asked to promote safer sex practices among the sexually active population. We conducted a survey among health workers in Moshi Rural District, Kilimanjaro, designed to assess their attitudes, perceived norms and self-efficacy with respect to the promotion of safer sexual practices among young adults 15-35 years old. Health workers at all private and governmental health facilities were included (n = 342; participation rate of 68.4%). We observed relatively strong associations between the frequency and quality of reported counselling behaviour and perceived norms, attitudes and self-efficacy (standardized regression coefficients (beta) of 0.329, 0.252 and 0.159 respectively). In addition, exposure to behaviour change strategies during formal training and marital status of the health workers were associated with counselling behaviour (beta of 0.133 and 0.118 respectively). Overall, these factors accounted for 40.8% of the observed variance in reported counselling behaviour. It is recommended that continued education for health workers focus on providing normative support for promoting safer sex, provide information which may help foster positive attitudes and teach practical counselling skills to further increase the self-efficacy regarding counselling young people. PMID:8547364

  18. Community Knowledge and Acceptance of Larviciding for Malaria Control in a Rural District of East-Central Tanzania

    PubMed Central

    Mboera, Leonard E. G.; Kramer, Randall A.; Miranda, Marie Lynn; Kilima, Stella P.; Shayo, Elizabeth H.; Lesser, Adriane

    2014-01-01

    The use of microbial larvicides, a form of larval source management, is a less commonly used malaria control intervention that nonetheless has significant potential as a component of an integrated vector management strategy. We evaluated community acceptability of larviciding in a rural district in east-central Tanzania using data from 962 household surveys, 12 focus group discussions, and 24 in-depth interviews. Most survey respondents trusted in the safety (73.1%) and efficacy of larviciding, both with regards to mosquito control (92.3%) and to reduce malaria infection risk (91.9%). Probing these perceptions using a Likert scale provides a more detailed picture. Focus group participants and key informants were also receptive to larviciding, but stressed the importance of sensitization before its implementation. Overall, 73.4% of survey respondents expressed a willingness to make a nominal household contribution to a larviciding program, a proportion which decreased as the proposed contribution increased. The lower-bound mean willingness to pay is estimated at 2,934 Tanzanian Shillings (approximately US$1.76) per three month period. We present a multivariate probit regression analysis examining factors associated with willingness to pay. Overall, our findings point to a receptive environment in a rural setting in Tanzania for the use of microbial larvicides in malaria control. PMID:24830448

  19. Inter-District Cooperation among Rural Schools In A Post-Industrial Society. Revised.

    ERIC Educational Resources Information Center

    Swanson, Austin D.

    The trends in post-industrial society toward decentralization, diversity, and individualization, with emphasis on synthesis rather than analysis, require educators who are more flexible, adaptable, and capable of managing diversity; this can prove advantageous to small and rural schools, which have long been using such a philosophy. Educators will…

  20. Revenues and Spending of Michigan's Urban, Suburban, Town and Rural School Districts, 2004-2010

    ERIC Educational Resources Information Center

    Van Beek, Michael

    2011-01-01

    In the passionate debates over providing equal educational opportunity for all children, it's frequently argued that large financial inequities create challenges for many public schools, particularly those in lower-income urban areas. This study compares the revenues and operating expenditures of Michigan's urban, suburban, town and rural school…

  1. HIGH LONESOME: A School Community Survey of the Encino Rural Independent School District.

    ERIC Educational Resources Information Center

    Church, Mary Josephine; And Others

    An assessment of school facilities and services and a survey of staff, student, and community attitudes was undertaken at the request of the Encino School Board to aid in educational planning and improvement for its small rural school which is faced with the problems of declining population (from 400 to 150 in the past 20 years), declining…

  2. Districts on the Edge: The Impact of Urban Sprawl on a Rural Community.

    ERIC Educational Resources Information Center

    Theobald, Paul

    1988-01-01

    Portrays the controversy surrounding schools and education in a rural community experiencing both an influx of urban and suburban newcomers and the effects of urban sprawl. Reports on surveys of student educational attitudes, household information, and outside activities, and on interviews with teachers, school administrators, and residents.…

  3. Labour complications remain the most important risk factors for perinatal mortality in rural Kenya.

    PubMed Central

    Weiner, Renay; Ronsmans, Carine; Dorman, Ed; Jilo, Hilton; Muhoro, Anne; Shulman, Caroline

    2003-01-01

    OBJECTIVES: To identify and quantify risk factors for perinatal mortality in a Kenyan district hospital and to assess the proportion of perinatal deaths attributable to labour complications, maternal undernutrition, malaria, anaemia and human immunodeficiency virus (HIV). METHODS: A cross-sectional study of 910 births was conducted between January 1996 and July 1997 and risk factors for perinatal mortality were analysed. FINDINGS: The perinatal mortality rate was 118 per 1000 births. Complications of labour such as haemorrhage, premature rupture of membranes/premature labour, and obstructed labour/ malpresentation increased the risk of death between 8- and 62-fold, and 53% of all perinatal deaths were attributable to labour complications. Placental malaria and maternal HIV, on the other hand, were not associated with perinatal mortality. CONCLUSIONS: Greater attention needs to be given to the quality of obstetric care provided in the rural district-hospital setting. PMID:14576887

  4. Salmonella and Shigella carrier rates and environmental sanitation in a rural district, Central Thailand.

    PubMed

    Sakdisiwasdi, O; Achananuparp, S; Limsuwan, A; Nanna, P; Barnyen, L

    1982-09-01

    The study of Salmonella and Shigella carrier rates were carried out in two Tambol (sub districts). Klongjik, Kanon-Laung and Amphur (district) Bang-Pa-In. The carrier rates of Salmonella and Shigella were 3.3% and 0.8% respectively. Most Salmonella strains were sensitive to the antibiotics commonly used; only 6.4% and 3.2% were resistant to tetracycline and neomycin. All Shigella isolated were resistant to chloramphenicol and 75% to tetracycline. One fourth of the families defecated in the river or canal or went to the field and one third disposed the garbage into the river or canal. This contaminated water was used for drinking by 62.7% of all families and only 28.1% treated the water by boiling. The disease vectors bothering the villagers were rats 58.8%, flies and cockroaches which served as important vehicles for cross contamination. The prevalence rate of diarrhoeal disease in the villages was 1933 per 100,000 and presented as the morbidity rate of this disease in the district hospital, only 355 to 363 per 100,000 in 1979 and 1980. Health care for diarrhoeal diseases in these villages were 61% by self-medication, 36% using the village healer and only 3% went to the district hospital. The effective means to eliminate transient and chronic carriers of Shigella and Salmonella typhi may be very important but other means of prevention of diarrhoeal diseases of typhoid fever are through the sanitary disposal of human excreta and the development of safe water supply should be emphasized. PMID:7163844

  5. Improving paediatric and neonatal care in rural district hospitals in the highlands of Papua New Guinea: a quality improvement approach

    PubMed Central

    Sa’avu, Martin; Duke, Trevor; Matai, Sens

    2014-01-01

    Background In developing countries such as Papua New Guinea (PNG), district hospitals play a vital role in clinical care, training health-care workers, implementing immunization and other public health programmes and providing necessary data on disease burdens and outcomes. Pneumonia and neonatal conditions are a major cause of child admission and death in hospitals throughout PNG. Oxygen therapy is an essential component of the management of pneumonia and neonatal conditions, but facilities for oxygen and care of the sick newborn are often inadequate, especially in district hospitals. Improving this area may be a vehicle for improving overall quality of care. Method A qualitative study of five rural district hospitals in the highlands provinces of Papua New Guinea was undertaken. A structured survey instrument was used by a paediatrician and a biomedical technician to assess the quality of paediatric care, the case-mix and outcomes, resources for delivery of good-quality care for children with pneumonia and neonatal illnesses, existing oxygen systems and equipment, drugs and consumables, infection-control facilities and the reliability of the electricity supply to each hospital. A floor plan was drawn up for the installation of the oxygen concentrators and a plan for improving care of sick neonates, and a process of addressing other priorities was begun. Results In remote parts of PNG, many district hospitals are run by under-resourced non-government organizations. Most hospitals had general wards in which both adults and children were managed together. Paediatric case-loads ranged between 232 and 840 patients per year with overall case-fatality rates (CFR) of 3–6% and up to 15% among sick neonates. Pneumonia accounts for 28–37% of admissions with a CFR of up to 8%. There were no supervisory visits by paediatricians, and little or no continuing professional development of staff. Essential drugs were mostly available, but basic equipment for the care of sick

  6. Prevalence and impact of water-borne zoonotic pathogens in water, cattle and humans in selected villages in Dodoma Rural and Bagamoyo districts, Tanzania

    NASA Astrophysics Data System (ADS)

    Kusiluka, L. J. M.; Karimuribo, E. D.; Mdegela, R. H.; Luoga, E. J.; Munishi, P. K. T.; Mlozi, M. R. S.; Kambarage, D. M.

    A study on the prevalence of water-borne zoonotic pathogens in water, cattle and humans was conducted in six villages in Dodoma Rural (5) and Bagamoyo (1) districts, Tanzania. Water sources were screened for faecal coliform organisms, thermophilic Campylobacter, Salmonella, Cryptosporidium and Giardia. Faecal samples from cattle and humans were also analysed for the above specific pathogens. Results indicate that 70.8% ( n = 48) of the water sources screened were contaminated with faecal coliform organisms. Water sources in two villages, one each in Dodoma Rural and Bagamoyo districts were also contaminated with Giardia lamblia. The overall prevalence of Campylobacter jejuni in cattle in the two study areas was 2.3% ( n = 942) and at least one animal in each village was infected with C. jejuni. Cryptosporidium parvum was detected in 0.5% ( n = 942) of the cattle examined in three villages in Dodoma district. Salmonella spp. was demonstrated in only 1.4% ( n = 144) of the cattle in Chalinze village in Dodoma Rural district while G. lamblia was only detected in 1.5% ( n = 202) of the animals examined in Chamakweza village in Bagamoyo district. Nine (1.9%) of the people screened at three heath centres in the study areas were infected with C. jejuni while 3.7% ( n = 484) of the people had C. parvum oocysts. G. lamblia was detected in 2.5% of the 202 people screened at the Chalinze health centre in Bagamoyo district. Analysis of the secondary data revealed that clinical complaints related to enteric diseases were prevalent in humans in the two areas throughout the year and the prevalence varied from about 1% to 25% in both <5 years and ⩾5 years patients. In conclusion, this study has highlighted the possible public health risks, which may be associated with keeping of animals and sharing of water sources between humans and animals.

  7. Improving district facility readiness: a 12-month evaluation of a data-driven health systems strengthening intervention in rural Rwanda

    PubMed Central

    Iyer, Hari S.; Kamanzi, Emmanuel; Mugunga, Jean Claude; Finnegan, Karen; Uwingabiye, Alice; Shyaka, Edward; Niyonzima, Saleh; Hirschhorn, Lisa R.; Drobac, Peter C.

    2015-01-01

    Background While health systems strengthening (HSS) interventions are recommended by global health policy experts to improve population health in resource-limited settings, few examples exist of evaluations of HSS interventions conducted at the district level. In 2009, a partnership between Partners In Health (PIH), a non-governmental organization, and the Rwandan Ministry of Health (RMOH) was provided funds to implement and evaluate a district-level HSS intervention in two rural districts of Rwanda. Design The partnership provided limited funds to 14 health centers for targeted systems support in 2010; six others received support prior to the intervention (reference). RMOH health systems norms were mapped across the WHO HSS framework, scored from 0 to 10 and incorporated into a rapid survey assessing 11 domains of facility readiness. Stakeholder meetings allowed partnership leaders to review results, set priorities, and allocate resources. Investments included salary support, infrastructure improvements, medical equipment, and social support for patients. We compared facility domain scores from the start of the intervention to 12 months and tested for correlation between change in score and change in funding allocation to assess equity in our approach. Results We found significant improvements among intervention facilities from baseline to 12 months across several domains [infrastructure (+4, p=0.0001), clinical services (+1.2, p=0.03), infection and sanitation control (+0.6, p=0.03), medical equipment (+1.0, p=0.02), information use (+2, p=0.002)]. Composite score across domains improved from 6.2 at baseline to 7.4 at 12 months (p=0.002). Across facilities, 50% had composite scores greater than the average score among reference facilities (7.4) at 12 months compared to none at baseline. Conclusions Rapid facility surveys, stakeholder engagement, and information feedback can be used for gap analysis and resource allocation. This approach can achieve effective use

  8. Adult Psychotic Symptoms, Their Associated Risk Factors and Changes in Prevalence in Men and Women Over a Decade in a Poor Rural District of Kenya

    PubMed Central

    Jenkins, Rachel; Othieno, Caleb; Ongeri, Linnet; Ogutu, Bernards; Sifuna, Peter; Kingora, James; Kiima, David; Ongecha, Michael; Omollo, Raymond

    2015-01-01

    There have been no repeat surveys of psychotic symptoms in Kenya or indeed subSaharan Africa. A mental health epidemiological survey was therefore conducted in a demographic surveillance site of a Kenyan household population in 2013 to test the hypothesis that the prevalence of psychotic symptoms would be similar to that found in an earlier sample drawn from the same sample frame in 2004, using the same overall methodology and instruments. This 2013 study found that the prevalence of one or more psychotic symptoms was 13.9% with one or more symptoms and 3.8% with two or more symptoms, while the 2004 study had found that the prevalence of single psychotic symptoms in rural Kenya was 8% of the adult population, but only 0.6% had two symptoms and none had three or more psychotic symptoms. This change was accounted for by a striking increase in psychotic symptoms in women (17.8% in 2013 compared with 6.9% in 2004, p < 0.001), whereas there was no significant change in men (10.6% in 2013 compared with 9.4% in 2004, p = 0.582). Potential reasons for this increase in rate of psychotic symptoms in women are explored. PMID:25996885

  9. Monthly deposition of cadmium in rural and industrial areas of Germany (Bayern, Pfalz, Ruhr district) and its influences upon an agricultural model system.

    PubMed

    Runkel, K H; Payer, H D

    1983-02-01

    Monthly depositions of cadmium were collected by a modified Bergerhoff method and measured by AAS during a 3-year period in rural areas of the Pfalz and in an industrial area of the Ruhr district. Another one year period included measurements in rural areas of southern Bavaria and on a Dutch island. The log-normally distributed deposition rates of cadmium at the rural areas in southern Germany amounted to only 20% of those of the industrial district. The depositions on the Dutch island were twice as high as the depositions on the rural areas of southern Germany. The monthly cadmium deposition rates show only little periodical fluctuation during the year and scatter around more or less constant median values of 25 and 120 micrograms . m-2 . month-1 at the rural and industrial areas, respectively. When open air mass cultures of algae were taken as an agricultural model, the organisms, depending on their growth rate, accumulated 0.4-4.0 ppm of cadmium (dry matter based). The course of the cadmium accumulation reflects the deposition rate of the area where the algae were grown. No growth depression of the algae due to cadmium can be observed under the given deposition rates. PMID:6303745

  10. Monitoring the referral system through benchmarking in rural Niger: an evaluation of the functional relation between health centres and the district hospital

    PubMed Central

    Bossyns, Paul; Abache, Ranaou; Abdoulaye, Mahaman S; Miyé, Hamidou; Depoorter, Anne-Marie; Van Lerberghe, Wim

    2006-01-01

    Background The main objective of this study is to establish a benchmark for referral rates in rural Niger so as to allow interpretation of routine referral data to assess the performance of the referral system in Niger. Methods Strict and controlled application of existing clinical decision trees in a sample of rural health centres allowed the estimation of the corresponding need for and characteristics of curative referrals in rural Niger. Compliance of referral was monitored as well. Need was matched against actual referral in 11 rural districts. The referral patterns were registered so as to get an idea on the types of pathology referred. Results The referral rate benchmark was set at 2.5 % of patients consulting at the health centre for curative reasons. Niger's rural districts have a referral rate of less than half this benchmark. Acceptability of referrals is low for the population and is adding to the deficient referral system in Niger. Mortality because of under-referral is highest among young children. Conclusion Referral patterns show that the present programme approach to deliver health care leaves a large amount of unmet need for which only comprehensive first and second line health services can provide a proper answer. On the other hand, the benchmark suggests that well functioning health centres can take care of the vast majority of problems patients present with. PMID:16608534

  11. Monthly deposition of cadmium in rural and industrial areas of Germany (Bayern, Pfalz, Ruhr district) and its influences upon an agricultural model system

    SciTech Connect

    Runkel, K.H.; Payer, H.D.

    1983-02-01

    Monthly depositions of cadmium were collected by a modified Bergerhoff method and measured by AAS during a 3-year period in rural areas of the Pfalz and in an industrial area of the Ruhr district. Another one year period included measurements in rural areas of southern Bavaria and on a Dutch island. The log-normally distributed deposition rates of cadmium at the rural areas in southern Germany amounted to only 20% of those of the industrial district. The depositions on the Dutch island were twice as high as the depositions on the rural areas of southern Germany. The monthly cadmium deposition rates show only little periodical fluctuation during the year and scatter around more or less constant median values of 25 and 120 micrograms . m-2 . month-1 at the rural and industrial areas, respectively. When open air mass cultures of algae were taken as an agricultural model, the organisms, depending on their growth rate, accumulated 0.4-4.0 ppm of cadmium (dry matter based). The course of the cadmium accumulation reflects the deposition rate of the area where the algae were grown. No growth depression of the algae due to cadmium can be observed under the given deposition rates.

  12. Dental Service Utilization: Patterns and Barriers among Rural Elderly in Guntur District, Andhra Pradesh

    PubMed Central

    Koka, Krishna Mohan; Pachava, Srinivas; Sanikommu, Suresh; Ravoori, Srinivas; Chandu, Viswa Chaitanya

    2016-01-01

    Introduction The biological process of ageing is outside human control and has its own dynamics. It is a known fact that elderly people have more treatment needs compared to the younger population and at the same time elderly people are facing a multitude of barriers in utilization of health care as well as oral health care. Aim To identify the utilization patterns of oral health care and barriers for utilization among rural population. Materials and Methods A cross-sectional study was done on 621 rural elderly subjects to identify the utilization of oral health care services and the barriers for utilization. Using stratified cluster sampling study area was stratified into 13 rural clusters, fifty houses were randomly selected from each stratum. All the elderly subjects, as defined by the age criteria were considered for study. The data were analysed using SPSS 20 v and Chi-square tests were used to analyse the data. Results Only 31.9% of participants reported visiting a dentist in the past while 36.7% reported experiencing a dental problem at some point in their life. There were no significant differences in utilization of dental services based on gender, socio-economic status, age groups and religion. However, significant differences were found in utilization of dental services based on the response of participants to past experience of dental problems. Conclusion The present study results conclude that fear was one of the most commonly reported barriers for utilisation of dental services and there is a need for oral health education and promotion among elderly population. PMID:27135000

  13. The use of oral herbal medicine by women attending antenatal clinics in urban and rural Tanga District in Tanzania.

    PubMed

    Mbura, J S; Mgaya, H N; Heggenhougen, H K

    1985-08-01

    A prospective study on the use of oral herbal medicine was conducted on 214 pregnant women attending antenatal clinics in urban and rural Tanga district, which is well-known for traditional healers. There is a perception that traditional healers are very respected locally, and should be cooperated with. However herb effects range from therapeutic to dangerous. The overall prevalence rate of use of herbal medicine was 42%. The prevalence in urban and rural areas was 43.3% and 40.2% respectively. The highest use rate was towards the end of the 1st trimester and during labor, for a total of 87.7%. Of the users, 54% did so to relieve pregnancy-associated symptoms, while the rest used it as a consequence of beliefs, possibly superstitious, circumstantial constraints, and combinations of these. Significant differences were found between women delivering at home (55% used herbal medicine) and in a modern health facility (38.8%), P=0.038, between Moslems (44.4%) and Christians (32.2%), P=0.22, and among tribes. It seems that oral herbal medicines are commonly used in pregnancies and childbirth in Tanga, as well as in other areas, Bagamoyo being an example. Fear of the health facility eivironment as being a place for dying is an interesting factor. A form of Koranic medicine known as Kombe, which included the use of Quranic inscriptions, was used widely. It is recommended that immediate and long-term outcomes of herb-tested pregnancies be evaluated. Phytochemical, toxicological, and pharmacological studies are necessary to enable health workers to warn against inappropriate and dangerous usage. PMID:4054028

  14. Prevalence of periodontal diseases among rural population of Mustabad, Krishna District

    PubMed Central

    Ramoji Rao, Mulpuri V.; Katari, Pavan Kumar; Vegi, Lokesh; Bypureddy, Tarun Teja; Prabhakara Rao, Koneru Samyuktha; Tejaswi, Kanikanti Siva

    2016-01-01

    Aims and Objectives: People in rural areas neglect oral health as they lack awareness on dental diseases and also due to inadequate availability of dental services. The prevalence of illiteracy is also a reason which can be attributed to a poor oral health. This epidemiological study is undertaken to assess the prevalence of periodontal diseases in the rural population of Mustabad – in Krishna, Andhra Pradesh. Materials and Methods: A cross-sectional study based on randomized sampling method was carried out using the WHO assessment form (1997) on a population of 470. The data were subjected to statistical analysis using Statistical Package for Social Sciences Version 15.0. Results: The subjects were 220 males and 250 females. Maximum numbers of subjects were in the age group of 35-44 years (21.91%). Prevalence of periodontal disease was found to be 73.62%. The periodontal status deteriorated with aging. Prevalence of periodontitis was higher in females (56.35%) compared to males (43.65%). Males had a higher prevalence of deep pockets (3.18%), whereas females had a higher prevalence of shallow pockets (3.20%). Females had twice the bleeding tendency (18.80%) compared to males (8.64%). Conclusion: The increasing prevalence of periodontal diseases is an impending problem which needs immediate intervention, if not it would have a serious negative impact on the future oral health. The need of the hour is more epidemiological studies with a bigger sample are required. PMID:27195229

  15. Sociodemographic drivers of multiple sexual partnerships among women in three rural districts of Tanzania

    PubMed Central

    Exavery, Amon; Kanté, Almamy Malick; Tani, Kassimu; Hingora, Ahmed; Phillips, James F

    2015-01-01

    Background This study examines prevalence and correlates of multiple sexual partnerships (MSP) among women aged 15+ years in Rufiji, Kilombero, and Ulanga districts of Tanzania. Materials and methods Data were collected in a cross-sectional household survey in Rufiji, Kilombero, and Ulanga districts in Tanzania in 2011. From the survey, a total of 2,643 sexually active women ages 15+ years were selected for this analysis. While the chi-square test was used for testing association between MSP and each of the independent variables, logistic regression was used for multivariate analysis. Results Number of sexual partners reported ranged from 1 to 7, with 7.8% of the women reporting multiple sexual partners (2+) in the past year. MSP was more likely among both ever married women (adjusted odds ratio [AOR] =3.83, 95% confidence interval [CI] 1.40–10.49) and single women (AOR =6.13, 95% CI 2.45–15.34) than currently married women. There was an interaction between marital status and education, whereby MSP was 85% less likely among single women with secondary or higher education compared to married women with no education (AOR =0.15, 95% CI 0.03–0.61). Furthermore, women aged 40+ years were 56% less likely compared to the youngest women (<20 years) to report MSP (AOR =0.44, 95% CI 0.24–0.80). The odds of MSP among Muslim women was 1.56 times as high as that for Christians women (AOR =1.56, 95% CI 1.11–2.21). Ndengereko women were 67% less likely to report MSP compared to Pogoro women (AOR =0.33, 95% CI 0.18–0.59). Conclusion Eight percent of the women aged 15+ in Rufiji, Kilombero, and Ulanga districts of Tanzania are engaged in MSP. Encouraging achievement of formal education, especially at secondary level or beyond, may be a viable strategy toward partner reduction among unmarried women. Age, religion, and ethnicity are also important dimensions for partner reduction efforts. PMID:25914557

  16. Perceptions and uptake of health insurance for maternal care in rural Kenya: a cross sectional study

    PubMed Central

    Maina, Jackson Michuki; Kithuka, Peter; Tororei, Samuel

    2016-01-01

    Introduction In Kenya, maternal and child health accounts for a large proportion of the expenditures made towards healthcare. It is estimated that one in every five Kenyans has some form of health insurance. Availability of health insurance may protect families from catastrophic spending on health. The study intended to determine the factors affecting the uptake of health insurance among pregnant women in a rural Kenyan district. Methods This was cross-sectional study that sampled 139 pregnant women attending the antenatal clinic at a level 5 hospital in a Kenyan district. The information was collected through a pretested interview schedule. Results The median age of the study participants was 28 years. Out of the 139 respondents, 86(62%) planned to pay for their deliveries through insurance. There was a significant relationship between insurance uptake and marital status Adjusted odds ratio (AOR) 6.4(1.4-28.8). Those with tertiary education were more likely to take up insurance AOR 5.1 (1.3-19.2). Knowing the benefits of insurance and the limits the insurance would settle in claims was associated with an increase in the uptake of insurance AOR 7.6(2.3-25.1), AOR 6.4(1.5-28.3) respectively. Monthly income and number of children did not affect insurance uptake. Results Being married, tertiary education and having some knowledge on how insurance premiums are paid are associated with uptake of medical insurance. Information generated from this study if utilized will bring a better understanding as to why insurance coverage may be low and may provide a basis for policy changes among the insurance companies to increase the uptake. PMID:27279952

  17. Community perceptions of malaria and malaria treatment behaviour in a rural district of Ghana: implications for artemisinin combination therapy

    PubMed Central

    2010-01-01

    Background Artesunate-amodiaquine (AS-AQ) was introduced in Ghana as the first line drug for treatment of uncomplicated malaria in 2004. We report the perceptions of malaria and malaria treatment behaviour, the community awareness of and perceptions about AS-AQ two years after the introduction of this ACT treatment for malaria. Methods Two surveys were conducted; a cross-sectional survey of 729 randomly selected household heads (urban-362, rural-367) and 282 women with children < 5 years (urban-121, rural-161) was conducted in 2006. A district wide survey was conducted in 2007 to assess awareness of AS-AQ. These were complemented with twenty-eight focus group discussions (FGDs) and 16 key informant interviews (KII) among community members and major stakeholders in the health care delivery services. All nine (9) health facilities and five (5) purposively selected drug stores were audited in order to identify commonly used anti-malarials in the study area at the time of the survey. Results Majority of respondents ( > 75%) in the sampled survey mentioned mosquito bites as the cause of malaria. Other causes mentioned include environmental factors (e.g. dirty surroundings) and standing in the sun. Close to 60% of the household heads and 40% of the care-givers interviewed did not know about AS-AQ. The community respondents who knew about and had ever taken AS-AQ perceived it to be a good drug; although they mentioned they had experienced some side effects including headaches and body weakness. Co-blistered AS-AQ was available in all the government health facilities in the study area. Different formulations of ACTs were however found in urban chemical shops but not in rural chemical stores where monotherapy antimalarials were predominant. Conclusion The knowledge of fever as a symptom of malaria is high among the study population. The awareness of AS-AQ therapy and its side-effect was low in the study area. Community education and sensitization, targeting all categories

  18. Classroom Interaction in Kenyan Primary Schools.

    ERIC Educational Resources Information Center

    Ackers, Jim; Hardman, Frank

    2001-01-01

    Reports on a study of classroom interaction in Kenyan primary schools. Analyzes video recordings of 102 lessons in English, mathematics, and science using systematic observation, discourse analysis, and a time-line analysis. Reveals the preponderance of teacher dominated lessons with little opportunity for student interaction. Considers…

  19. Costs and Consequences of a Cash Transfer for Hospital Births in a Rural District of Uttar Pradesh, India

    PubMed Central

    Coffey, Diane

    2014-01-01

    The Janani Suraksha Yojana, India’s “safe motherhood program,” is a conditional cash transfer to encourage women to give birth in health facilities. Despite the program’s apparent success in increasing facility-based births, quantitative evaluations have not found corresponding improvements in health outcomes. This study analyses original qualitative data collected between January, 2012 and November, 2013 in a rural district in Uttar Pradesh to address the question of why the program has not improved health outcomes. It finds that health service providers are focused on capturing economic rents associated with the program, and provide an extremely poor quality care. Further, the program does not ultimately provide beneficiaries a large net monetary transfer at the time of birth. Based on a detailed accounting of the monetary costs of hospital and home deliveries, this study finds that the value of the transfer to beneficiaries is small due to costs associated with hospital births. Finally, this study also documents important emotional and psychological costs to women of delivering in the hospital. These findings suggest the need for a substantial rethinking of the program, paying careful attention to incentivizing health outcomes. PMID:24911512

  20. Study of gastro-intestinal helminths of scavenging chickens in four rural districts of Amhara region, Ethiopia.

    PubMed

    Eshetu, Y; Mulualem, E; Ibrahim, H; Berhanu, A; Aberra, K

    2001-12-01

    A total of 267 rural scavenging chickens were examined from October 1998 to August 1999 in four woredas (districts) of the Amhara Region, Ethiopia. Of these chickens, 243 (91.01%) were found to harbour one to nine different helminth parasites and 24 (8.99%) were free of helminth parasites. A significant difference (P < 0.01) was found between the prevalence rates of helminth parasites in the different agro-ecological zones; the highest prevalence was observed in the lowland areas. This suggests that agro-ecology has a major influence on the distribution of helminth parasites. Nematodes recovered included Heterakis gallinarum (17.28%), Subulura brumpti (17.60%), Ascaridia galli (35.58%), Cheilospirura hamulosa (0.75%) and Dyspharynx spiralis (2.62%). The principal cestode species encountered were Raillietina echinobothrida (25.84%), Raillietina tetragona (45.69%), Raillietina cesticillus (5.62%), Amoebotaenia sphenoides (40.45%), Davainea proglottina (1.12%) and Choanotaenia infundibulum (4.49%). PMID:11732422

  1. Trends in blunt abdominal trauma among hospital in-patients. Developments in a Swedish rural district over 30 years.

    PubMed

    Bergqvist, D; Hedelin, H

    1979-01-01

    To analyse changes in background factors, injury pattern, and prognosis regarding blunt abdominal trauma in Sweden, the 30-year postwar (1946--75) development was investigated in a rural district. 396 patients were treated, showing a great increase during the last 5 years. The highest frequency was seen in patients aged 11--30 years. Abdominal trauma occurred most commonly during July and August. The growing aetiological importance of road accidents is shown. Equestrian accidents were common early in the period and again towards the end. The incidence of cerebrally confused patients increased. The organs most commonly traumatized were kidney, liver, and spleen. The frequency of multiple intra-abdominal injuries and also associated extra-abdominal injuries increased with time. There was a tendency towards shorter hospital stays. Mortality rates did not change during the period, even though injuries have become increasingly severe (judged by the Injury Severity Score). It is concluded that the improved care of patients compensated precisely for the increased severity of injuries, as reflected in mortality. PMID:432565

  2. Attitudes and Orientations of Rural Groups and Effects on Educational Decision-Making and Innovation in Rural School Districts: A Synthesis of Research.

    ERIC Educational Resources Information Center

    Hughes, Larry W.; Spence, Dolphus L.

    The rural community is characterized by a decreasing population and an eroding of local taxable wealth which contribute to the ineffectiveness of community agencies or institutions to serve citizens' needs. The rural community resists widespread effort to change existing conditions since rural people are generally conservative and often do not…

  3. Genetic diversity of Leishmania tropica strains isolated from clinical forms of cutaneous leishmaniasis in rural districts of Herat province, Western Afghanistan, based on ITS1-rDNA.

    PubMed

    Fakhar, Mahdi; Pazoki Ghohe, Hossein; Rasooli, Sayed Abobakar; Karamian, Mehdi; Mohib, Abdul Satar; Ziaei Hezarjaribi, Hajar; Pagheh, Abdol Sattar; Ghatee, Mohammad Amin

    2016-07-01

    Despite the high incidence of cutaneous leishmaniasis (CL) in Afghanistan, there is a little information concerning epidemiological status of the disease and phylogenetic relationship and population structure of causative agents. This study was conducted to determine the prevalence and distribution of CL cases and investigate the Leishmania tropica population structure in rural districts of Heart province in the West of Afghanistan in comparison to neighboring foci. Overall, 4189 clinically suspected CL cases from 177 villages (including 12 districts) in Herat province were enrolled in the referral laboratory of WHO sub-office in Herat city from January 2012 to December 2013. 3861 cases were confirmed as CL by microscopic examination of Giemsa-stained slides. ITS1 PCR-RFLP analysis showed dominance of L. tropica (more than 98%) among 127 randomly chosen samples. Analysis of the ITS1 sequences revealed 4 sequence types among the 21 L. tropica isolates. Comparison of sequence types from Herat rural districts with the representatives of L. tropica from Iran, India, and Herat city showed two main population groups (cluster A and B). All isolates from Herat province, India and Southeast, East, and Central Iran were found exclusively in cluster A. The close proximity of West Afghanistan focus and Birjand county as the capital of Southern Khorasan province in East Iran can explain relatively equal to the genetic composition of L. tropica in these two neighboring regions. In addition, two populations were found among L. tropica isolates from Herat rural districts. Main population showed more similarity to some isolates from Birjand county in East Iran while minor population probably originated from the Southeast and East Iranian L. tropica. Recent study provided valuable information concerning the population structure of L. tropica and epidemiology of ACL in the West of Afghanistan, which could be the basis for molecular epidemiology studies in other regions of Afghanistan

  4. Modeling and estimating manganese concentrations in rural households in the mining district of Molango, Mexico.

    PubMed

    Cortez-Lugo, Marlene; Rodríguez-Dozal, Sandra; Rosas-Pérez, Irma; Alamo-Hernández, Urinda; Riojas-Rodríguez, Horacio

    2015-12-01

    Airborne manganese (Mn) is considered the most hazardous route of exposure since Mn particles can enter into the body through the lung and may access the brain directly through olfactory uptake, thereby bypassing homeostatic excretory mechanisms. Environmental indoor and outdoor manganese concentrations in PM2.5 were monitored in ten rural households from two communities of Hidalgo, Mexico, from 2006 to 2007. Indoor and outdoor air samples of PM2.5 were collected using MiniVol samplers, and Mn concentrations in the filters were measured using proton-induced X-ray emission (PIXE). An adjusted generalized linear mixed model was applied and then used for estimating indoor concentrations in non-monitored households. Our monitoring results showed a higher daily average concentration of indoor PM2.5 vs. outdoor PM2.5 (46.4 vs. 36.2 μg/m(3), respectively); however, manganese concentration in PM2.5 indoor and outdoor was 0.09 μg/m(3) in both sceneries. Predictor variables of indoor Mn concentration were outdoor Mn concentration (64.5% increase per 0.1 μg/m(3) change in Mn) and keeping the windows open (4.2% increase). Using these predictors, the average estimated indoor Mn concentration in PM2.5 was 0.07 μg/m(3) (SD = 0.05). Our results confirm the direct effect of outdoor Mn levels, opening house windows, and the distance to the mining chimney in indoor Mn levels in houses. PMID:26573689

  5. Snakebites in Two Rural Districts in Lao PDR: Community-Based Surveys Disclose High Incidence of an Invisible Public Health Problem

    PubMed Central

    Vongphoumy, Inthanomchanh; Phongmany, Panom; Sydala, Sengdao; Prasith, Nouda; Reintjes, Ralf; Blessmann, Joerg

    2015-01-01

    Background The Lao PDR (Laos) is one of the least developed countries in Asia with an estimated 25% of the population living in poverty. It is the habitat of some highly venomous snakes and the majority of the population earns their living from agricultural activities. Under these circumstances the incidence of snakebites is expected to be high. Methods Two cross-sectional, community-based surveys were performed in Champone and Phin district, Savannakhet province, Lao PDR to estimate snakebite incidence. Multistage random sampling was used. In the first stage approximately 40% of all villages in each district were randomly selected. In the second stage 33% of all households in each village were randomly chosen. Members of the selected households were interviewed about snakebites during the previous 12 months. Results Thirty-five of 9856 interviewees reported a snakebite in a 12 month period in Champone district and 79 of 7150 interviewees in Phin district. The estimated incidence is 355 snakebites per 100,000 persons per year and 1105 per 100,000 in Champone and Phin district respectively. All snakebite victims received treatment by traditional healers or self-treatment at home and nobody went to a hospital. Incidence of snakebites, calculated on the basis of hospital records of 14 district hospitals and Savannakhet provincial hospital, ranged from 3 to 14 cases per 100,000 persons per year between 2012 and 2014. Conclusion Incidence of snakebites is high in rural communities in Laos with significant regional differences. Poverty most likely contributes significantly to the higher number of snakebites in Phin district. Hospital statistics profoundly underestimates snakebite incidence, because the majority of snakebite victims receive only treatment by traditional healers or self-treatment in their village. There is an urgent need to train medical staff and students in management of snakebite patients and make snake antivenom available to cope effectively with this

  6. Acceptability of condom promotion and distribution among 10–19 year-old adolescents in Mpwapwa and Mbeya rural districts, Tanzania

    PubMed Central

    2012-01-01

    Background The HIV/AIDS pandemic remains a leading challenge for global health. Although condoms are acknowledged for their key role on preventing HIV transmission, low and inappropriate use of condoms persists in Tanzania and elsewhere in Africa. This study assesses factors affecting acceptability of condom promotion and distribution among adolescents in Mpwapwa and Mbeya rural districts of Tanzania. Methods Data were collected in 2011 as part of a larger cross-sectional survey on condom use among 10–19 year-olds in Mpwapwa and Mbeya rural districts of Tanzania using a structured questionnaire. Associations between acceptability of condom promotion and distribution and each of the explanatory variables were tested using Chi Square. Multivariate logistic regression model was used to examine independent predictors of the acceptability of condom promotion and distribution using STATA (11) statistical software at 5% significance level. Results Mean age of the 1,327 adolescent participants (50.5% being males) was 13.5 years (SD = 1.4). Acceptance of condom promotion and distribution was found among 37% (35% in Mpwapwa and 39% in Mbeya rural) of the adolescents. Being sexually active and aged 15–19 was the strongest predictor of the acceptability of condom promotion and distribution (OR = 7.78, 95% CI 4.65-12.99). Others were; not agreeing that a condom is effective in preventing transmissions of STIs including HIV (OR = 0.34, 95% CI 0.20-0.56), being a resident of Mbeya rural district (OR = 1.67, 95% CI 1.28-2.19), feeling comfortable being seen by parents/guardians holding/buying condoms (OR = 2.20, 95% CI 1.40-3.46) and living with a guardian (OR = 1.48, 95% CI 1.08-2.04). Conclusion Acceptability of condom promotion and distribution among adolescents in Mpwapwa and Mbeya rural is low. Effect of sexual activity on the acceptability of condom promotion and distribution is age-dependent and was the strongest. Feeling comfortable being

  7. Implementing intimate partner violence care in a rural sub-district of South Africa: a qualitative evaluation

    PubMed Central

    Rees, Kate; Zweigenthal, Virginia; Joyner, Kate

    2014-01-01

    Background Despite a high burden of disease, in South Africa, intimate partner violence (IPV) is known to be poorly recognised and managed. To address this gap, an innovative intersectoral model for the delivery of comprehensive IPV care was piloted in a rural sub-district. Objective To evaluate the initiative from the perspectives of women using the service, service providers, and managers. Design A qualitative evaluation was conducted. Service users were interviewed, focus groups were conducted amongst health care workers (HCW), and a focus group and interviews were conducted with the intersectoral implementation team to explore their experiences of the intervention. A thematic analysis approach was used, triangulating the various sources of data. Results During the pilot, 75 women received the intervention. Study participants described their experience as overwhelmingly positive, with some experiencing improvements in their home lives. Significant access barriers included unaffordable indirect costs, fear of loss of confidentiality, and fear of children being removed from the home. For HCW, barriers to inquiry about IPV included its normalisation in this community, poor understanding of the complexities of living with violence and frustration in managing a difficult emotional problem. Health system constraints affected continuity of care, privacy, and integration of the intervention into routine functioning, and the process of intersectoral action was hindered by the formation of alliances. Contextual factors, for example, high levels of alcohol misuse and socio-economic disempowerment, highlighted the need for a multifaceted approach to addressing IPV. Conclusions This evaluation draws attention to the need to take a systems approach and focus on contextual factors when implementing complex interventions. The results will be used to inform decisions about instituting appropriate IPV care in the rest of the province. In addition, there is a pressing need for

  8. Educational Intervention Increased Referrals to Allopathic Care by Traditional Healers in Three High HIV-Prevalence Rural Districts in Mozambique

    PubMed Central

    Audet, Carolyn M.; Salato, José; Blevins, Meridith; Amsalem, David; Vermund, Sten H.; Gaspar, Felisbela

    2013-01-01

    Introduction Delayed uptake of clinical services impedes favorable clinical outcomes in Mozambique. Care is delayed among patients who initiate care with traditional healers; patients with conditions like human immunodeficiency virus (HIV) or tuberculosis are rarely referred to the health system in a timely fashion. Methods We conducted a pre-post educational intervention with traditional healers, assessing healer referral rates and HIV knowledge in three rural districts in Zambézia Province. Results The median monthly referral rate prior to the intervention was 0.25 patients (interquartile range [IQR]: 0–0.54) compared with a post-intervention rate of 0.34 patients (IQR: 0–0.71), a 35% increase (p = 0.046). A median HIV knowledge score of 67% (IQR: 59–78) was noted 4-months pre-intervention and a median score of 81% (IQR: 74–89) was recorded 2½ months post-intervention (p<0.001). One hundred and eleven healers referred 127 adults, 36 pregnant women, and 188 children to health facilities. Referred patients were most likely to be diagnosed with bronchopneumonia (20% adults; 13% children) and/or malaria (15% adults; 37% children). Of 315 non-pregnant persons referred, 3.5% were tested for HIV and 2.5% were tested for tuberculosis. Discussion We engaged traditional healers with some success; referral rates were low, but increased post-intervention. Once seen in the clinics, patients were rarely tested for HIV or tuberculosis, though symptoms suggested screening was indicated. We found increased referral rates through an inexpensive intervention with traditional healers, a viable, cost-effective method of directing patients to health facilities. However, quality improvement within the clinics is necessary before a substantial impact can be expected. PMID:23936407

  9. Postgraduate training for family medicine in a rural district hospital in South Africa: Appropriateness and sufficiency of theatre procedures as a sentinel indicator

    PubMed Central

    Plessis, Dawie Du; Alfred Kapp, Paul; Giddy, Laurel

    2016-01-01

    Background Since 2007, the postgraduate training of family physicians for South African district hospitals has been formalised. This training differs from European and North American programmes as up to 30% of the skills needed rely on district hospital surgical, obstetrics and anaesthetics procedures, particularly in rural areas, as outlined in the national unit standards. The aim of this study was to evaluate the appropriateness and sufficiency of learning opportunities for these skills in a rural district hospital. Methods A descriptive, cross-sectional study was undertaken of the number and type of procedures performed in theatre for a 1-year period and compared with the required procedural skills stipulated in the national unit standards. Descriptive statistical analyses were used to analyse categorical data. Results Three thousand seven hundred and forty-one procedures were performed during the study period. Anaesthesia was the most common procedure, followed by Caesarean section. There were adequate opportunities for teaching most core skills. Conclusions Sufficient and appropriate learning opportunities exist for postgraduate family medicine training in all the core skills performed in a theatre according to the national unit standards. PMID:27380781

  10. Fatherhood in Kenyan Ethnic Communities: Implication for Child Development

    ERIC Educational Resources Information Center

    Lasser, Jon; Fite, Kathleen; Wadende, Akinyi P.

    2011-01-01

    This article reviews the traditional and evolving constructions of fatherhood in Kenyan society, with an emphasis on fatherhood's impact on child development outcomes. Western influence and increased access to technology have changed the role of the Kenyan father, and in turn affected his role in the family. Special attention is given to…

  11. Competing Motivations for NP Order in Kenyan English.

    ERIC Educational Resources Information Center

    Kuha, Mai

    1998-01-01

    Examines competition between conflicting principles in Kenyan English (animacy hierarchy and discourse pressure to place given information before new), manifested in news discourse. Results suggest some differences between spoken and written Kenyan English pointing to a tendency toward a more standard native-speaker variety in news discourse, and…

  12. Oral Health Status of Rural and Urban Population of Gurgaon Block, Gurgaon District Using WHO Assessment Form through Multistage Sampling Technique

    PubMed Central

    Prasad, Sumanth; Rajashekharappa, Chinmaya Byali; Garg, Aarti; Ryana, Haneet Kour; Khurana, Charu

    2016-01-01

    Introduction Oral health is an integral part of general health and well being. Poor oral health can affect a person physiologically and psychologically irrespective of age group. Aim To assess the oral health status and treatment needs of urban and rural population of Gurgaon Block, Gurgaon District, Haryana, India. Materials and Methods A descriptive cross-sectional study was conducted among 810 urban and rural subjects belonging to index age groups of 5, 12, 15, 35-44 and 65-74 years as recommended by WHO, in the city of Gurgaon, Haryana. The World Health Organization Oral Health Assessment Form (1997) was used for data collection in which clinical examination, soft and hard tissue findings as well as dentofacial anomalies were recorded. The subjects were selected by multistage random sampling and examined throughout the area by a house to house survey. Statistical Analysis The data was collected and subjected to analysis through SPSS 21. Chi-square was used for compilation of results. Results Of the total population 44.9% had dental caries with a mean DMFT of 1.61. Prevalence of periodontal diseases was 65%; 46% of the population suffered from malocclusions of which 21.19 % had the severe type. Dental fluorosis was found to be highly prevalent (46%) out of which 11.23% had moderate and 9.6% had severe type of fluorosis. Treatment was found to be required among 83% of population. Conclusion The dental health care needs are very high both in rural and urban areas in spite of basic facilities available in urban areas. Hence professional and administrative attention is required both in urban and rural areas. Gurgaon Block can be used as a model district to find the effectiveness of programs in bringing down the oral diseases and maintenance of the oral health of the people on a long term basis. PMID:27437359

  13. [Ambulatory management of moderately and severely malnourished children in the rural health district of Kapolowe in Shaba (Zaire)].

    PubMed

    Tellier, V; Luboya, N; De Graeve, G; Beghin, I

    1996-01-01

    In Kapalowe rural health district, hospitalisation of malnourished children is restricted to complicated cases; once the complication is under control or eliminated, the child's treatment is continued at home, based on a 13 weeks contract, between parents and health centre. The parents commit themselves to feed their child four times a day (two porridge and two family dish portions), to consult once a week at the health centre and to welcome a weekly home visit. The objective of this visit is to support the parents, to detect possible problems and to reach the roots for this particular child. During the contract period, cost of medical treatment and recommended soya flour, is borne by the parents through a lump sum contribution. In this article, data concerning the first 95 children home rehabilitated (1989-1991) in Kapalowe are analysed. Characteristics of these children are classical regarding malnutrition; for example, age distribution is similar to that of weaning and of defunction of children at the hospital during the same year. Approximately half of them are still breastfed at the beginning of the contract. Most of them are correctly immunized and have been seen at the health centre at least two times in the last six months. Seventy-four children finished the contract; there were 17 abandons and 4 deaths. Weight gain is inferior to that observed in specialized feeding centres which do benefit from external resources, which is not the case here. It was not possible to show a significant catch up for the height for age indicator after the three months contract. These anthropometrical results are less important than the global and subjective improvement in the child's general health status observed at the end of the contract. None of the children reached the target weight after 13 weeks but important changes were observed in their behaviour, in their resistance to infection and in the attitude of their parents. The parents generally followed the instructions

  14. Masculinity, social context and HIV testing: an ethnographic study of men in Busia district, rural eastern Uganda

    PubMed Central

    2014-01-01

    Background Uptake of HIV testing by men remains low in high prevalence settings in many parts of Africa. By focusing on masculinity, this study explores the social context and relations that shape men’s access to HIV testing in Mam-Kiror, Busia district, rural eastern Uganda. Methods From 2009–2010 in-depth interviews were undertaken with 26 men: nine being treated for HIV, eight who had tested but dropped out of treatment, six not tested but who suspected HIV infection and three with other health problems unrelated to HIV. These data were complemented by participant observation. Thematic analysis was undertaken. Results There were two main categories of masculinity in Mam-Kiror, one based on ‘reputation’ and the other on ‘respectability’, although some of their ideals overlapped. The different forms of masculine esteem led to different motives for HIV testing. Men positioned HIV testing as a social process understood within the social context and relationships men engaged in rather than an entirely self-determined enterprise. Wives’ inferior power meant that they had less influence on men’s testing compared to friends and work colleagues who discussed frankly HIV risk and testing. Couple testing exposed men’s extra-marital relationships, threatening masculine esteem. The fear to undermine opportunities for sex in the context of competition for partners was a barrier to testing by men. The construction of men as resilient meant that they delayed to admit to problems and seek testing. However, the respectable masculine ideal to fulfil responsibilities and obligations to family was a strong motivator to seeking an HIV test and treatment by men. Conclusion The two main forms of masculine ideals prevailing in Mam-Kiror in Busia led men to have different motives for HIV testing. Reputational masculinity was largely inconsistent with the requirements of couple testing, community outreach testing and the organisation of testing services, discouraging men

  15. [The use of contraceptive methods by the Mossi in a rural health district of Kaya, Burkina Faso].

    PubMed

    Sondo, B; Sya, D; Paré, R; Kouanda, S; Savadogo, L

    2001-01-01

    We investigated contraceptive practices in the rural health district of Kaya in Burkina Faso with the aim of a) comparing the sociodemographic and cultural characteristics of individuals who were well and poorly informed concerning contraceptive methods; b) analyzing the pattern of use of these contraceptive methods by the populations. We carried out a two-level cluster survey by the Hendersen method. For each household investigated, the chief, his wife (or one wife selected at random in polygamous families) and an adolescent (or one adolescent selected at random if there was more than one adolescent) were interviewed. Significantly more men than women were well informed concerning contraceptive methods. Similarly, a higher proportion of male adolescents than of female adolescents were well informed concerning contraceptive methods. The individuals who were well informed concerning contraceptive methods differed from those who were not well informed in terms of age, religion, level of education and radio listening habits. The prevalence of use of contraceptive methods in this study was found to be 4 to 36%, depending on the group studied. The majority of individuals expressed an intention to use contraceptive methods in the future: 59 to 78%, depending on the group studied. The contraceptive methods chosen for current and future use were, in order: the pill, condoms and contraceptive implants and the intrauterine device. Current patterns of contraceptive use favor, in decreasing order of preference, abstinence, the pill, condoms and contraceptive implants. There was also a strong tendency for individuals to experiment with diverse contraceptive methods. Thus, in the future, there is likely to be a trend towards the abandoning of abstinence in favor of the pill, condoms and contraceptive implants. Of these newer methods, condoms are likely to be the least popular and their relegation to a lower level of importance is likely to have disastrous consequences in terms

  16. Neurodevelopmental Outcome of High Risk Newborns Discharged from Special Care Baby Units in a Rural District in India

    PubMed Central

    Chattopadhyay, Nandita; Mitra, Kaninika

    2015-01-01

    Background High risk newborns are most vulnerable to develop neuro-developmental delay (NDD). Early detection of delay in this group and identification of associated perinatal factors and their prevention can prevent disability in later life. Design and methods Observational cohort study. Field based tracking and neuro-developmental screening of high risk newborns discharged between January 2010 to June 2012 from a district Hospital in India was conducted by a team of developmental specialists, using standardized tools like Denver Developmental Screening Tool II, Trivandrum Developmental Screening Chart and Amiel-Tison method of tone assessment. Associated perinatal factors were identified. Early intervention was initiated on those detected with NDD. Results Developmental delay was detected in 31.6% of study population. Prevalence of NDD was significantly higher in low birth weight (LBW, >2 kg), preterm (<36 weeks) and twins. Neonatal sepsis/meningitis and convulsions also showed significant association with NDD. Of the 134 with developmental delay, 61 were preterm, 80 LBW, with h/o sepsis in 52, convulsion in 14, birth asphyxia in 39 and jaundice in 14 neonates. Conclusions Incidence of NDD among high risk newborns is significantly high with LBW, prematurity and neonatal illnesses are major contributors. Most NDDs go undetected in the early years of life. Improved perinatal care, early detection and early intervention at the grass root level will bring down incidence of developmental challenges in this vulnerable group. Significance for public health The public health significance of this study lies in the fact that a large proportion of high-risk newborns in rural India were detected with developmental delay and some preventable perinatal and neonatal factors like prematurity, low birth weight, sepsis and meningitis were found to be associated with the problem. So, it suggests that prevention of these perinatal factors, timely detection with proper screening

  17. The financial protection effect of Ghana National Health Insurance Scheme: evidence from a study in two rural districts

    PubMed Central

    2011-01-01

    Background One of the key functions of health insurance is to provide financial protection against high costs of health care, yet evidence of such protection from developing countries has been inconsistent. The current study uses the case of Ghana to contribute to the evidence pool about insurance's financial protection effects. It evaluates the impact of the country's National Health Insurance Scheme on households' out-of-pocket spending and catastrophic health expenditure. Methods We use data from a household survey conducted in two rural districts, Nkoranza and Offinso, in 2007, two years after the initiation of the Ghana National Health Insurance Scheme. To address the skewness of health expenditure data, the absolute amount of out-of-pocket spending is estimated using a two-part model. We also conduct a probit estimate of the likelihood of catastrophic health expenditures, defined at different thresholds relative to household income and non-food consumption expenditure. The analysis controls for chronic and self-assessed health conditions, which typically drive adverse selection in insurance. Results At the time of the survey, insurance coverage was 35 percent. Although the benefit package of insurance is generous, insured people still incurred out-of-pocket payment for care from informal sources and for uncovered drugs and tests at health facilities. Nevertheless, they paid significantly less than the uninsured. Insurance has been shown to have a protective effect against the financial burden of health care, reducing significantly the likelihood of incurring catastrophic payment. The effect is particularly remarkable among the poorest quintile of the sample. Conclusions Findings from this study confirm the positive financial protection effect of health insurance in Ghana. The effect is stronger among the poor group than among general population. The results are encouraging for many low income countries who are considering a similar policy to expand social

  18. Use of traditional medicines in the management of HIV/AIDS opportunistic infections in Tanzania: a case in the Bukoba rural district

    PubMed Central

    Kisangau, Daniel P; Lyaruu, Herbert VM; Hosea, Ken M; Joseph, Cosam C

    2007-01-01

    Background Ethnobotanical surveys were carried out to document herbal remedies used in the management of HIV/AIDS opportunistic infections in Bukoba Rural district, Tanzania. The district is currently an epicenter of HIV/AIDS and although over 90% of the population in the district relies on traditional medicines to manage the disease, this knowledge is impressionistic and not well documented. The HIV/AIDS opportunistic conditions considered during the study were Tuberculosis (TB), Herpes zoster (Shingles), Herpes simplex (Genital herpes), Oral candidiasis and Cryptococcal meningitis. Other symptomatic but undefined conditions considered were skin rashes and chronic diarrhea. Methods An open-ended semi-structured questionnaire was used in collecting field information. Descriptive statistics were used to analyze the ethnobotanical data collected. Factor of informant consensus (Fic) was used to analyze the ethnobotanical importance of the plants. Results In the present study, 75 plant species belonging to 66 genera and 41 families were found to be used to treat one or more HIV/AIDS related infections in the district. The study revealed that TB and oral candidiasis were the most common manifestations of HIV/AIDS opportunistic infections affecting most of the population in the area. It unveils the first detailed account of ethnomedical documentation of plants focusing the management of HIV/AIDS related infections in the district. Conclusion It is concluded that the ethnopharmacological information reported forms a basis for further research to identify and isolate bioactive constituents that can be developed to drugs for the management of the HIV/AIDS opportunistic infections. PMID:17623081

  19. Planning a School Construction Referendum: A Case Study of a Small Rural School District in Southern New Jersey

    ERIC Educational Resources Information Center

    Russo, Christopher J.

    2010-01-01

    The idea to do research in the area of school construction planning came from this writer's experience in a district that was still using a high school that was built in 1914 and the community was happy with that fact. During this writer's time the district had gone to referendum to ask the voters to approve a $67 million building project that…

  20. LONG-TERM STUDY OF EDUCATIONAL EFFECTIVENESS OF NEWLY FORMED CENTRALIZED SCHOOL DISTRICTS IN RURAL AREAS, PART TWO.

    ERIC Educational Resources Information Center

    KREITLOW, BURTON W.

    THE BASIC PURPOSES OF THIS LONGITUDINAL STUDY WERE TO ASCERTAIN WHETHER OR NOT SCHOOL DISTRICT REORGANIZATION IS WORTHWHILE IN TERMS OF TIME, EFFORT, AND EXPENDITURES OF FUNDS, AND TO DETERMINE THE EFFECTS OF SUCH SCHOOL DISTRICT REORGANIZATIONS ON THE EDUCATIONAL OUTCOMES OF THE SCHOOL. THE SAMPLE CONSISTED OF 10 WISCONSIN COMMUNITIES, 5 WITH…

  1. The Perceived Impact of the Curriculum Administrator in Facilitating a Vision of Learning in Small, Rural Pennsylvania School Districts

    ERIC Educational Resources Information Center

    Wolf, Mary A.

    2010-01-01

    One important element of school district reform involves quality district leadership. Researchers have shown that effective school leadership requires numerous responsibilities including knowledge of curriculum, instruction, and assessment (Marzano, Waters & McNulty, 2005). Principals typically have difficulty being strong leaders in this…

  2. "It is not possible for me to have diabetes"-community perceptions on diabetes and its risk factors in Rural Purworejo District, Central Java, Indonesia.

    PubMed

    Pujilestari, Cahya Utamie; Ng, Nawi; Hakimi, Mohammad; Eriksson, Malin

    2014-09-01

    Accumulating evidence suggests that negative perceptions towards diabetes can limit the management and prevention of the disease. The negative perceptions towards diabetes are prevalent in many different settings, especially among rural communities. Few qualitative studies have been performed to understand how the community views diabetes and its associated risk factors. This study aimed to explore general community perceptions of diabetes and its risk factors in rural Indonesia. A total of 68 participants were recruited to 12 focus group discussions (FGDs) comprised of different age groups and sexes. The FGDs were conducted in six villages in rural Purworejo District, Central Java, Indonesia, from 2011 to 2012. All FGDs were recorded and transcribed. Qualitative content analysis was performed to describe and analyse how the rural community perceived diabetes and its risk factors. Diabetes was perceived as a visible and scary sugar disease, and the affected individuals themselves were blamed for getting the disease. Recognised as 'sugar' or 'sweet-pee' disease with terrifying effects, diabetes was believed to be a disease with no cure. The participants seemed to have an unrealistic optimism with regards to the diabetes risk factors. They believed that diabetes would not affect them, only others, and that having family members with diabetes was necessary for one to develop diabetes. Our findings demonstrate that rural communities have negative perceptions about diabetes and at the same time individuals have unrealistic optimism about their own risk factors. Understanding how such communities perceive diabetes and its risk factors is important for planning prevention strategies. Health messages need to be tailored to health-related behaviours and the local culture's concepts of diseases and risk factors. PMID:25168994

  3. “It is not possible for me to have diabetes”–Community Perceptions on Diabetes and Its Risk Factors in Rural Purworejo District, Central Java, Indonesia

    PubMed Central

    Pujilestari, Cahya Utamie; Ng, Nawi; Hakimi, Mohammad; Eriksson, Malin

    2014-01-01

    Accumulating evidence suggests that negative perceptions towards diabetes can limit the management and prevention of the disease. The negative perceptions towards diabetes are prevalent in many different settings, especially among rural communities. Few qualitative studies have been performed to understand how the community views diabetes and its associated risk factors. This study aimed to explore general community perceptions of diabetes and its risk factors in rural Indonesia. A total of 68 participants were recruited to 12 focus group discussions (FGDs) comprised of different age groups and sexes. The FGDs were conducted in six villages in rural Purworejo District, Central Java, Indonesia, from 2011 to 2012. All FGDs were recorded and transcribed. Qualitative content analysis was performed to describe and analyse how the rural community perceived diabetes and its risk factors. Diabetes was perceived as a visible and scary sugar disease, and the affected individuals themselves were blamed for getting the disease. Recognised as ‘sugar’ or ‘sweet-pee’ disease with terrifying effects, diabetes was believed to be a disease with no cure. The participants seemed to have an unrealistic optimism with regards to the diabetes risk factors. They believed that diabetes would not affect them, only others, and that having family members with diabetes was necessary for one to develop diabetes. Our findings demonstrate that rural communities have negative perceptions about diabetes and at the same time individuals have unrealistic optimism about their own risk factors. Understanding how such communities perceive diabetes and its risk factors is important for planning prevention strategies. Health messages need to be tailored to health-related behaviours and the local culture’s concepts of diseases and risk factors. PMID:25168994

  4. A Comparison of Zimbabwe's Rural and Urban Primary School Pupils' Views about Homework: A Case of Masvingo District

    ERIC Educational Resources Information Center

    Mapako, Felix Petros; Mareva, Rugare; Chindedza, Winnet

    2013-01-01

    The study sought to establish and compare the views of rural and urban primary school pupils on homework in Zimbabwe, using six purposively sampled Masvingo rural and urban primary schools. The inquiry employed a qualitative methodology in which data were gathered through semi-structured personal interviews and document analysis. A sample of…

  5. Student Mobility in Rural and Nonrural Districts in Five Central Region States. Issues & Answers. REL 2010-No. 089

    ERIC Educational Resources Information Center

    Beesley, Andrea; Moore, Laurie; Gopalani, Sarah

    2010-01-01

    This report describes the extent and distribution of student mobility in five Central Region states. The study, which calculated student mobility percentages in each state and compared percentages by locale (city, suburb, town, and rural locale, and degree of rurality) within each state, found no consistent patterns across locales. Research…

  6. Disaster Risk Management - The Kenyan Challenge

    NASA Astrophysics Data System (ADS)

    Nabutola, W.; Scheer, S.

    2009-04-01

    Keywords: natural disasters; man-made disasters; terrorist attacks; land slides; disaster policies and legislations; fire; earthquakes; hurricanes; soil erosion; disaster research policy; Preamble: "Risk does not begin and end on the floor of the New York Stock Exchange. The vastness of the subject matter is daunting. Risk touches on the most profound aspects of psychology, mathematics, statistics and history. The literature is monumental; each day's headlines bring many new items of interest. But I know we are not unique, everywhere in the world risks abound." "AGAINST THE GODS the remarkable story of risk" by Peter L. Bernstein, 1998 The real challenge is what can we, as a nation do to avert, prevent them, or in the unfortunate event that they occur, how can we mitigate their impact on the economy? Introductory remarks: Disaster in Kenya, as indeed anywhere else, is not one of those happenings we can wish away. It can strike anywhere any time. Some of it is man-made but most of it is natural. The natural are sometimes induced by man in one way or another. For example, when we harvest trees without replacing them, this diminishes the forest cover and can lead to soil erosion, whose advanced form is land slides. Either way disasters in their different forms and sizes present challenges to the way we live our lives or not, perhaps, even how we die. Disasters in our country have reached crisis stage. ‘In Chinese language, crisis means danger, but it also means opportunity' Les Brown, motivational speaker in "the power of a larger vision" Why I am interested Whereas Kenya experiences man made and natural disasters, there are more sinister challenges of the man-made variety. These loom on the horizon and, from time to time raise their ugly heads, taking many Kenyan lives in their wake, and property destroyed. These are post election violence and terrorist attacks, both related to politics, internal and external. In January 2008, soon after presidential and national

  7. Disaster Risk Management - The Kenyan Challenges

    NASA Astrophysics Data System (ADS)

    Nabutola, W.

    2009-04-01

    Keywords: natural disasters; man-made disasters; terrorist attacks; land slides; disaster policies and legislations; fire; earthquakes; hurricanes; soil erosion; disaster research policy; Preamble: "Risk does not begin and end on the floor of the New York Stock Exchange. The vastness of the subject matter is daunting. Risk touches on the most profound aspects of psychology, mathematics, statistics and history. The literature is monumental; each day's headlines bring many new items of interest. But I know we are not unique, everywhere in the world risks abound." "AGAINST THE GODS the remarkable story of risk" by Peter L. Bernstein, 1998 The real challenge is what can we, as a nation do to avert, prevent them, or in the unfortunate event that they occur, how can we mitigate their impact on the economy? Introductory remarks: Disaster in Kenya, as indeed anywhere else, is not one of those happenings we can wish away. It can strike anywhere any time. Some of it is man-made but most of it is natural. The natural are sometimes induced by man in one way or another. For example, when we harvest trees without replacing them, this diminishes the forest cover and can lead to soil erosion, whose advanced form is land slides. Either way disasters in their different forms and sizes present challenges to the way we live our lives or not, perhaps, even how we die. Disasters in our country have reached crisis stage. ‘In Chinese language, crisis means danger, but it also means opportunity' Les Brown, motivational speaker in "the power of a larger vision" Why I am interested Whereas Kenya experiences man made and natural disasters, there are more sinister challenges of the man-made variety. These loom on the horizon and, from time to time raise their ugly heads, taking many Kenyan lives in their wake, and property destroyed. These are post election violence and terrorist attacks, both related to politics, internal and external. In January 2008, soon after presidential and national

  8. Diterpenoid derivatives of Kenyan Croton sylvaticus.

    PubMed

    Ndunda, Beth; Langat, Moses K; Midiwo, Jacob O; Omosa, Leonidah K

    2015-04-01

    Kenyan Croton sylvaticus Hochst. ex Krauss gave four clerodane diterpenoids, the new ent-3,13E-clerodadiene-15-formate (1), the known 15-acetoxy-ent-3,13E-clerodadiene (2), ent-3,13E-clerodadien-15-ol (3) and hardwickiic acid (4), two known halimane diterpenoids, penduliflaworosin (5) and crotohalimaneic acid (6) and one labdane diterpenoid, labda-13E-ene-8a,15-diol (7). The compounds, when tested for their anti-microbial activities against Bacillus subtilis, Xanthomonas campestris and Candida albicans, were found to be inactive. PMID:25973474

  9. Disaster Risk Management - The Kenyan Challenges

    NASA Astrophysics Data System (ADS)

    Nabutola, W.

    2009-04-01

    Keywords: natural disasters; man-made disasters; terrorist attacks; land slides; disaster policies and legislations; fire; earthquakes; hurricanes; soil erosion; disaster research policy; Preamble: "Risk does not begin and end on the floor of the New York Stock Exchange. The vastness of the subject matter is daunting. Risk touches on the most profound aspects of psychology, mathematics, statistics and history. The literature is monumental; each day's headlines bring many new items of interest. But I know we are not unique, everywhere in the world risks abound." "AGAINST THE GODS the remarkable story of risk" by Peter L. Bernstein, 1998 The real challenge is what can we, as a nation do to avert, prevent them, or in the unfortunate event that they occur, how can we mitigate their impact on the economy? Introductory remarks: Disaster in Kenya, as indeed anywhere else, is not one of those happenings we can wish away. It can strike anywhere any time. Some of it is man-made but most of it is natural. The natural are sometimes induced by man in one way or another. For example, when we harvest trees without replacing them, this diminishes the forest cover and can lead to soil erosion, whose advanced form is land slides. Either way disasters in their different forms and sizes present challenges to the way we live our lives or not, perhaps, even how we die. Disasters in our country have reached crisis stage. ‘In Chinese language, crisis means danger, but it also means opportunity' Les Brown, motivational speaker in "the power of a larger vision" Why I am interested Whereas Kenya experiences man made and natural disasters, there are more sinister challenges of the man-made variety. These loom on the horizon and, from time to time raise their ugly heads, taking many Kenyan lives in their wake, and property destroyed. These are post election violence and terrorist attacks, both related to politics, internal and external. In January 2008, soon after presidential and national

  10. Disaster Risk Management - The Kenyan Challenge

    NASA Astrophysics Data System (ADS)

    Nabutola, W.; Scheer, S.

    2009-04-01

    Keywords: natural disasters; man-made disasters; terrorist attacks; land slides; disaster policies and legislations; fire; earthquakes; hurricanes; soil erosion; disaster research policy; Preamble: "Risk does not begin and end on the floor of the New York Stock Exchange. The vastness of the subject matter is daunting. Risk touches on the most profound aspects of psychology, mathematics, statistics and history. The literature is monumental; each day's headlines bring many new items of interest. But I know we are not unique, everywhere in the world risks abound." "AGAINST THE GODS the remarkable story of risk" by Peter L. Bernstein, 1998 The real challenge is what can we, as a nation do to avert, prevent them, or in the unfortunate event that they occur, how can we mitigate their impact on the economy? Introductory remarks: Disaster in Kenya, as indeed anywhere else, is not one of those happenings we can wish away. It can strike anywhere any time. Some of it is man-made but most of it is natural. The natural are sometimes induced by man in one way or another. For example, when we harvest trees without replacing them, this diminishes the forest cover and can lead to soil erosion, whose advanced form is land slides. Either way disasters in their different forms and sizes present challenges to the way we live our lives or not, perhaps, even how we die. Disasters in our country have reached crisis stage. ‘In Chinese language, crisis means danger, but it also means opportunity' Les Brown, motivational speaker in "the power of a larger vision" Why I am interested Whereas Kenya experiences man made and natural disasters, there are more sinister challenges of the man-made variety. These loom on the horizon and, from time to time raise their ugly heads, taking many Kenyan lives in their wake, and property destroyed. These are post election violence and terrorist attacks, both related to politics, internal and external. In January 2008, soon after presidential and national

  11. Primary healthcare system capacities for responding to storm and flood-related health problems: a case study from a rural district in central Vietnam

    PubMed Central

    Van Minh, Hoang; Tuan Anh, Tran; Rocklöv, Joacim; Bao Giang, Kim; Trang, Le Quynh; Sahlen, Klas-Göran; Nilsson, Maria; Weinehall, Lars

    2014-01-01

    Background As a tropical depression in the East Sea, Vietnam is greatly affected by climate change and natural disasters. Knowledge of the current capacity of the primary healthcare system in Vietnam to respond to health issues associated with storms and floods is very important for policy making in the country. However, there has been little scientific research in this area. Objective This research was to assess primary healthcare system capacities in a rural district in central Vietnam to respond to such health issues. Design This was a cross-sectional descriptive study using quantitative and qualitative approaches. Quantitative methods used self-administered questionnaires. Qualitative methods (in-depth interviews and focus groups discussions) were used to broaden understanding of the quantitative material and to get additional information on actions taken. Results 1) Service delivery: Medical emergency services, especially surgical operations and referral systems, were not always available during the storm and flood seasons. 2) Governance: District emergency plans focus largely on disaster response rather than prevention. The plans did not clearly define the role of primary healthcare and had no clear information on the coordination mechanism among different sectors and organizations. 3) Financing: The budget for prevention and control of flood and storm activities was limited and had no specific items for healthcare activities. Only a little additional funding was available, but the procedures to get this funding were usually time-consuming. 4) Human resources: Medical rescue teams were established, but there were no epidemiologists or environmental health specialists to take care of epidemiological issues. Training on prevention and control of climate change and disaster-related health issues did not meet actual needs. 5) Information and research: Data that can be used for planning and management (including population and epidemiological data) were largely

  12. Successful Tuberculosis Treatment Outcomes among HIV/TB Coinfected Patients Down-Referred from a District Hospital to Primary Health Clinics in Rural South Africa

    PubMed Central

    Jacobson, Karen B.; Moll, Anthony P.; Friedland, Gerald H.; Shenoi, Sheela V.

    2015-01-01

    Background HIV and tuberculosis (TB) coinfection remains a major public health threat in sub-Saharan Africa. Integration and decentralization of HIV and TB treatment services are being implemented, but data on outcomes of this strategy are lacking in rural, resource-limited settings. We evaluated TB treatment outcomes in TB/HIV coinfected patients in an integrated and decentralized system in rural KwaZulu-Natal, South Africa. Methods We retrospectively studied a cohort of HIV/TB coinfected patients initiating treatment for drug-susceptible TB at a district hospital HIV clinic from January 2012-June 2013. Patients were eligible for down-referral to primary health clinics(PHCs) for TB treatment completion if they met specific clinical criteria. Records were reviewed for patients’ demographic, baseline clinical and laboratory information, past HIV and TB history, and TB treatment outcomes. Results Of 657(88.7%) patients, 322(49.0%) were female, 558(84.9%) were new TB cases, and 572(87.1%) had pulmonary TB. After TB treatment initiation, 280(42.6%) were down-referred from the district level HIV clinic to PHCs for treatment completion; 377(57.4%) remained at the district hospital. Retained patients possessed characteristics indicative of more severe disease. In total, 540(82.2%) patients experienced treatment success, 69(10.5%) died, and 46(7.0%) defaulted. Down-referred patients experienced higher treatment success, and lower mortality, but were more likely to default, primarily at the time of transfer to PHC. Conclusion Decentralization of TB treatment to the primary care level is feasible in rural South Africa. Treatment outcomes are favorable when patients are carefully chosen for down-referral. Higher mortality in retained patients reflects increased baseline disease severity while higher default among down-referred patients reflects failed linkage of care. Better linkage mechanisms are needed including improved identification of potential defaulters, increased

  13. Working Together, Staying Vital. Proceedings of the Joint Conference of the Western Australian District High Schools Administrators' Association and the National Society for the Provision of Education in Rural Australia (20th, Fremantle, Western Australia, June 2004)

    ERIC Educational Resources Information Center

    Boylan, Colin, Ed.; Hemmings, Brian, Ed.

    2004-01-01

    The 20th National Society for the Provision of Education in Rural Australia (SPERA) and Western Australia District High School Administrators' Association (WADHSAA) joint conference proceedings, based on the theme "Working Together, Staying Vital," was held in Fremantle, Perth, Western Australia, in June 2004. The proceedings contain 13 keynote…

  14. Victimization and PTSD in A Rural Kenyan Youth Sample

    PubMed Central

    Karsberg, Sidsel H; Elklit, Ask

    2012-01-01

    Within the last ten years, there has been a growing number of epidemiological studies, examining the effect of trauma exposure in children and adolescents. Although studies concerning Post-traumatic Stress Disorder (PTSD) have been conducted in a wide array of different cultural contexts [1], the knowledge on traumatization and development of PTSD is still limited [2]. Most studies conducted are clinical studies, which deal with subjects that have already been traumatized or affected by specific single events such as war [3], natural disasters [1], serious accidents [4] or physical/sexual abuse [5-7]. Though research indicates that adolescents are very vulnerable to the exposure of Potentially Traumatic Events (PTEs) [8], studies targeting non-clinical youth populations and the impact of their life experiences are very few. With the increasing ethnic diversity of populations worldwide, it is of particular interest to compare the prevalence of exposure and PTSD in children and adolescents of different ethnic backgrounds. When designing preventive interventions and treatment programs for youth suffering from PTSD it is crucial to understand the complex interaction of variables behind the disorder. Differences in prevalence of exposure, PTSD and demographic variables between ethnicities may reveal some important clues to the etiology of the disease. The present study replicated six previous non-clinical studies which were designed to provide epidemiological information about exposure to PTEs, and the prevalence of PTSD among adolescents (see Table 1). The six studies were conducted in different countries and were very similar in their research methods and samples. The studies have been conducted in four European countries: Denmark [9], Iceland, [10], Lithuania [11], and the Faroe Islands [2], as well as in two Asian countries: Israel [12], and India [13] of which the four first samples were nationally representative. PMID:23002396

  15. Speech and Language Disorders in Kenyan Children: Adapting Tools For Regions With Few Assessment Resources

    PubMed Central

    Carter, Julie Anne; Murira, Grace; Gona, Joseph; Tumaini, Judy; Lees, Janet; Neville, Brian George; Newton, Charles Richard

    2013-01-01

    This study sought to adapt a battery of Western speech and language assessment tools to a rural Kenyan setting. The tool was developed for children whose first language was KiGiryama, a Bantu language. A total of 539 Kenyan children (males=271, females=268, ethnicity=100% Kigiryama. Data were collected from 303 children admitted to hospital with severe malaria and 206 age-matched children recruited from the village communities. The language assessments were based upon the Content, Form and Use (C/F/U) model. The assessment was based upon the adapted versions of the Peabody Picture Vocabulary Test, Test for the Reception of Grammar, Renfrew Action Picture Test, Pragmatics Profile of Everyday Communication Skills in Children, Test of Word Finding and language specific tests of lexical semantics, higher level language. Preliminary measures of construct validity suggested that the theoretical assumptions behind the construction of the assessments were appropriate and re-test and inter-rater reliability scores were acceptable. These findings illustrate the potential to adapt Western speech and language assessments in other languages and settings, particularly those in which there is a paucity of standardised tools. PMID:24294109

  16. A Qualitative Evaluation of Hand Drying Practices among Kenyans

    PubMed Central

    Person, Bobbie; Schilling, Katharine; Owuor, Mercy; Ogange, Lorraine; Quick, Rob

    2013-01-01

    Background Recommended disease prevention behaviors of hand washing, hygienic hand drying, and covering one’s mouth and nose in a hygienic manner when coughing and sneezing appear to be simple behaviors but continue to be a challenge to successfully promote and sustain worldwide. We conducted a qualitative inquiry to better understand current hand drying behaviors associated with activities of daily living, and mouth and nose covering practices, among Kenyans. Methods and Findings We conducted 7 focus group discussions; 30 in-depth interviews; 10 structured household observations; and 75 structured observations in public venues in the urban area of Kisumu; rural communities surrounding Kisumu; and a peri-urban area outside Nairobi, Kenya. Using a grounded theory approach, we transcribed and coded the narrative data followed by thematic analysis of the emergent themes. Hand drying, specifically on a clean towel, was not a common practice among our participants. Most women dried their hands on their waist cloth, called a leso, or their clothes whether they were cooking, eating or cleaning the nose of a young child. If men dried their hands, they used their trousers or a handkerchief. Children rarely dried their hands; they usually just wiped them on their clothes, shook them, or left them wet as they continued with their activities. Many people sneezed into their hands and wiped them on their clothes. Men and women used a handkerchief fairly often when they had a runny nose, cold, or the flu. Most people coughed into the air or their hand. Conclusions Drying hands on dirty clothes, rags and lesos can compromise the benefits of handwashing. Coughing and sneezing in to an open hand can contribute to spread of disease as well. Understanding these practices can inform health promotion activities and campaigns for the prevention and control of diarrheal disease and influenza. PMID:24069302

  17. Urban, Suburban, and Rural Contexts of School Districts and Neighborhood Revitalization Strategies: Rediscovering Equity in Education Policy and Urban Planning

    ERIC Educational Resources Information Center

    Silverman, Robert Mark

    2014-01-01

    This article revisits the debate about school reform and homeownership-based strategies for neighborhood revitalization. It is based on an analysis of school districts in New York State using data from the American Community Survey (ACS) and the New York State Education Department (NYSED). Findings indicate that the relationship between schools…

  18. Economic Assessment of Rural District Heating by Bio-Steam Supplied by a Paper Mill in Canada

    ERIC Educational Resources Information Center

    Marinova, Mariya; Beaudry, Catherine; Taoussi, Abdelaziz; Trepanier, Martin; Paris, Jean

    2008-01-01

    The article investigates the feasibility of district heating in a small town adjacent to a Kraft pulp mill in eastern Canada. A detailed heat demand analysis is performed for all buildings using a geographical information system and archived data provided by the municipality. The study shows that the entire space heating requirement of the town…

  19. The Relationship between Oral Reading Fluency and Reading Comprehension for Third Grade Students in a Rural Louisiana School District

    ERIC Educational Resources Information Center

    Conway Sledge-Murphy, Felicia

    2011-01-01

    "Dynamic Indicators of Basic Early Literacy Skills (DIBELS)," a diagnostic reading tool used in the majority of school districts throughout the state of Louisiana, has been identified by many researchers as a reliable and valid tool to identify reading deficiencies in struggling readers (Good, Simmons, & Kame'enui, 2001;…

  20. An Evaluation of Student Achievement before and after Training in Response to Instruction in a Rural School District

    ERIC Educational Resources Information Center

    Davis, Caroline

    2014-01-01

    The purpose of this quantitative study was to provide research in examining the difference in student achievement in reading and math through the quantitative data collection of North Carolina EOG scores for students in third through fifth grade from one high poverty and high performing North Carolina public school district before and after…

  1. Assessment of factors which affect multiple uses of water sources at household level in rural Zimbabwe - A case study of Marondera, Murehwa and Uzumba Maramba Pfungwe districts

    NASA Astrophysics Data System (ADS)

    Katsi, Luckson; Siwadi, Japson; Guzha, Edward; Makoni, Fungai S.; Smits, Stef

    Water with all its multiple uses plays a pivotal role in the sustenance of rural livelihoods, especially the poor. As such, the provision of water which go beyond domestic to include water for small-scale productive uses should be encouraged to enhance peoples’ livelihood options by making significant contribution to household income, food security, improved nutrition and health. All these multiple benefits, if combined can assist in the fight against hunger and poverty. This study was conducted in Mashonaland East province, covering Marondera, Murehwa and Uzumba Maramba Pfungwe districts in Zimbabwe for the period December 2005-May 2006 to assess factors which affect multiple uses of water sources at household level. Participatory Rural Appraisal tools such as discussions, observations and interviews were used for data collection. The survey found that people indeed require water for productive purposes apart from domestic uses, which are often given top priority. The study found out that multiple uses of water sources at household level can be affected by segmentation of water services into domestic and productive water supply schemes, technology and system design, water quality and quantity and distance to water sources among other factors. The study recommends that water service providers to be able to provide appropriate, efficient and sustainable services, they should understand and appreciate that people’s water needs are integrated and are part and parcel of their multifaceted livelihood strategies.

  2. Knowledge and Attitudes of Parkinson's Disease in Rural and Urban Mukono District, Uganda: A Cross-Sectional, Community-Based Study.

    PubMed

    Kaddumukasa, Mark; Kakooza, Angelina; Kaddumukasa, Martin N; Ddumba, Edward; Mugenyi, Levi; Sajatovic, Martha; Katabira, Elly

    2015-01-01

    Background. Parkinson's disease (PD) negatively affects the quality of life. There is limited information on PD published from Africa. Lack of adequate knowledge poses a barrier in the provision of appropriate treatment and care for individuals with PD. Methods. A cross-sectional survey was conducted in urban and rural Mukono district, central Uganda. Through the systematic sampling method, data were gathered from 377 adult participants, interviewed on selected aspects of PD knowledge and attitudes. Results. Of the 377 participants, 47% were from urban settings and 68% (260/377) were women with a median age (IQR) of 34 (26-48) years. Half of the study respondents did not know the body part involved in or apparent cause of PD. Nearly 1/3 of individuals believed that PD is a form of insanity and 17% believed that PD is contagious. Rural dwellers were more likely to have incorrect knowledge regarding selected aspects of PD. Conclusions. Understanding the cause of PD is very limited in our setting. Some beliefs about PD aetiology may potentially worsen stigma and social isolation. This study highlights the need for increasing PD awareness in our settings. Public health approaches that improve knowledge are urgently needed to promote care access and community response to Parkinson's disease. PMID:26688774

  3. Knowledge and Attitudes of Parkinson's Disease in Rural and Urban Mukono District, Uganda: A Cross-Sectional, Community-Based Study

    PubMed Central

    Kaddumukasa, Mark; Kakooza, Angelina; Kaddumukasa, Martin N.; Ddumba, Edward; Mugenyi, Levi; Sajatovic, Martha; Katabira, Elly

    2015-01-01

    Background. Parkinson's disease (PD) negatively affects the quality of life. There is limited information on PD published from Africa. Lack of adequate knowledge poses a barrier in the provision of appropriate treatment and care for individuals with PD. Methods. A cross-sectional survey was conducted in urban and rural Mukono district, central Uganda. Through the systematic sampling method, data were gathered from 377 adult participants, interviewed on selected aspects of PD knowledge and attitudes. Results. Of the 377 participants, 47% were from urban settings and 68% (260/377) were women with a median age (IQR) of 34 (26–48) years. Half of the study respondents did not know the body part involved in or apparent cause of PD. Nearly 1/3 of individuals believed that PD is a form of insanity and 17% believed that PD is contagious. Rural dwellers were more likely to have incorrect knowledge regarding selected aspects of PD. Conclusions. Understanding the cause of PD is very limited in our setting. Some beliefs about PD aetiology may potentially worsen stigma and social isolation. This study highlights the need for increasing PD awareness in our settings. Public health approaches that improve knowledge are urgently needed to promote care access and community response to Parkinson's disease. PMID:26688774

  4. The Impact an Integrated Workforce of a Rural Southwestern School District Has in the Making of a Blue Ribbon School

    ERIC Educational Resources Information Center

    Goolsby, Annie J.

    2013-01-01

    This study utilized a contemporary approach to qualitative research, the descriptive survey design, to discover whether a diverse workforce was a major influence in producing a rural Blue Ribbon School. The population represented the school systems of a county located in the West South Central region of the United States. In this study, the terms…

  5. An assessment of the water quality of drinking water in rural districts in Zimbabwe. The case of Gokwe South, Nkayi, Lupane, and Mwenezi districts

    NASA Astrophysics Data System (ADS)

    Hoko, Zvikomborero

    Zimbabwe generally receives an average rainfall of 675 mm per annum of which only a maximum of 10% finds its way to rivers as runoff. Gokwe, Nkayi, Lupane and Mwenezi are some of the driest districts in Zimbabwe having mean annual runoffs (MAR) in the range 17-70 mm. River flows especially in Nkayi and Lupane are seasonal and often dry in the period June to November every year. The Kalahari sands predominantly found in such areas as Gokwe, Nkayi, and Lupane promote rapid percolation of rainwater leaving little runoff. The main source of water for domestic purposes in these areas is groundwater with very little reliance on surface water. This study analyzed the water quality of water points in Gokwe South, Nkayi, Lupane, and Mwenezi districts. Parameters analyzed were pH, temperature, dissolved oxygen (DO), turbidity and electrical conductivity (EC). Water quality perceptions from the villagers and the research team were investigated and possible correlations studied. Water quality perceptions included, taste and soap consumption and colour. The uses of the water at domestic level as well as available alternatives to borehole water were investigated. The pH generally ranged from 6.5 to 8.0, which is within the Canadian guidelines. DO was 0.3-5.9 mg/l while turbidity ranged from 0 to 259 NTU with Mwenezi having the highest turbidity value. Conductivity ranged from 70 to 9800 μS/cm with the lowest and highest values recorded in Gokwe and Mwenezi. It was found out that the water quality in terms of taste and odour was 97% satisfactory for Gokwe South, 85% Nkayi, 64% Lupane, and 62% for Mwenezi. High soap consumption which is related to hardness was perceived to be least in Lupane (14%) and highest in Mwenezi with 81%. In general taste complaints also corresponded to high soap consumption but the opposite was not true. It was observed that there was no clear correlation between the quality parameters studied and perceived quality as for example satisfactory taste

  6. Institutional Delivery Service Utilization among Women from Rural Districts of Wolaita and Dawro Zones, Southern Ethiopia; a Community Based Cross-Sectional Study

    PubMed Central

    Arba, Mihiretu Alemayehu; Darebo, Tadele Dana; Koyira, Mengistu Meskele

    2016-01-01

    Introduction The highest number of maternal deaths occur during labour, delivery and the first day after delivery highlighting the critical need for good quality care during this period. Therefore, for the strategies of institutional delivery to be effective, it is essential to understand the factors that influence individual and household factors to utilize skilled birth attendance and institutions for delivery. This study was aimed to assess factors affecting the utilization of institutional delivery service of women in rural districts of Wolaita and Dawro Zones. Methods A community based cross-sectional study was done among mothers who gave birth within the past one year preceding the survey in Wolaita and Dawro Zones, from February 01 –April 30, 2015 by using a three stage sampling technique. Initially, 6 districts were selected randomly from the total of 17 eligible districts. Then, 2 kebele from each district was selected randomly cumulating a total of 12 clusters. Finally, study participants were selected from each cluster by using systematic sampling technique. Accordingly, 957 mothers were included in the survey. Data was collected by using a pretested interviewer administered structured questionnaire. The questionnaire was prepared by including socio-demographic variables and variables of maternal health service utilization factors. Data was entered using Epi-data version 1.4.4.0 and exported to SPSS version 20 for analysis. Bivariate and multiple logistic regressions were applied to identify candidate and predictor variables respectively. Result Only 38% of study participants delivered the index child at health facility. Husband’s educational status, wealth index, average distance from nearest health facility, wanted pregnancy, agreement to follow post-natal care, problem faced during delivery, birth order, preference of health professional for ante-natal care and maternity care were predictors of institutional delivery. Conclusion The use of

  7. The costs of introducing artemisinin-based combination therapy: evidence from district-wide implementation in rural Tanzania

    PubMed Central

    Njau, Joseph D; Goodman, Catherine A; Kachur, S Patrick; Mulligan, Jo; Munkondya, John S; Mchomvu, Naiman; Abdulla, Salim; Bloland, Peter; Mills, Anne

    2008-01-01

    Background The development of antimalarial drug resistance has led to increasing calls for the introduction of artemisinin-based combination therapy (ACT). However, little evidence is available on the full costs associated with changing national malaria treatment policy. This paper presents findings on the actual drug and non-drug costs associated with deploying ACT in one district in Tanzania, and uses these data to estimate the nationwide costs of implementation in a setting where identification of malaria cases is primarily dependant on clinical diagnosis. Methods Detailed data were collected over a three year period on the financial costs of providing ACT in Rufiji District as part of a large scale effectiveness evaluation, including costs of drugs, distribution, training, treatment guidelines and other information, education and communication (IEC) materials and publicity. The district-level costs were scaled up to estimate the costs of nationwide implementation, using four scenarios to extrapolate variable costs. Results The total district costs of implementing ACT over the three year period were slightly over one million USD, with drug purchases accounting for 72.8% of this total. The composite (best) estimate of nationwide costs for the first three years of ACT implementation was 48.3 million USD (1.29 USD per capita), which varied between 21 and 67.1 million USD in the sensitivity analysis (2003 USD). In all estimates drug costs constituted the majority of total costs. However, non-drug costs such as IEC materials, drug distribution, communication, and health worker training were also substantial, accounting for 31.4% of overall ACT implementation costs in the best estimate scenario. Annual implementation costs are equivalent to 9.5% of Tanzania's recurrent health sector budget, and 28.7% of annual expenditure on medical supplies, implying a 6-fold increase in the national budget for malaria treatment. Conclusion The costs of implementing ACT are

  8. Health worker preferences for performance-based payment schemes in a rural health district in Burkina Faso

    PubMed Central

    Yé, Maurice; Diboulo, Eric; Kagoné, Moubassira; Sié, Ali; Sauerborn, Rainer; Loukanova, Svetla

    2016-01-01

    Background One promising way to improve the motivation of healthcare providers and the quality of healthcare services is performance-based incentives (PBIs) also referred as performance-based financing. Our study aims to explore healthcare providers’ preferences for an incentive scheme based on local resources, which aimed at improving the quality of maternal and child health care in the Nouna Health District. Design A qualitative and quantitative survey was carried out in 2010 involving 94 healthcare providers within 34 health facilities. In addition, in-depth interviews involving a total of 33 key informants were conducted at health facility levels. Results Overall, 85% of health workers were in favour of an incentive scheme based on the health district's own financial resources (95% CI: [71.91; 88.08]). Most health workers (95 and 96%) expressed a preference for financial incentives (95% CI: [66.64; 85.36]) and team-based incentives (95% CI: [67.78; 86.22]), respectively. The suggested performance indicators were those linked to antenatal care services, prevention of mother-to-child human immunodeficiency virus transmission, neonatal care, and immunization. Conclusions The early involvement of health workers and other stakeholders in designing an incentive scheme proved to be valuable. It ensured their effective participation in the process and overall acceptance of the scheme at the end. This study is an important contribution towards the designing of effective PBI schemes. PMID:26739784

  9. Women's experiences and views about costs of seeking malaria chemoprevention and other antenatal services: a qualitative study from two districts in rural Tanzania

    PubMed Central

    2010-01-01

    Background The Tanzanian government recommends women who attend antenatal care (ANC) clinics to accept receiving intermittent preventive treatment against malaria during pregnancy (IPTp) and vouchers for insecticide-treated nets (ITNs) at subsidized prices. Little emphasis has been paid to investigate the ability of pregnant women to access and effectively utilize these services. Objectives To describe the experience and perceptions of pregnant women about costs and cost barriers for accessing ANC services with emphasis on IPTp in rural Tanzania. Methods Qualitative data were collected in the districts of Mufindi in Iringa Region and Mkuranga in Coast Region through 1) focus group discussions (FGDs) with pregnant women and mothers to infants and 2) exit-interviews with pregnant women identified at ANC clinics. Data were analyzed manually using qualitative content analysis methodology. Findings FGD participants and interview respondents identified the following key limiting factors for women's use of ANC services: 1) costs in terms of money and time associated with accessing ANC clinics, 2) the presence of more or less official user-fees for some services within the ANC package, and 3) service providers' application of fines, penalties and blame when failing to adhere to service schedules. Interestingly, the time associated with travelling long distances to ANC clinics and ITN retailers and with waiting for services at clinic-level was a major factor of discouragement in the health seeking behaviour of pregnant women because it seriously affected their domestic responsibilities. Conclusion A variety of resource-related factors were shown to affect the health seeking behaviour of pregnant women in rural Tanzania. Thus, accessibility to ANC services was hampered by direct and indirect costs, travel distances and waiting time. Strengthening of user-fee exemption practices and bringing services closer to the users, for example by promoting community-directed control of

  10. Attitudes and perceived impact of antiretroviral therapy on sexual risk behaviour among young people in Kahe, Moshi Rural District, Tanzania.

    PubMed

    Ezekiel, M J; Talle, A; Juma, J M; Mnyika, K S; Klepp, K-I

    2008-10-01

    Free antiretroviral therapy (ART) has been provided through the public health system in Tanzania since 2004. The success of national ART roll out programme is premised upon collaborative efforts of health systems, communities and policy environment. However, community perceptions of ART and its implications on sexual behaviours and HIV/AIDS prevention remain largely unknown. Drawing on focus group discussions with young people, this paper examines perception about ART and the potential impact of antiretroviral therapy on risk sexual behaviour in rural Tanzania. Participants included a purposively selected sample of males and females aged 14-24 years. Results show that young people were both optimistic and concerned regarding availability of ART. Positive attitudes toward ART were associated with public health significance of therapy in managing opportunistic infections and extending lives of HIV infected persons. However, the positive outcomes of therapy were considered to be short lived, unsustainable and potentially threatening to the sexual health and wellbeing of HIV negative members in the community. ART was considered to empower infected persons to intentionally spread HIV to uninfected individuals in the community through deliberate unprotected sexual activities. The study highlights the significance of reinforcing HIV prevention while underscoring the need to provide appropriate information and increasing access to ART in rural areas of Tanzania. In conclusion, creating a therapy friendly atmosphere through information delivery is crucial in promoting social acceptability of antiretroviral therapy among youths. Efforts to improve access to antiretroviral drugs should re-emphasize prevention counselling to minimize sexual transmission of HIV. PMID:19402581