Sarita Dhakal

Exclusive Breastfeeding Practice and Its Association among Mothers of under 5 Children in Kwango District, DR Congo

The benefit of the breastfeeding has been well-established. In comparison to partial breast feeding, exclusive breastfeeding has even more benefits. The aim of this study was to identify the factors associated with breastfeeding exclusivity during the first 6 months of life in order to better target public health interventions in this community towards healthier infant nutrition and address child mortality in this population. A cross-sectional survey among 1145 random households was conducted in the Kwango district of the Democratic Republic of the Congo (DRC) during 2 November 2015 to 13 November 2015. Women of reproductive age from 15–49 years and having less than 5 years old child were selected for the study. Chi-squared test and bivariate and multivariate analyses were performed using SPSS. A major finding of this study is 49.2% of the mothers are exclusively breastfeeding their children, and marital status, literacy, place of delivery, knowledge of exclusive breastfeeding and access to radio are the key indicators for exclusive breastfeeding. Exclusive breastfeeding rate is almost equivalent to the national prevalence rate for the DRC. Providing adequate knowledge to raise awareness of exclusive breast feeding and increase involvement of health care providers in enhancing knowledge through antenatal care and during delivery and postnatal care will be the best approaches to increase exclusive breastfeeding practice.

Analyzing Barriers to Accessing Health Care Services in Holeta Town, Ethiopia

Introduction: In Ethiopia, visit to health care services remains low and unevenly distributed. To ensure appropriate health care use, it is necessary to understand factors affecting health care use, and the reasons for low levels of visit to health care service. Objective: The objective of this study was to identify barriers to health care services for the people of the Oromia Region, Ethiopia. Method: A cross sectional survey was conducted from 23 September to 31 November, 2013 in Holeta Town. All eight kebeles were included in the study. 1,422 households were selected using systematic random sampling. Descriptive and bivariate analyses were conducted using SPSS window version 20. Result: Based on the result, 60.1% respondent are used to visit for the health care service. The majority of the respondents (52.0%) mentioned health status is excellent according to self-perceived health status. 92.4% respondents were not included in the medical insurance scheme. As a result, the majority were sick because they are not aware of health problems and they can’t afford the medication cost. Conclusion: The major barrier to accessing the health care service includes income, marital status, ethnicity, evaluated health and individual attitude towards health services. Most of the respondents reported that their selfperceived health rate is excellent. Respondent also worry that the health care providers may provide unnecessary care to make money.

Empowerment for Healthy Cities and Communities in Korea

The Healthy Cities project started in 1998 in Korea. Around the world, public health and healthy cities are becoming bigger and bigger priorities. Capacity mapping is an important tool for improving a country’s health status. This study aims to review the initiation of the Korean “Healthy City” project. Korea follows a bottom-up approach for the development of Healthy City policies and has implemented plans accordingly. Korea has created a unique program through Healthy Cities; it has developed a Healthy City act, indicators for evaluating the program, a health impact assessment program, an award system, and a domestic networking system.

Analysis of Insecticide-Treated Net Use by Pregnant Women: Implications for Donor Organizations.

Background The World Health Organization (WHO) recommends the use of insecticide-treated nets (ITNs) for the prevention of malaria and reduction of mortality and morbidity from mosquito-borne diseases. Although many countries, including the Democratic Republic of Congo, have adopted this recommendation and distributed bed nets to their inhabitants, the percentage of the population using ITNs remains low. Methods This study was conducted with 400 mothers with at least one child under 5 years of age in health zones in the Bandundu province. Face-to-face interviews were conducted using structured pre-coded questionnaires. Chi-square tests and logistic regressions were calculated using the SPSS Version 21.0 software. Results Among the studied variables, education status (p = 0.013), marital status (p = 0.004), ANC utilization (p = 0.13), suffering from malaria during pregnancy (p = 0.019), and knowledge of the seriousness of malaria (p = 0.013) were significant determinants of the use of ITNs in logistic regression analyses. Conclusion The results of this study indicate that the regular use of ITNs by women during pregnancy is associated with marital status, attending ANC services, and awareness of the serious nature of malaria. Therefore, education about the risk factors among populations is needed.

Improving Maternal Health in the Volta Region of Ghana: Development Action Plan from a Baseline Assessment using 5As Framework

Introduction: KOICA and the Yonsei Global Health Center of Yonsei University finalized a baseline survey for the development of a maternal health program in the Volta Region of Ghana. Community, Health facility and health care provider surveys were conducted in the Region (Keta Municipality, Ketu North and South District) to evaluate the accessibility of essential reproductive health care, especially maternity services. Access to quality maternal health care is essential to reduce maternal mortality. Objective: To assess the strength and weakness of maternal health service and develop an action plan according to the problems to strengthen maternal health and reduce maternal mortality ratio in the Volta Region Method: Access to maternal health service had been categorized into five dimensions: availability, accessibility, affordability, accommodation and acceptability. 5As framework was used to assess the strength and weakness to the improvement of the maternal health. Results: Bested on the result it was found that, many obstacles to achieving every “A”, excluding acceptability and problems include; insufficient health personnel, inadequate knowledge in health service provider and inadequate instruments in health facilities. Conclusion: Based on the survey, training of service providers, regular supply of essential medicine and equipment and strengthening basic unit of the health service are recommended to improve access to maternal health care in the Volta Region, Ghana.

Analyze the characteristics of the healthy cities projects using HP-Source.net in Korea

This study is to analyze the characteristics of Healthy City projects to make suggestions for better development in the future. Self-administered questionnaires were distributed to 38 dedicated full members of the Korea Healthy Cities Partnership (KHCP). The survey tool was developed with reference to the website HP-Source.net. Questionnaires contained items concerning eight areas of health promotion capacities and 34 questionnaires were analyzed; response rate was 89.5%. Middle-sized or small cities are more interested and active in Healthy City projects. Twenty-seven Healthy Cities (79.41%) have full-time personnel for the projects. Twenty-five Healthy Cities (73.53%) set up the project team in the public health center, and nine in city or county offices. The heads of 22 Healthy Cities (64.71%) are deeply involved in the Healthy City project. Twenty cities (58.82%) developed mid- or long-term plans. Only 14 cities conducted self-evaluation of their projects. Twenty-two cities responded that the central government should grant awards to boost the projects and motivate workers. The Health Promotion Fund financing to 10 local governments, accounts for 29.41%. Twenty-one cities (61.76%) secured project financing from the general budgets. One city allocates the entire revenue from the local tobacco tax for Healthy City projects. In Korea, Healthy City projects have been voluntarily initiated by local governments. Korean Healthy Cities are active in exploring ties with KHCP, Alliances for Healthy Cities. The analytical tools found on HP-source.net would provide the database for more useful and meaningful information than simply analysis of current status. Support from the central government and funding from the Health Promotion Fund may help to boost the projects. This study shows characteristic and challenges of the Healthy City project in Korea. The outcomes of this study can be utilized for development, implementation and scalining up Healthy Cities.