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Mapping the quality of prenatal and postnatal care and demographic differences on child mortality in 26 low to middle-income countries

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World Journal of Pediatrics 2023年第9期19卷 835-850页

作者： Kelly Lin Serena Chern Jing Sun School of Medicine and Dentistry Griffith UniversityParkland DriveGold CoastQLD4215Australia Institute for Integrated and Intelligent Systems Griffith UniversityGold Coast4222Australia Menzies Health Institute Queensland Griffith UniversityGold CoastAustralia

Background Closing the gap between child mortality in low-and middle-income countries(LMICs)and high-income countries is a priority set by the WHO in sustainable development goals(SDGs).We aimed to examine poor nutrition and prenatal and postnatal care that could increase the risk of child mortality in *** The Demographic and Health Survey(DHS)was used to examine data from 26 countries to compare prenatal,postnatal,nutritional,and demographic factors across *** of child death was classified into death before one month of age,between 1 to 11 months,between one to two years,between three to five years,and overall death before five ***-square analyses identified differences in prenatal care,postnatal care,nutrition,and demographic factors between children who died and those who *** regression identified factors that increased child mortality *** The majority of deaths occurred before the ages of one month and one *** poorer quality of prenatal care,postnatal care,and nutrition were found in low-income and low-middle-income countries in the contemporary *** child mortality and poor quality of prenatal and postnatal care coincide with low *** in LMICs were exposed to less vitamin A-rich foods than children in higher-middle-income *** use of intestinal parasite drugs and the absence of postpartum maternal vitamin A supplementation significantly increased child mortality *** socio-demographic risk factors were associated with an increased mortality rate in children,including lack of education,maternal marital status,family wealth index,living rurally,and financial problems hindering access to *** Poor nutrition remains a vital factor across all LMICs,with numerous children being exposed to foods low in iron and vitamin ***,most deaths occur in neonates and infants,indicating an urgent need to address risk factors associated with early chil

关键词： child mortality Low-and middle-income countries Postnatal care Prenatal care

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Ethical challenges in mass drug administration for reducing childhood mortality:a qualitative study

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Infectious Diseases of Poverty 2022年第5期11卷 93-94页

作者： Ahmed Alasmar Alex C.Kong Anthony D.So Matthew DeCamp 不详 Division of General Internal Medicine and Center for Bioethics and Humanities Department of MedicineUniversity of Colorado School of MedicineUniversity of Colorado Anschutz Medical Campus13080 E.19th AveMail Stop B137AuroraCO 80045USA

Background:Mass drug administration(MDA)of medications to entire at-risk communities or populations has shown promise in the control and elimination of global infectious *** of the broad-spectrum antibiotic azithromycin has demonstrated the potential to reduce childhood mortality in children at risk of premature death in some global ***,MDA of antibiotics raises complex ethical challenges,including weighing near-term benefts against longer-term risks—particularly the development of antimicrobial resistance that could diminish antibiotic efectiveness for current or future *** aim of this study was to understand how key actors involved in MDA perceive the ethical challenges of ***:We conducted 35 semi-structured interviews from December 2020–February 2022 with investigators,funders,bioethicists,research ethics committee members,industry representatives,and others from both highincome countries(HICs)and low-and middle-income countries(LMICs).Interview participants were identifed via one of seven MDA studies purposively chosen to represent diversity in terms of use of the antibiotic azithromycin;use of a primary mortality endpoint;and whether the study occurred in a high child mortality *** were analyzed using constructivist grounded theory ***:The most frequently discussed ethical challenges related to meaningful community engagement,how to weigh risks and benefts,and the need to target MDA We developed a concept map of how participants considered ethical issues in MDA for child mortality;it emphasizes MDA’s place alongside other public health interventions,empowerment,and *** over an ethical double standard in weighing risks and benefts emerged as a unifying theme,albeit one that participants interpreted in radically diferent *** thought MDA for reducing child mortality was ethically obligatory;others suggested it was ***:Ethical challenges raised by MDA of antib

关键词： Antimicrobial resistance Decolonizing global health Mass drug administration child mortality Ethics Global health equity

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Assessing the influence of digital technologies on antenatal care visits in Zimbabwe:insights from 2019 Zimbabwe Multiple Indicator Cluster Survey

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Global Health Journal 2023年第3期7卷 167-174页

作者： Elliot Mbunge Garikayi Bernard Chemhaka Tafadzwa Dzinamarira Enos Moyo Department of Computer Science Faculty of Science and EngineeringUniversity of EswatiniKwaluseniManziniM201Eswatini Department of Statistics and Demography Faculty of Social SciencesUniversity of EswatiniKwaluseniManziniM201Eswatini School of Health Systems and Public Health University of PretoriaPretoria 0028South Africa Schoolof Nursing and Public Health College of Health SciencesUniversity of KwaZulu-NatalDurban 3601South Africa

Background and objective:To provide good health and well-being as established by the Sustainable Development Goal(SDG)3,access to digital technologies can act as conduits to achieve such progress in a *** guided by the World Health Organization,antenatal care(ANC)attendance is one of the measures promoted to curtail the global health burden of maternal and infant *** services are seldom utilized to their full potential in *** study explores if any of the women's digital technology characteristics were associated with antenatal care ***:The study analyzed population-based cross-sectional data with a subsample of 1932 women aged 15-49 years from the 2019 Zimbabwe Multiple Indicator Cluster *** of associations with chi-square test,bivariate,and multivariate multinomial logistic regression analyses were used to examine the predictors of adequate(4-7)and optimal(≥8)ANC visits relative to undesirable(1-3)antenatal care visits among women who had given births 2 years before the ***:The results indicate that 64.5%(1246/1932)of the women attained adequate ANC while about 9.8%(189/1932)attained optimal *** a newspaper/magazine at least once a week(odds ratio[OR] 1.73,β'=0.551,t=2.030,P=0.043)and watching television at least once a week(OR 1.72,β=0.545,t=2.454,P=0.015),listening to the radio less than once a week(OR 1.28,β'=0.247,t=1.750,P=0.080),and owning a mobile phone(OR 1.48,β'=0.394,t=3.020,P=0.003)were positively associated with adequate *** ANC was significantly associated with women being able to read a newspaper at least once a week(OR 2.93,β'=1.074,t=3.120,P=0.002),listen to the radio less than 0nce a week(OR 2.07,p'=0.73,t=2.700,P=0.007)and have ownership of a mobile phone(OR 1.88,β'=0.631,t=2.620,P=0.009).Conclusion:Access to a newspaper,radio,television,and mobile phone were important predictors of a woman's ability to achieve her ANC *** to improve the knowledge of ANC pa

关键词： Digital technologies Maternal and child health Africa child mortality Maternal mortality Prenatal care

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Mass drug administration of antibacterials: weighing the evidence regarding benefits and risks

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Infectious Diseases of Poverty 2022年第3期11卷 87-87页

作者： Robert J.Rolfe Hassaan Shaikh L.Gayani Tillekeratne Division of Infectious Diseases Department of MedicineDuke University School of MedicineDurhamNCUSA 不详

Background: Mass drug administration(MDA)is a strategy to improve health at the population level through widespread delivery of medicine in a *** surveyed the literature to summarize the benefits and potential risks associated with MDA of antibacterials,focusing predominantly on azithromycin as it has the greatest evidence *** body: High-quality evidence from randomized controlled trials(RCTs)indicate that MDA-azithromycin is effective in reducing the prevalence of infection due to yaws and *** addition,RCTs suggest that MDA-azithromycin reduces under-five mortality in certain low-resource settings that have high childhood mortality rates at *** reduction in mortality appears to be sustained over time with twice-yearly MDA-azithromycin,with the greatest effect observed in childrenchildhood mortality remains *** autopsies performed in MDA-azithromycin childhood mortality studies have produced conflicting data and are underpowered to answer this *** addition to benefits,there are several important risks associated with *** adverse effects potentially resulting from MDA-azithromycin include gastrointestinal side effects,idiopathic hypertrophic pyloric stenosis,cardiovascular side effects,and increase in chronic diseases such as asthma and *** resistance is also a risk associated with MDA-azithromycin and has been reported for both gram-positive and enteric ***,there is the risk for cross-resistance with other antibacterial agents,especially ***: Evidence shows that MDA-azithromycin programs may be beneficial for reducing

关键词： Mass drug administration child mortality Under-developed nations Antibacterial drug resistance

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