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Background: The World Health Organization (WHO) Integrated Management of Childhood Illness (IMCI) guidelines established in 1992 to decrease preventable under-five child morbidity and mortality, was adopted by Nigeria in 1997. Over 20 years later, while under-five child mortality remains high, less than 25% of first level facilities have trained 60% of community health workers (CHW) who care for sick children with IMCI. This study investigated the impact in CHWs overall adherence to IMCI guidelines, particularly for critical danger signs, as well as usability and feasible following the implementation of THINKMD's IMCI-based digital clinical decision support (CDS) platform. Methods: Adherence to IMCI guidelines was assessed by observational and digital data acquisition of key IMCI clinical data points by 28 CHWs, prior, during, and post CDS platform implementation. Change in IMCI adherence was determined for individual CHW and for the cohort by analyzing the number of IMCI data points acquired by each CHW per clinical evaluation. Consistency of adherence was also calculated by averaging the percentage of total evaluations each data point was observed. Usability and acceptability surveys were administered following use of the CDS platform. Results: THINKMD CDS platform implementation notably enhanced the CHWs' ability to capture key IMCI clinical data elements. We observed a significant increase in the mean percentage of data points captured between the baseline period and during the CDS technology implementation (T-test, t = -31.399, p < 0.016, Holm-Bonferroni correction, two-sided), with the mean values going from 30.7% to 72.4%. Notably, even after the completion of the technology implementation phase, the mean percentage of IMCI elements captured by CHWs remained significantly elevated compared to the baseline, with a 26.72 percentage point increase (from 30.7% to 57.4%, T-test, t = -15.779, p < 0.05, Holm-Bonferroni correction, two-sided). Usability and feasibility of the platform was high. CHWs reported that the CDS platform was easy to learn and use (93%) and enabled them to identify sick children (100%). Conclusion: These results demonstrate that utilization of a digital clinical decision support tool such as THINKMD's IMCI based CDS platform can significantly increase CHW adherence to IMCI guidelines over paper-based utilization, increase clinical quality and capacity, and improve identification of key danger signs for under-five children while being highly accepted and adopted. [ABSTRACT FROM AUTHOR]

Background: Acute respiratory illness (ARI) is one of the most common reasons children receive antibiotic treatment. Measurement of C-reaction protein (CRP) has been shown to reduce unnecessary antibiotic use among children with ARI in a range of clinical settings. In many resource-constrained contexts, patients seek care outside the formal health sector, often from lay community health workers (CHWs). This study's objective was to determine the impact of CRP measurement on antibiotic use among children presenting with febrile ARI to CHW in Uganda. Methods and findings: We conducted a cross-sectional, stepped wedge cluster randomized trial in 15 villages in Bugoye subcounty comparing a clinical algorithm that included CRP measurement by CHW to guide antibiotic treatment (STAR Sick Child Job Aid [SCJA]; intervention condition) with the Integrated Community Care Management (iCCM) SCJA currently in use by CHW in the region (control condition). Villages were stratified into 3 strata by altitude, distance to the clinic, and size; in each stratum, the 5 villages were randomly assigned to one of 5 treatment sequences. Children aged 2 months to 5 years presenting to CHW with fever and cough were eligible. CHW conducted follow-up assessments 7 days after the initial visit. Our primary outcome was the proportion of children who were given or prescribed an antibiotic at the initial visit. Our secondary outcomes were (1) persistent fever on day 7; (2) development of prespecified danger signs; (3) unexpected visits to the CHW; (4) hospitalizations; (5) deaths; (6) lack of perceived improvement per the child's caregiver on day 7; and (7) clinical failure, a composite outcome of persistence of fever on day 7, development of danger signs, hospitalization, or death. The 65 participating CHW enrolled 1,280 children, 1,220 (95.3%) of whom had sufficient data. Approximately 48% (587/1,220) and 52% (633/1,220) were enrolled during control (iCCM SCJA) and intervention periods (STAR SCJA), respectively. The observed percentage of children who were given or prescribed antibiotics at the initial visit was 91.8% (539/587) in the control periods as compared to 70.8% (448/633) during the intervention periods (adjusted prevalence difference −24.6%, 95% CI: −36.1%, −13.1%). The odds of antibiotic prescription by the CHW were over 80% lower in the intervention as compared to the control periods (OR 0.18, 95% CI: 0.06 to 0.49). The frequency of clinical failure (iCCM SCJA 3.9% (23/585) v. STAR SCJA 1.8% (11/630); OR 0.41, 95% CI: 0.09, 1.83) and lack of perceived improvement by the caregiver (iCCM SCJA 2.1% (12/584) v. STAR SCJA 3.5% (22/627); OR 1.49, 95% CI: 0.37, 6.52) was similar. There were no unexpected visits or deaths in either group within the follow-up period. Conclusions: Incorporating CRP measurement into iCCM algorithms for evaluation of children with febrile ARI by CHW in rural Uganda decreased antibiotic use. There is evidence that this decrease was not associated with worse clinical outcomes, although the number of adverse events was low. These findings support expanded access to simple, point-of-care diagnostics to improve antibiotic stewardship in rural, resource-constrained settings where individuals with limited medical training provide a substantial proportion of care. Trial registration: ClinicalTrials.govNCT05294510. The study was reviewed and approved by the University of North Carolina Institutional Review Board (#18–2803), Mbarara University of Science and Technology Research Ethics Committee (14/03-19), and Uganda National Council on Science and Technology (HS 2631). Emily J. Ciccone and colleagues investigate if measuring C-reactive protein levels can lead to decreased antibiotic use in rural Uganda's children with fever and respiratory illness. Author summary: Why was this study done?: Globally, antibiotics are frequently used to treat children with fever and respiratory symptoms. However, most of these illnesses are likely viral and/or self-resolving and therefore do not require antibiotics. This overuse can lead to the development and spread of antimicrobial resistance (AMR). Measurement of C-reactive protein (CRP) levels in blood can decrease antibiotic use in children with fever and respiratory illness in health care facilities in low- and middle-income countries (LMICs). Many children in sub-Saharan Africa, when ill, present first to lay community health workers, outside of the formal health care system. What did the researchers do and find?: We conducted a stepped wedge cluster randomized trial involving 65 community health workers (CHW) in 15 villages in rural western Uganda that compared the Integrated Community Care Management (iCCM) algorithm currently in use by CHW in the region with an amended study algorithm (STAR Sick Child Job Aid [SCJA]) that included semiquantitative CRP measurement by CHW to guide antibiotic treatment decisions among children presenting with fever and respiratory symptoms. We enrolled 1,280 children, 1,220 of whom were included in the analyses. Our primary outcome of interest was antibiotics given or prescribed at the initial visit. As secondary outcomes, we assessed for adverse effects at 7 days after initial visit to the CHW, including clinical failure (a composite outcome that included persistent fever, development of danger signs, hospitalization, or death) and perceived improvement by the child's caregiver. We observed a decrease in antibiotic use of 24.6% (95% CI: −36.1%, −13.1%) in the SCJA (intervention) group compared to the iCCM (control) group. There was no statistical difference in rates of clinical failure, perceived improvement by the caregiver, or other safety outcomes at day 7, although the number of these events in both groups was small, and therefore, our estimates are imprecise. What do these findings mean?: This study shows that point-of-care CRP testing by CHW with limited clinical training outside of the formal healthcare system is feasible and has the potential to decrease unnecessary antibiotic use. We did not observe a concomitant increased risk of adverse effects in the SCJA group, although our study was not specifically designed to detect a difference in these outcomes. The results provide rationale for larger-scale studies of clinical algorithms for CHW including CRP that focus on safety outcomes, implementation, and cost-effectiveness. This research supports the use of simple, point-of-care diagnostics in rural, resource-constrained settings to improve antibiotic stewardship. [ABSTRACT FROM AUTHOR]

Background: As utilization of individual antenatal care (I-ANC) has increased throughout sub-Saharan Africa, questions have arisen about whether individual versus group-based care might yield better outcomes. We implemented a trial of group-based antenatal care (G-ANC) to determine its impact on birth preparedness and complication readiness (BPCR) among pregnant women in Ghana. Methods: We conducted a cluster randomized controlled trial comparing G-ANC to routine antenatal care in 14 health facilities in the Eastern Region of Ghana. We recruited women in their first trimester to participate in eight two-hour interactive group sessions throughout their pregnancies. Meetings were facilitated by midwives trained in G-ANC methods, and clinical assessments were conducted in addition to group discussions and activities. Data were collected at five timepoints, and results are presented comparing baseline (T0) to 34 weeks' gestation to 3 weeks post-delivery (T1) for danger sign recognition, an 11-point additive scale of BPCR, as well as individual items comprising the scale. Results: 1285 participants completed T0 and T1 assessments (N = 668 I-ANC, N = 617, G-ANC). At T1, G-ANC participants were able to identify significantly more pregnancy danger signs than I-ANC participants (mean increase from 1.8 to 3.4 in G-ANC vs. 1.7 to 2.2 in I-ANC, p < 0.0001). Overall BPCR scores were significantly greater in the G-ANC group than the I-ANC group. The elements of BPCR that showed the greatest increases included arranging for emergency transport (I-ANC increased from 1.5 to 11.5% vs. G-ANC increasing from 2 to 41% (p < 0.0001)) and saving money for transportation (19–32% in the I-ANC group vs. 19–73% in the G-ANC group (p < 0.0001)). Identifying someone to accompany the woman to the facility rose from 1 to 3% in the I-ANC group vs. 2–20% in the G-ANC group (p < 0.001). Conclusions: G-ANC significantly increased BPCR among women in rural Eastern Region of Ghana when compared to routine antenatal care. Given the success of this intervention, future efforts that prioritize the implementation of G-ANC are warranted. Trial registration: ClinicalTrials.gov Identifier: NCT04033003 (25/07/2019). Protocol available: Protocol Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9508671/. [ABSTRACT FROM AUTHOR]

In this article, we overview the research literature exploring the teaching of evaluative language in written and/or visual texts in the elementary years of schooling. We then review the recently redrafted Australian Curriculum: English to identify the emphasis given to the teaching of evaluative language and the grammar of visual design across the elementary years of schooling in Australia. Also featured is the importance of the persuasive genre, and multimodal texts. The focus of our research work is on one Year 4 elementary years school teacher who scaffolds her students to bring all of this knowledge together to read/view and write/create in ways that take seriously the powerful written and visual language use of persuasive multimodal texts. The students are undertaking an inquiry topic "Sharks: Dangerous or Misunderstood?". As part of the unit, students are exploring the written and visual grammar of danger signs. The students explore these texts by making a danger sign they would expect to see at the beach, as well as a danger sign for something that is not typically dangerous such as a ladybug. We examine the students' use of the grammar of appraisal and the grammar of visual design, and their capacity to discuss the knowledge/power relationship of their own persuasive multimodal texts during an interview with their teacher. [ABSTRACT FROM AUTHOR]

Background: Identification of neonatal danger signs and immediate access to health care are two global efforts aimed at enhancing newborn and child survival by preventing 75% of neonatal deaths. Despite various small-scale studies on women's awareness of neonatal danger signs in Ethiopia, little is known about the level of receiving health information on those danger signs during the immediate postpartum period at the national level. Hence, this study aimed at assessing the level, and its determinants of the service uptake in Ethiopia. Methods: The data for this study was taken from the Ethiopian Demographic and Health Survey (EDHS), which took place from January to June 2016 and covered all administrative regions of Ethiopia. A weighted sample of 7,589.8 women was analyzed using STATA version 16. To account for data clustering, a multivariable multilevel mixed-effect logistic regression analysis was employed to determine the effects of each predictor on the outcome variable. Adjusted odds ratio with its corresponding 95% confidence interval was used to declare the statistical significance of the explanatory variables. Results: The receipt of health information on neonatal danger signs during the immediate postpartum period was 10.70% [95% CI:10.01, 11.40]. Variables namely living in Metropolitans [AOR = 2.06; 95%CI: 1.48, 2.88] and Large central [AOR = 1.83; 95%CI: 1.38, 2.42] regions, being in the highest wealth quintile [AOR = 1.87; 95% CI: 1.23, 2.84], being nulliparous [AOR = 0.27; 95% CI: 0.08, 0.87] and primiparous[AOR = 0.61;95% CI: 0.46, 0.79], getting adequate antenatal visits [AOR = 2.42; 95% CI: 1.75, 3.33], institutional delivery [AOR = 5.91; 95% CI: 4.66, 7.53], and receipt of postnatal visits [AOR = 3.52; 95% CI: 2.84, 4.38] were identified as significant determinants of receiving health information on newborn danger signs. Conclusion: The findings revealed that unacceptably low uptake of health information on newborn danger signs during the immediate postpartum period in Ethiopia. A concerted effort is needed from all stakeholders in the health sector to enhance the uptake of maternal health services (antenatal care, skilled delivery service, and postnatal care). Healthcare providers should pay special attention to nulliparous and primiparous women during and after delivery, and the government should also focus on women of peripheral regions, who make up a large portion of the low coverage. [ABSTRACT FROM AUTHOR]

A child born in developing countries has a 10 times higher mortality risk compared to one born in developed countries. Uganda still struggles with a high neonatal mortality rate at 27/1000 live births. Majority of these death occur in the community when children are under the sole care of their parents and guardian. Lack of knowledge in new born care, inappropriate new born care practices are some of the contributors to neonatal mortality in Uganda. Little is known about parent/caregivers' knowledge, practices and what influences these practices while caring for the newborns. We systematically studied and documented newborn care knowledge, practices and associated factors among parents and care givers. To assess new born care knowledge, practices and associated factors among parents and care givers attending MRRH. We carried out a quantitative cross section methods study among caregivers of children from birth to six weeks of life attending a regional referral hospital in south western Uganda. Using pretested structured questionnaires, data was collected about care givers' new born care knowledge, practices and the associated factors. Data analysis was done using Stata version 17.0. We interviewed 370 caregivers, majority of whom were the biological mothers at 86%. Mean age was 26 years, 14% were unemployed and 74% had monthly earning below the poverty line. Mothers had a high antenatal care attendance of 97.6% and 96.2% of the deliveries were at a health facility Care givers had variant knowledge of essential newborn care with associated incorrect practices. Majority (84.6%) of the respondents reported obliviousness to putting anything in the babies' eyes at birth, however, breastmilk, water and saliva were reportedly put in the babies' eyes at birth by some caregivers. Hand washing was not practiced at all in 16.2% of the caregivers before handling the newborn. About 7.4% of the new borns received a bath within 24 hours of delivery and 19% reported use of herbs. Caregivers practiced adequate thermal care 87%. Cord care practices were inappropriate in 36.5%. Only 21% of the respondents reported initiation of breast feeding within 1 hour of birth, Prelacteal feeds were given by 37.6% of the care givers, water being the commonest prelacteal feed followed by cow's milk at 40.4 and 18.4% respectively. Majority of the respondents had below average knowledge about danger signs in the newborn where 63% and mean score for knowledge about danger signs was 44%. Caretaker's age and relationship with the newborn were found to have a statistically significant associated to knowledge of danger signs in the newborn baby. There are variable incorrect practices in the essential new born care and low knowledge and awareness of danger signs among caregivers of newborn babies. There is high health center deliveries and antenatal care attendance among the respondents could be used as an opportunity to increase caregiver awareness about the inappropriate practices in essential newborn care and the danger signs in a newborn. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to compare knowledge and attitudes towards obstetric danger signs and care between females receiving maternal care and their male partners. Methods and Materials: A community-based comparative cross-sectional study was conducted in the rural setting of Jimma, Ethiopia. Female and their male partners were selected randomly. The number of participants included from each sex was 3235 totaling 6470. Face-to-face data collection was employed using open data kit (ODK) software. A pre-test was performed before the data collection. Descriptive and analytical statistical analysis was used to compare knowledge and attitudes regarding obstetric danger signs and care. Predictor variables were declared considering a 95% confidence interval, adjusted odds ratio (AOR) and P-value less than 0.05. Results: On average, male and female participants identified at least two obstetric danger signs. More females could mention more antenatal, childbirth, and postnatal danger signs than their male partners. Both females and their male partners who listened to the radio at least once per week had a statistically significant positive attitude towards obstetric care. Nonetheless, both had an almost similar magnitude of attitude towards obstetric care irrespective of belonging to different occupational, educational, and other social strata. Males' knowledge of danger signs during pregnancy (95% CI = (1.07– 1.62), AOR = 1.32, P < 0.008) and postnatal care (95% CI = (1.16– 1.89), AOR = 1.48, P < 0.002) had a statistically significant association with the females utilization antenatal care (ANC) service, though not delivery care (DC) or postnatal (PNC). Conclusion: There were inequalities in obstetric danger signs knowledge between females and their male partners. Male partners' knowledge of obstetric danger signs is not only significant during pregnancy and delivery but also has a lasting impact on post-natal service utilization, which underscores the importance of their involvement in maternal healthcare. [ABSTRACT FROM AUTHOR]

Background: Viruses are the leading etiology of acute respiratory infections (ARI) in children. However, there is limited knowledge on drivers of severe acute respiratory infection (SARI) cases involving viruses. We aimed to identify factors associated with severity and prolonged hospitalization of viral SARI among children < 5 years in Burkina Faso. Methods: Data were collected from four SARI sentinel surveillance sites during October 2016 through April 2019. A SARI case was a child < 5 years with an acute respiratory infection with history of fever or measured fever ≥ 38 °C and cough with onset within the last ten days, requiring hospitalization. Very severe ARI cases required intensive care or had at least one danger sign. Oropharyngeal/nasopharyngeal specimens were collected and analyzed by multiplex real-time reverse-transcription polymerase chain reaction (rRT-PCR) using FTD-33 Kit. For this analysis, we included only SARI cases with rRT-PCR positive test results for at least one respiratory virus. We used simple and multilevel logistic regression models to assess factors associated with very severe viral ARI and viral SARI with prolonged hospitalization. Results: Overall, 1159 viral SARI cases were included in the analysis after excluding exclusively bacterial SARI cases (n = 273)very severe viral ARI cases were common among children living in urban areas (AdjOR = 1.3; 95% CI: 1.1–1.6), those < 3 months old (AdjOR = 1.5; 95% CI: 1.1–2.3), and those coinfected with Klebsiella pneumoniae (AdjOR = 1.9; 95% CI: 1.2–2.2). Malnutrition (AdjOR = 2.2; 95% CI: 1.1–4.2), hospitalization during the rainy season (AdjOR = 1.71; 95% CI: 1.2–2.5), and infection with human CoronavirusOC43 (AdjOR = 3; 95% CI: 1.2-8) were significantly associated with prolonged length of hospital stay (> 7 days). Conclusion: Younger age, malnutrition, codetection of Klebsiella pneumoniae, and illness during the rainy season were associated with very severe cases and prolonged hospitalization of SARI involving viruses in children under five years. These findings emphasize the need for preventive actions targeting these factors in young children. [ABSTRACT FROM AUTHOR]

Introduction: : Mothers/caregivers should be aware of a newborn's danger signs and promptly seek medical attention. Hence, this study assessed mothers'/caregivers' awareness, healthcare seeking behaviors for neonatal danger signs and their determinants in the developing regional state of Ethiopia. Methods: A community-based cross-sectional study was employed among mothers/caregivers of neonates in the developing regional state of Ethiopia. The sample was determined in collaboration with the Central Statistics Agency of Ethiopia. Stratified multi-stage cluster sampling was used to recruit the sample. Data were collected through an interviewer administered structured questionnaire using a tablet computer. Descriptive statistics and binary logistic regression were applied to identify determinants of awareness and treatment-seeking behavior for neonatal danger signs. Results: The result of the study showed that nearly one-third (32.7%) of the respondents had a good level of awareness of neonatal danger signs, and 69.0% of the respondents had good healthcare-seeking practice about neonatal danger signs. Regional state (Benishangul-Gumuz) [AOR = 1.61; 95% CI (1.09, 2.39)], Muslim's [AOR = 1.75; 95% CI (1.20, 2.55)] and permission to travel to a health facility [AOR = 0.48; 95% CI (0.37, 0.63)] were determinants of mothers'/caregivers' awareness about neonatal danger signs. Antenatal care (ANC) attendance and institutional delivery were shown to have a positive association with neonatal healthcare seeking (AOR = 2.14 and AOR = 2.37, respectively). Conclusion: In Ethiopia's developing regional states, mothers/caregivers were remarkably unaware of neonatal danger signs. Region, religion, mothers'/caregivers' age, and need for permission to travel to a health facility were predictor variables for neonatal danger sign awareness. Better healthcare seeking practices, which are determined by ANC attendance and institutional delivery, are observed in these regions. Federal and regional governments should give these regions due attention. Moreover, regional health bureaus and health professionals should tackle the problem by focusing on the identified factors. [ABSTRACT FROM AUTHOR]

Background In integrated community case management (iCCM) care, community health workers (CHWs) provide home-based management of fever, diarrhea and fast breathing for children aged <5 y. The iCCM protocol recommends that children with danger signs for severe illness are referred by CHWs to health facilities within their catchment area. This study examines the management of danger signs by CHWs implementing iCCM in a rural context. Methods A retrospective observational study that examined clinical records for all patients with danger signs evaluated by CHWs from March 2014 to December 2018 was conducted. Results In total, 229 children aged <5 y had been recorded as having a danger sign during 2014–2018. Of these children, 56% were males with a mean age of 25 (SD 16.9) mo, among whom 78% were referred by the CHWs as per the iCCM protocol. The age category of 12 to 35 mo had the highest numbers of prereferred and referred cases (54% and 46%, respectively). Conclusions CHWs play a key role in early symptomatic detection, prereferral treatment and early referral of children aged <5 y. Danger signs among children aged <5 y, if left untreated, can result in death. A high proportion of the children with danger signs were referred as per the iCCM protocol. Continuous CHW training is emphasized to reduce the number of referral cases that are missed. More studies need to focus on children aged 12–35 mo and why they are the most referred category. Policymakers should occasionally revise iCCM guidelines to detail the types of danger signs and how CHWs can address these. [ABSTRACT FROM AUTHOR]

Background: The purpose of the project was to assess the health seeking behaviour and knowledge on neonatal danger signs among neonatal caregivers in Upper Denkyira East Municipality. Methods: The study used a cross-sectional design and simple random sampling technique was employed to sample mothers' neonates visiting the postnatal clinic in the selected health facilities. The target population was mothers with neonates and above 18 years visiting the health facilities and were willing to be part of the study. Total population for the study was 387 however, 381 responded to the questionnaire. Structured questionnaire was the main data collection tool for the study. Data were analysed with SPSS version 23.0. Logistic regression with Pearson Chi square, p-value and odd ratio were the main statistical methods for the data analysis. Results: The results showed that 138 (36.2%) of the respondents stated that diarrhoea and vomiting constituted the major danger signs that sent their neonates to the hospital. Also the health seeking behaviour of the mothers showed positive results as most of the mothers (77.2%) attended hospital upon seeing neonatal danger sign. Finally, the association between mothers' socio-demographic characteristics and recognition of neonatal danger signs showed that mothers educational level and occupation were statistically significant (p-value = 0.000). Conclusion: The study concluded that mothers' knowledge level on neonatal danger signs was high and also caregivers had good health seeking behaviour. It is recommended that community health nurses and midwives should embark on home visits to encourage mothers to practice the knowledge and skills acquired during counselling at the hospital. Mothers should be empowered to make decisions concerning their children's health care. [ABSTRACT FROM AUTHOR]

Background: Acute respiratory infection (ARI) is one of the leading causes of morbidity and eventually mortality in under-five children across the globe. Awareness regarding ARI among mothers of these children is very essential to detect danger signs early, prevent the delay in health-seeking and thereby limiting its progression to severe illness. The present study was undertaken to assess the awareness of mothers regarding ARI in their under-five children and their healthcare-seeking behavior for the same. Materials and Methods: The present cross-sectional study was carried out among 200 mothers of under-five children attending the outpatient department of a rural health center in Tamil Nadu. A predesigned questionnaire was used to assess their sociodemographic characteristics, awareness about ARIs, and healthcare-seeking behavior regarding ARIs in under-five children. Descriptive and inferential statistics were applied for data analysis. Results: The mean awareness score (±standard deviation) of mothers regarding ARI in their under-five children was 8.34 ± 1.49, and overall, 94.50% of mothers had fair awareness regarding ARI. The association between occupation and awareness level of mothers regarding ARI was found to be statistically significant, while that of other variables was not statistically significant. Most of the mothers (88.0%) preferred to consult a qualified allopathic doctor for their child's ARI. Those who do not seek health-care services for their child's illness believe that the disease is self-limiting, while others try traditional medicines at home before seeking health-care services. Conclusion: Majority of mothers had fair awareness regarding childhood ARI in this study. It is necessary to put more effort into educating these mothers about the importance of early detection and seeking appropriate health care for ARI in their children. [ABSTRACT FROM AUTHOR]

His height Number death Mother in Indonesia caused by a number of factor health and nonhealth, for example there are still many births assisted by witch doctor baby or caused by disease or problem nutrition. The maternal mortality rate (MMR) is one indicator of maternal health in Indonesia Still tall when compared to with country ASEAN. Knowledge about the danger signs of pregnancy is very important for mothers to know pregnant if found sign danger pregnancy can quick Possible request help to power health. The aim of this community service is as a form of the tri dharma of higher education and also to increase the knowledge of pregnant women about the danger signs of pregnancy in Aek Haruaya Village, Portibi District, North Padang Lawas Regency. This community service was carried out on January 8 2024 and the implementation went well with the number of participants being 25 pregnant women. It is hoped that after carrying out this activity it can increase pregnant women's knowledge about the signs and dangers that can occur during pregnancy. [ABSTRACT FROM AUTHOR]

Training of health cadres in postpartum maternal management has a crucial role in ensuring the health and well-being of mothers after childbirth. Postpartum mothers face a variety of physical and emotional changes that require proper attention and care. The training aims to increase the knowledge of cadres in the management of postpartum mothers. The method offered is to conduct socialization and knowledge improvement training for health cadres. This training covers important aspects such as understanding of postpartum physical changes, danger signs to watch out for, providing episiotomy or cesarean wound care, pain management, promotion of breast milk, as well as communicative and empathetic approaches in providing emotional support to postpartum mothers. This training also encourages health cadres to play a role as disseminators of health information that can help postpartum mothers in making informed decisions regarding selfcare and their babies. Health Cadres are able to provide accurate information and provide comprehensive initial care to postpartum mothers in the community. This training also has a positive impact in reducing the number of postpartum complications, increasing exclusive breastfeeding, and increasing awareness of postpartum mothers to danger signs that require further medical attention. Result: increased knowledge of health cadres in the management of postpartum mothers. Conclusion: this training is able to increase the knowledge of health cadres in postpartum maternal management. [ABSTRACT FROM AUTHOR]

Introduction: Danger signs are specific indicators signaling potential serious or life-threatening health conditions, crucial for prompt intervention in healthcare settings. Recognizing these signs can be challenging due to variations in cultural perceptions and individual interpretations. Additionally, danger signs are context-dependent, requiring awareness and contextual analysis. This complexity is amplified when dealing with abstract or non-physical signs. Understanding and consistently applying the concept of danger signs is essential for effective healthcare delivery. Method: This paper utilized Walker and Avant's eight-step concept analysis method, offering a systematic and structured approach for defining and understanding concepts. The method promotes clarity, precision, and thorough exploration of the concept's relationships with others, enhancing comprehensive understanding within its context. Result: Conceptually, danger signs represent a broad array of indicators signaling potential harm or imminent risk. Through analysis, this paper defines danger signs operationally as objective, measurable cues that are contextdependent, indicating the presence of a potential negative outcome. Conclusion: This paper contributes to existing knowledge by identifying danger sign attributes, reducing ambiguity and facilitating clearer application in health specialties training. The enhanced clarity also allows for the development of more precise tools to assess competence in danger sign identification. [ABSTRACT FROM AUTHOR]

Background: Homebirth preference is the intention/plan to give birth outside health facilities with the help of unskilled birth attendants. The preference to give birth at home without a skilled birth attendant leads to care-seeking delays, intrapartum mortality, multiple stillbirths, and postpartum morbidities and mortality. Therefore, this study aimed to estimate the pooled prevalence of homebirth preference and associated factors among pregnant women in Ethiopia. Methods: Search of Google Scholar, Medline, PubMed, Cochrane Library and Web of Science were done for this study from 20th August 2022 to 6th November 2022. For data extraction and analysis, the standardized data extraction checklist and Stata version 14 were used respectively. Sentence as "Cochrane Q test statistics and I2 statistics were used to check heterogeneity of the studies. The pooled prevalence of homebirth preference was estimated using a random-effects model. The association between homebirth preference and independent variables was determined using an odd ratio with a 95% confidence interval. A funnel plot and Egger's test were used to assess publication bias. Results: A total of 976 research articles were identified. Seven studies that fulfilled eligibility criteria were included in this systematic review and meta-analysis. The pooled prevalence of homebirth preference in Ethiopia was 39.62% (95% CI 27.98, 51.26). The current meta-analysis revealed that average monthly income <1800 ETB (OR = 2.66, 95% CI 1.44, 4.90) lack of ANC follow-up (OR = 2.57, 95%CI 1.32, 5.01), being multipara (OR = 1.77, 95%CI 1.39, 2.25), poor knowledge about obstetric danger sign (OR = 5.75, 95%CI 1.o2, 32.42), and not discussing the place of delivery with a partner (OR = 5.89 (95%CI 1.1, 31.63) were significantly associated with homebirth preference. Conclusion: This systematic review and meta-analysis examined the substantial prevalence of homebirth preference in Ethiopia which may contribute maternal and child health crisis. The homebirth preference was associated with low average monthly income (<1800 ETB), lack of ANC follow-up, multipara, poor knowledge about obstetric danger signs, and not discussing with their partner the place of delivery. Improving knowledge of pregnant women about the benefit of health facility delivery and obstetric danger signs is necessary to decrease the prevalence of homebirth preference; for these can reduce negative outcomes occurred during delivery. [ABSTRACT FROM AUTHOR]

Objective: To assess the magnitude and factors associated with birth preparedness and complication readiness (BPCR) among pregnant women in Humbo district, Wolaita Zone, Ethiopia. Methods: A community‐based cross‐sectional study was conducted from August 1 to 30, 2020. A total of 506 pregnant women were randomly selected and interviewed using a questionnaire. Data were entered using EpiData version 4.6.0, and analysis was made using SPSS version 24. An adjusted odds ratio (aOR) with a 95% confidence interval (CI) was calculated. Results: The magnitude of BPCR in the Humbo district was 26.0%. The odds of being prepared for birth and its complications were higher among women who had a history of obstetric complications (aOR 2.77; 95% CI 1.18–6.52), participated in pregnant women's conferences (aOR 3.84; 95% CI 2.13–6.93), received advice on BPCR (aOR 2.39; 95% CI 1.36–4.22), and were knowledgeable on labor and childbirth danger signs (aOR 2.64; 95% CI 1.55–4.49). Conclusion: The magnitude of birth preparedness and complication readiness was low in the study area. The healthcare provider should encourage the women to participate in conferences and provide continuous counseling during their prenatal care visits. Synopsis: Magnitude of birth preparedness and complication readiness (BPCR) indicates the need for further interventional activities; prenatal care conferences have good outcomes towards BPCR. [ABSTRACT FROM AUTHOR]

Introduction: Knowledge of obstetric danger signs would equip women to make the right decisions and appropriate actions timely to have better health care assistance which will impose a significant impact on maternal mortality and morbidity. Hence, this study aimed to know the factors associated with the knowledge of obstetric danger signs among pregnant women who attend the primary health care clinics, which is considered as the first gate to seek health care for pregnant women during antenatal checkups. Methodology: This is a cross-sectional study conducted among 400 pregnant women selected by simple random sampling technique who were attending antenatal clinics at primary health care centers at Abha City by using an interview-based questionnaire.cores of <50%, 50–75%, and >75% were considered to be poor, intermediate, and good scores. Frequencies and percentages were used for descriptive variables, whereas for association, tests of significance (Chi square, t-test, and F-test) were applied. Results: Almost 70.8% of participants received health information on obstetric danger signs. The main sources of information were the Internet (23%), family, relatives or friends (17%), and health care providers. The highest participants' correct responses regarding obstetric danger signs were related to severe vaginal bleeding (93.5%), convulsions (76.8%), and decreased fetal movements (76.5%). Proportions of participants with poor knowledge showed an inverse and significant increase with their educational levels (P < 0.001). The highest percentage of poor knowledge grade was observed among participants with no children (54.6%). Participants who received previous information on danger signs had significantly better knowledge grades than those who have not received previous information (P < 0.001). Conclusions: Women's knowledge was suboptimal regarding obstetric danger signs. 30% of women did not receive information about danger signs. Health education provided on obstetric danger signs to pregnant women should be enforced to those who are illiterate, are unemployed, have a low family income, and are with no or less previous pregnancies. [ABSTRACT FROM AUTHOR]

Across several African countries, birth preparedness and complication readiness (BPACR) among pregnant women is poor. The practice of BPACR, though improving in recent years, is not commensurate with the knowledge available to pregnant women. Maternal health indices remain sub-optimal. This study evaluates the determinants of this "know-do' gap among women receiving antenatal care at a secondary health facility in Benin City, Nigeria. A cross-sectional study involving 427 pregnant women was conducted between October and December 2020 using a structured interviewer-administered questionnaire. The prevalence of knowledge and practice were described, and the determinants of BPACR practice evaluated using bivariable (chi-square) analysis and multivariable ordinal logistic regression with post-estimation predictive margins analysis. About 77% of respondents had good birth preparedness practice. Multivariable regression revealed that respondents with poor knowledge and moderate knowledge of components of BPACR had statistically significant lower odds (OR:0.05 (95% CI: 0.02-0.13) and 0.10 (95% CI: 0.03-0.30) times, respectively) for greater practice of BPACR when compared to those with good knowledge. Respondents with poor knowledge of danger signs had statistically significant lower odds (OR: 0.08 (95% CI: 0.03-0.26) for greater practice of BPACR when compared to those with good knowledge. But predictive margins analyses demonstrates that knowledge, though critical to practice, is insufficient to optimize practice. The optimum number of danger signs women need to know to improve practice may be between eight to ten. Beyond this number, practice may not change significantly. Other predictors of BPACR practice include income level, parity, gravidity, and residential settings. The number of antenatal clinic visits had no statistically significant correlation with BPACR practice. Interventions to facilitate practice at the community level may be helpful to improve outcomes and bridge the know-do gap with respect to BPACR within the study context. [ABSTRACT FROM AUTHOR]

To assess pregnancy risk perception, attitude towards skilled delivery service, and knowledge of obstetric danger signs and associated factors among pregnant mothers.Methods: A cross-sectional community-based study design was used. The 668 pregnant women who participated in this study were chosen using a multi-stage sampling methodology. Data were gathered using a pretested questionnaire that was presented by an interviewer. To find independent factors, logistic regression analysis was used. With a p-value of less than 0.05, which denotes statistical significance, a corresponding 95% confidence interval (CI) was calculated.Results: Pregnancy risk perception was shown to have a lower mean score (23) overall. Only 40.9% of the study participants had high pregnancy risk perception. Over 50% (337) of respondents had a positive attitude towards skilled delivery service utilization. In all categories of obstetric danger signs, only 153 respondents (or 22.9%) knew what the obstetric danger signs were. Maternal age (AOR = 1.966, CI: 1.185– 3.261), maternal education (AOR = 1.965, 1.002– 3.854), and parity (AOR = 0.534, CI: 0.305– 0.933) were factors affecting knowledge of obstetric danger signs. Pregnancy risk Perception (AOR = 14.7, CI: 9.849– 22.235) and parity (AOR = 2.27, CI: 1.381– 3.733) were significantly associated with attitudes on the use of skilled delivery services.Conclusion: This study found that pregnant women in rural locations had poor levels of knowledge of obstetric danger sign, attitude toward using skilled delivery services, and perception of pregnancy risk. The knowledge of obstetric danger indicators among pregnant women was considerably affected by the mother's age, education, and parity. The perception of pregnancy risk and parity were found to be substantially associated with attitudes towards skilled delivery services. [ABSTRACT FROM AUTHOR]

Background and Objectives: Neonates can show subtle signs of illness that could be overlooked by their mothers and caregivers. Therefore, basic knowledge regarding neonatal health and early detection of neonatal diseases can help improve survival. We assessed nursing students' knowledge and attitudes toward the danger signs of neonatal illnesses. Materials and Methods: We performed a descriptive cross-sectional study using a structured online questionnaire based on danger signs categorized by the World Health Organization to assess knowledge of neonatal illness danger signs among nursing students. Results: We assessed 342 students, of which 67.0% (95% CI: 61.8–71.7) had good knowledge regarding neonatal illness danger signs, and 71.6% received information about neonatal care. About 33% of the participants had a basic knowledge of neonatal care, such as breastfeeding, immunization, routine postnatal care, and eye care. Students who received information on neonatal care were three times (AOR = 2.95, 95% CI: 11.59–5.47, p = 0.001) more likely to have good knowledge than those who did not. The students also showed a positive attitude towards the importance of knowledge regarding neonatal illness danger signs, teaching this subject in their college, participating in studies involving the practice and knowledge of mothers regarding neonatal illness danger signs, and the importance of knowledge in reducing neonatal mortality in the region. Conclusions: More training programs on neonatal care should be implemented to enhance knowledge and raise nursing students' awareness of the dangerous signs of neonatal illnesses. [ABSTRACT FROM AUTHOR]

Background: Malaria remains a major public health issue in the Democratic Republic of the Congo (DRC), accounting for 44% deaths among outpatient visits in children < 5 years of age, and 22% of facility deaths. Understanding determinants of caregivers' treatment-seeking patterns and decision-making is crucial in reducing the malaria burden. Methods: In the frame of the Community Access to Rectal Artesunate for Malaria (CARAMAL) project, cross-sectional household surveys that randomly sampled villages and households were carried-out in three rural DRC health zones prior to the rollout of pre-referral Rectal Artesunate (RAS) and then 9 and 19 months after RAS rollout (post-RAS). Data were captured electronically through face-to-face interviews with the main caregivers of children < 5 years. Capillary blood samples of the children were tested for malaria and anaemia. The main study outcome was whether caregiver "sought treatment outside home" when the child had fever. Multilevel mixed effects logistic regression models using village as random effect and health zone as a fixed effect was performed to assess treatment-seeking predictors. Results: 2439 household interviews were completed (pre-RAS 888 and post-RAS 1551), including 316 and 653 treatment-seeking interviews. Overall, 3499 children < 5 years were tested for malaria and anaemia (pre-RAS 1,315 and post-RAS 2184). Caregiver's recognition of severe malaria signs was poor, while knowledge of symptoms of uncomplicated malaria seemed high. Despite this, danger signs significantly increased the odds of seeking treatment (aOR = 2.12, 95%CI 1.03–4.38), the same was found for the "least poor" quintile (aOR = 3.01, 95%CI 1.03–8.82), as well as residents of Kingandu (aOR = 2.78, 95%CI 1.01–7.65). "Doing something at home" against fever negatively affected treatment-seeking in both study phases. RAS acceptance was high, at almost 100%. Malaria prevalence was higher post-RAS (45.2%) compared to pre-RAS (34.4%), p = 0.003, but anaemia, although high (≥ 75%), was similar in both study phases (p = 0.92). Conclusion: In remote communities with high malaria prevalence in the DRC, malaria remains a major problem. Improving the recognition of danger signs of severe disease and introducing pre-referral RAS may improve treatment-seeking and contribute to reducing malaria-related mortality among children—if quality of care can be guaranteed. [ABSTRACT FROM AUTHOR]

Introduction: Maternal mortality remains a public health challenge worldwide, particularly in developing countries. Men should be informed about these danger signs to be better equipped to act if they occur. Studies on the topic have been limited in the area. The study aimed to assess men’s knowledge, attitudes, and related factors about obstetrics danger signs in Debre Tabor, Ethiopia. Materials and Methods: A study was conducted in Debre Tabor Town with 609 participants using a pre-tested questionnaire. The data were analyzed using EpiData version 4.6 and SPSS version 25. Variables with P values ≤0.2 were analyzed with multi‑variable logistic regression. A statistically significant association was determined using an adjusted odds ratio with a 95% confidence interval (CI) and a P value <0.05. Results: In this study, 609 men were interviewed, with a response rate of 96.9%. Men’s knowledge of obstetric danger signs was 44.8%, while their attitudes were 35.6%. Wives’ education level (AOR = 7.27, 2.13-8.83), history of obstetric danger signs (AOR = 5.34, 3.49-8.16), receiving antenatal care (AOR = 2.44, 1.29-4.64), giving birth in a hospital (AOR = 4.38, 1.69-11.31), and having a health development army leader (AOR = 3.86, 1.38-10.75) were all associated with knowledge at 95% CI. Having a higher wealth index (AOR = 6.30, 3.44-11.53) and having two or more children (AOR = 2.80, 1.51-5.25) at 95% CI were associated with attitude. Conclusions: Men’s awareness and attitudes concerning obstetric danger signs were low. The husband’s education, place of birth, and prenatal care are all important factors in increasing men’s understanding and attitudes. As a result, the government and stakeholders must prioritize education, attitude reform, and health education for men. [ABSTRACT FROM AUTHOR]

Background: Little is known whether women's knowledge of perceived severity of illness and sociodemographic characteristics of women influence healthcare seeking behavior for maternal health services in Afghanistan. The aim of this study was to address this knowledge gap. Methods: Data were used from the Afghanistan Health Survey 2018. Women's knowledge in terms of danger signs or symptoms during pregnancy was assessed. The signs or symptoms were bleeding, swelling of the body, headache, fever, or any other danger sign or symptom (e.g., high blood pressure). A categorical variable of knowledge score was created. The outcome variables were defined as ≥ 4 ANC vs. 0–3 ANC; ≥ 4 PNC vs. 0–3 PNC visits; institutional vs. non-institutional deliveries. A multivariable generalized linear model (GLM) was used. Results: Data were used from 9,190 ever-married women, aged 13–49 years, who gave birth in the past two years. It was found that 56%, 22% and 2% of women sought healthcare for institutional delivery, ≥ 4 ANC, ≥ 4 PNC visits, respectively, and that women's knowledge is a strong predictor of healthcare seeking [odds ratio (OR)1.77(1.54–2.05), 2.28(1.99–2.61), and 2.78 (2.34–3.32) on knowledge of 1, 2, and 3–5 signs or symptoms, respectively, in women with ≥ 4 ANC visits when compared with women who knew none of the signs or symptoms. In women with ≥ 4 PNC visits, it was 1.80(1.12–2.90), 2.22(1.42–3.48), and 3.33(2.00–5.54), respectively. In women with institutional deliveries, it was 1.49(1.32–1.68), 2.02(1.78–2.28), and 2.34(1.95–2.79), respectively. Other strong predictors were women's education level, multiparity, residential areas (urban vs. rural), socioeconomic status, access to mass media (radio, TV, the internet), access of women to health workers for birth, and decision-making for women where to deliver. However, age of women was not a strong predictor. Conclusion: Our findings suggest that pregnant women's healthcare seeking behaviour is influenced by women's knowledge of danger signs and symptoms during pregnancy, women's education, socioeconomic status, access to media, husband's, in-laws' and relatives' decisions, residential area, multiparity, and access to health workers. The findings have implications for promoting safe motherhood and childbirth practices through improving women's knowledge, education, and social status. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess the effects of health education and community-level participatory interventions at the community level and the use of community maternal health promoters on the utilization of maternal health care services in poor rural settings of northern Ghana. Methods: A randomized controlled survey design was conducted from June 2019 to July 2020 in two rural districts of northern Ghana. A multistage cluster sampling technique was used to select the participants. Data were collected from a repeated cross-sectional household survey. Descriptive analysis, bivariate and covariates adjusted simple logistic regression analyses were performed using STATA version 16 statistical software. Results: At post-intervention, the two groups differed significantly in terms of ANC (p = 0.001), skilled delivery (SD) (p = 0.003), and PNC (p < 0.0001). Women who received health education on obstetric danger signs had improved knowledge by 50% at the end of the study. Women who received the health education intervention (HEI) on practices related to ANC and skilled delivery had increased odds to utilize ANC (AOR = 4.18; 95% CI = 2.48–7.04) and SD (AOR = 3.90; 95% CI = 1.83–8.29) services. Institutional delivery and PNC attendance for at least four times significantly increased from 88.5 to 97.5% (p < 0.0001), and 77.3–96.7% (p < 0.0001) respectively at postintervention. Women who had received the HEI were significantly more likely to have good knowledge about obstetric danger signs (AOR = 10.17; 95% CI = 6.59–15.69), and BPCR (AOR = 2.10; 95% CI = 1.36–3.24). Women who had obtained tertiary education were significantly more likely to make at least four visits to ANC (AOR = 2.38; 95% CI = 0.09–1.67). Conclusions: This study suggests that the use of health education and participatory sessions led by community-based facilitators could be a potentially effective intervention to improve the knowledge of women about obstetric danger signs and encourage the uptake of maternity care services in resource-poor settings of Ghana. [ABSTRACT FROM AUTHOR]

The prevalence of cesarean sections as much as 80% have exceeded the figure recommended by WHO, about 10-15%, supported by several factors. One of them is self-autonomy which is not owned by the mother causing a lack of knowledge about pregnancy. Knowledge has an effect of 1.8 times on readiness for pregnancy, childbirth, and postpartum. Antenatal education is a service requested by most pregnant women worldwide such as childbirth education programs or birth preparation classes. This research uses a qualitative research design. Data collection was done through in-depth interviews using a sample of 9 main informants (pregnant women). The primary and secondary qualitative data were collected through data processing and analysis techniques, imported into NVivo and classified according to the type of data to facilitate the processing and analysis of data in NVivo 12 Plus. Knowledge of the pregnancy process of pregnant women with low results; Knowledge of pregnancy signs of pregnant women with low results; Knowledge of the benefits of pregnancy examination with high results; Knowledge of the examination schedule of pregnant women is high; Knowledge of physical changes of pregnant women with low results; Knowledge of gestational age with high results; Knowledge of pregnancy danger signs with low results. Knowledge of pregnant women about pregnancy with results is still lacking, namely the knowledge of the pregnancy process, signs of pregnancy, physical changes, and signs of danger of pregna Therefore, it is necessary to provide educational services at Pratama Az-Zahra Tangerang Clinic. [ABSTRACT FROM AUTHOR]

Background: Over the previous few decades, significant progress has been made in reducing newborn mortality, but the worldwide scale of the problem remains high. A considerable number of newborn death and difficulties owing to neonatal danger signs could be avoided if mothers sought appropriate health care for common neonatal risk indications, according to a number of studies presently underway in Ethiopia. The aim of this study is to assess health care seeking behavior of mothers' in related to neonatal danger signs. Method: A community-based cross-sectional study was conducted among 410 participants in Wolaita Sodo, From October 1 to October 30, 2019. To collect data, structured interviewer administered questionnaire was used. Data was coded, cleaned, recoded and entered in to epi-data version 3.1 and transported to SPSS window version 21 for analysis. Multivariable logistic regression was carried out and p-value of less than or equal to 0.05 was considered statistically significant. Result: A total of 410 mothers participated in this study, 110 (47.6%) mothers preferred health intuition for their neonate. Husband educational status (AOR = 2.4, 95% CI = 1.1, 5.5), communication media (AOR = 4.3, 95% CI = 2.4, 7.5), place of residence (AOR = 3.5, 95% C.I = 1.9, 6.7), ANC follow up (AOR = 2.8, 95% CI = 1.4, 5.8), and PNC follow (AOR = 1.7, 95% CI = 1.1, 3.1) were all factors that significantly associated with health care seeking practice neonatal dander signs. Conclusion: Overall, there was a low degree of health-seeking practice. The educational status of the mother's husband, communication media, residence, ANC follow-up, and PNC follow-up all predicted the mothers' health-care seeking behavior. The study also identifies the Wolaita Zone and Sodo town health offices, the health development army, one to five local community organizations with and health extension workers as key contributors. [ABSTRACT FROM AUTHOR]

Background. The outcome of patients with neuroblastoma in South Africa has always been very poor. We conducted a retrospective study in one state-funded paediatric oncology unit (POU), to describe the clinical course, evaluate prognostic factors and report outcomes of patients with neuroblastoma. Methods. We analysed routine data from one POU, gathered between 1993 and 2018. Kaplan-Meier curves were used to illustrate 2-year survival rates and to evaluate possible prognostic factors. Results. Data from 87 patients were included and analysed. The median age was 41 months. The majority of the patients presented with stage 4 disease (77%). The most common presenting symptoms were bone pain, loss of weight, and abdominal distention. Chemotherapy was administered to 74 patients, and only 5 patients (6%) received palliative chemotherapy as first-line treatment. Only 18 of the 87 patients had surgery (21%) and 13 of 87 had radiation (15%), while 10 patients received palliative radioactive iodine (131I-miBG) therapy. Patients with ferritin levels >120 ng/dL did not have a poorer outcome, and those with a raised lactate dehydrogenase (LDH) level displayed a shorter survival time but it was not statistically significant. The 2-year overall survival was 24% for the whole cohort and 16% for the stage 4 patients at diagnosis. Conclusion. Neuroblastoma is a disease with a dismal outcome in our POU, mostly as a result of late presentation. To improve prognosis the focus should be on recognising danger signs to ensure early diagnosis and referral. We recommend adding danger signs for childhood cancer to the Integrated Management of Childhood Illness (IMCI) strategy in an attempt to improve early recognition and diagnosis of childhood cancer. [ABSTRACT FROM AUTHOR]

The mother's ability to care for premature infants will affect the success of the interaction between mother and baby as well as the growth and development of the baby. The study aimed to assess the impact of coping interventions on mothers' ability to care for premature infants at home. This quasi-experimental research involved 80 respondents, divided into a treatment group and a control group, with 40 participants in each. The treatment group received a 3-month coping intervention, while the control group did not. The mothers' abilities were evaluated using questionnaires and the Developmental Pre-Screening Questionnaire (KPSP) instrument. The results revealed significant improvements in the treatment group's abilities in providing nutrition, maintaining body temperature, preventing infection, recognizing danger signs, and stimulating development in premature infants. These positive outcomes underscore the effectiveness of coping interventions in enhancing maternal abilities. It is recommended that health workers incorporate coping interventions into their support for mothers of premature infants, aiming to empower them with the skills and knowledge needed for better care and development of their infants at home. This approach can contribute to the overall well-being and growth of premature infants while reducing the burdens on healthcare providers. [ABSTRACT FROM AUTHOR]

Background: Neonatal danger signs contribute to the high mortality of neonates in developing countries. Delays in recognition of danger signs and the decision to seek care contribute to most neonatal deaths in Ethiopia. Therefore, the current study aimed to assess mothers’ knowledge and associated factors on neonatal danger signs in Nekemte town, Western Ethiopia. Methods: The current community-based cross-sectional study was conducted in Nekemte, Ethiopia, in March 2019. The sample included 727 mothers who had given birth within the past 12 months. A multistage sampling technique was utilized to recruit participants and data were collected using face-to-face interviews. The collected data were entered into EPI info (version 7.2.0.1) and analyzed using SPSS (version 23). To evaluate the knowledge of neonatal danger signs, a median score was used as the cut-off point. Mothers who spontaneously mentioned at least five danger signs were considered to have good knowledge of neonatal danger signs. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with knowledge of danger signs. Results: Of 727 participants, 707 mothers were interviewed, yielding a response rate of 98.3%. The median age of the participants was 27 years, with an interquartile range of ± 5. The result of the study indicated that 55.6% [95%CI (52.1% - 59.3%)] of mothers had good knowledge of neonatal danger signs. The adds ratio of having good knowledge of neonatal danger signs were associated with being married [AOR=2.87, 95%CI (1.27, 6.52)], mother’s educational status of secondary level or higher [AOR= 1.71, 95%CI (1.03, 2.84)], antenatal care visits of four and more [AOR=1.58, 95%CI (1.09, 2.31)], and postnatal follow-up [AOR=2.13, 95%CI (1.39, 3.27)]. Furthermore, delivery at health institutions [AOR=3.11, 95%CI (1.10, 8.76)], access to TV [AOR=1.58, 95%CI (1.05, 2.37)], and Internet use [AOR=2.39, 95%CI (1.52, 3.77)] were also significantly associated with good knowledge. Conclusion: The proportion of mothers with good knowledge of neonatal danger signs was found to be low. Therefore, it is recommended to enhance counseling services during antenatal care and strengthen community-based health information dissemination efforts related to neonatal danger signs. [ABSTRACT FROM AUTHOR]

Background: Maternal mortality due to pregnancy, childbirth and postpartum is a global challenge. Particularly, in low-and lower-income countries, the outcomes of these complications are quite substantial. In recent years, studies exploring the effect of mobile health on the improvement of maternal health are increasing. However, the effect of this intervention on the improvement of institutional delivery and postnatal care utilization was not well analyzed systematically, particularly in low and lower-middle-income countries. Objective: The main aim of this review was to assess the effect of mobile heath (mHealth) interventions on improving institutional delivery, postnatal care service uptake, knowledge of obstetric danger signs, and exclusive breastfeeding among women of low and lower-middle-income countries. Methods: Common electronic databases like PubMed, EMBASE, the Web of Science, Medline, CINAHL, Cochrane library, Google scholar, and gray literature search engines like Google were used to search relevant articles. Articles that used interventional study designs and were conducted in low and lower-middle-income countries were included. Sixteen articles were included in the final systematic review and meta-analysis. Cochrane's risk of bias tool was used to assess the quality of included articles. Results: The overall outcome of the systematic review and meta-analysis showed that MHealth intervention has a positive significant effect in improving the institutional delivery (OR = 2.21 (95%CI: 1.69–2.89), postnatal care utilization (OR = 4.13 (95%CI: 1.90–8.97), and exclusive breastfeeding (OR = 2.25, (95%CI: 1.46–3.46). The intervention has also shown a positive effect in increasing the knowledge of obstetric danger signs. The subgroup analysis based on the intervention characteristics showed that there was no significant difference between the intervention and control groups based on the intervention characteristics for institutional delivery (P = 0.18) and postnatal care utilizations (P = 0.73). Conclusions: The study has found out that mHealth intervention has a significant effect on improving facility delivery, postnatal care utilization, rate of exclusive breastfeeding, and knowledge of danger signs. There were also findings that reported contrary to the overall outcome which necessitates conducting further studies to enhance the generalizability of the effect of mHealth interventions on these outcomes. [ABSTRACT FROM AUTHOR]

Background: Mother's awareness of obstetric danger signs is the degree of a pregnant woman to fully utilize her knowledge of the signs and symptoms of complications of pregnancy, which helps the mother and family to seek medical help immediately. High maternal and infant mortality rates in developing countries are due to a combination of a lack of quality, resources and access to health services coupled with mother's lack of awareness. The purpose of this study was to collect current empirical studies to describe the pregnant women awareness about the obstetric danger sign in developing country. Method: This review employed the Prisma-ScR checklist. The articles searched in four electronic databases (Scopus, CINAHL, Science Direct, Google Scholar). Variables that used to search the articles (pregnant woman, knowledge, awareness, danger signs pregnancy). The Framework used to review is PICOS. Result: The results of the article found 20 studies which met inclusion criteria. The determinants were high educational status, more pregnancy experience, more ANC visit, and labour in the health facility. Conclusion: The level of awareness is low to medium, only some have fair awareness, in which related to determinant. The recommended effective strategy is to improve the ANC program by assess the risk of obstetric danger sign promptly, assess the barrier of health seeking related to the family support, i.e. the husband and the elderly. Additionally, use MCH handbook or mobile application to record the ANC visit and communicate with the family. [ABSTRACT FROM AUTHOR]

Background: Due to the type of activities and the long-term exposure to chemicals, hospital cleaning workers require the necessary knowledge about the chemicals used and proper safety culture. This study aimed to evaluate the safety culture and perception of hospital cleaning workers' warning signs of chemical hazards. Methods: This cross-sectional study was conducted in 2022 with the participation of 68 cleaning workers with the mean age ± (SD) and work experience ± (SD) of 36.19 ± (7.619) and 9.21 ± (5.462), respectively, in four selected Tehran hospitals in Iran. After ensuring the confidentiality of the received information and completing the demographic information checklist, each participant completed Global Harmonization System (GHS) sign perception and the safety culture questionnaires in this survey. Data were analyzed using regression and Pearson correlation tests. Results: This study showed that the participant's correct perception in nine cases (81.8%) of presented GHS signs was lower than the ANSI Z535.3 standard. Among the investigated signs, "Flammable substances" and "Harmful to the environment" signs had the highest, and "Skin irritant" signs had the lowest correct perception. In addition, it was found that 55 people (80.9%) had an overall positive attitude toward the safety culture. The levels of "Work environment" (83.8%) and "Information exchange" (76.5%) had the highest and lowest positive scores for safety culture. Furthermore, there is a direct and significant relationship between the overall score of safety culture and the overall perception of the symptoms of GHS (CC = 0.313, P = 0.009). Conclusion: According to the obtained results, it is recommended to take the necessary measures to increase the employees' perception of the signs of chemical substances and improve their safety culture. [ABSTRACT FROM AUTHOR]

This research examines the factors contributing to the exterior material degradation of subsea oil and gas pipelines monitored with autonomous underwater systems (AUS). The AUS have a role of gathering image data that is further analyzed with artificial intelligence data analysis methods. Corrosion and potential ruptures on pipeline surfaces are complex processes involving several competing elements, such as the geographical properties, composition of soil, atmosphere, and marine life, whose eflt in substantial environmental damage and financial loss. Despite extensive research, corrosion monitoring and prediction remain a persistent challenge in the industry. There is a lack of knowledge map that can enable image ausing an AUS to recognize ongoing degradation processes and potentially prevent substantial damage. The main contribution of this research is the knowledge map for increased context and risk awareness to improve the reliability of image-based monitoring and inspection by autonomous underwater systems in detecting hazards and early signs of material degradation on subsea pipeline surfaces. [ABSTRACT FROM AUTHOR]

Background and Objective: Poor postnatal care can increase morbidity and mortality. This study assessed the current deficiencies in quality of postnatal care provided to mothers in Lady Aitchison hospital, Lahore when compared to WHO standards and identifies the areas for quality improvement. Methods: It is a descriptive cross-sectional study which employs quantitative method to collect and analyze the data. It was conducted to include ninety-six maternities attending the wards of Lady Aitchison Hospital, Lahore during January 2022 to February 2022. Consenting post-partum mothers were selected by random sampling and interviewed by using a structured proforma. Results: Among 96 mothers, 56% were below 25 years of age, 39% had secondary education, with more than one child (71%) and 57% visited for the first time. Majority of mothers, were given medicine timely (82%) and found the attitude (85%) and information (83%) provided by the healthcare workers helpful. Their subjective satisfaction rate with staff was 90%. The main areas of concern were lack of proper examination guidelines and facilities, limited information to mothers regarding neonatal care and substandard interior of hospitals. The statistics on the detailed maternal and neonatal examination showed that it was left out in 30% to 50% patients. Information regarding the danger signs of mothers and neonates was not given in 69% and information on family planning was provided to only 28%. Contentment with the infrastructure of the hospital was subpar and it was suggested that the sanitary conditions of washrooms and the paraphernalia of the wards i.e., ACs and beds needed improvement. Conclusions: This study suggests that in developing countries like Pakistan, majority of the patients were satisfied by the services of healthcare workers. The prime improvement area is the infra-structure of the hospital which can be upgraded to provide better quality facilities in terms of air-conditioning, washrooms and well-designed areas for extensive examination of breast, pelvis, abdomen and neonates. There is also need for introduction of standard guidelines for postnatal care. [ABSTRACT FROM AUTHOR]

Background: Sub-Saharan Africa (SSA) has seen an increase in facility-based births over the years. However, the region has the world's highest newborn mortality rate (42% in 2019). Quality care around the time of birth can avert these deaths. This study examined the newborn care interventions given to women who gave birth in health facilities in 17 countries in SSA. Methods: A cross-sectional population-based study was conducted. We used data from the most recent Demographic and Health Surveys (DHS) conducted in 17 sub-Saharan African countries. We analysed a weighted sample of 226,706 women aged 15–49 years who gave birth in the five years preceding the surveys. We described the coverage of nine newborn care services, namely weighing at birth, breastfeeding initiation within 1 h after birth, skin-to-skin contact, temperature measurement, cord examination, counselling on newborn danger signs, counselling on breastfeeding, breastfeeding observation, and child health assessment before discharge. Results: Overall, 72.0% (95% CI: 71.1, 72.8) of births occurred in health facilities, ranging from 40.0% (95% CI: 38.0, 42.1) in Nigeria to 96.3% (95% CI: 95.4, 97.1) in South Africa. Weighing at birth was the most common intervention (91.4%), followed by health checks before discharge (81%). The other interventions, including those given immediately at birth (breastfeeding and skin-to-skin contact), had suboptimal coverage. For instance, 66% of newborns were breastfed within 1 h after birth, and 56% had immediate skin-to-skin contact. Service coverage varied considerably by country and healthcare provider type. Conclusions: The majority of the examined services, namely early breastfeeding, skin-to-skin contact, cord examination, temperature measurement, counselling on newborn danger signs, breastfeeding observation, and counselling on breastfeeding, were found to have suboptimal coverage. Even though many pregnant women in SSA give birth in healthcare facilities, some newborns do not always get the care they need to be healthy and live. This is a missed chance to improve newborn health and survival around the time of birth. [ABSTRACT FROM AUTHOR]

Introduction: Tanzania had an estimated 5.400 maternal deaths in 2020. Suboptimal quality of antenatal care (ANC) presents a major challenge. It is not known what precisely the uptake of the various ANC components is, such as counseling on birth preparedness and complication readiness, preventive measures and screening tests. We assessed the level of receiving the various ANC components and associated factors in order to identify opportunities to improve ANC. Methods: A cross-sectional household survey using a structured questionnaire through face-to-face interviews, was conducted in April 2016 in Mara and Kagera regions, Tanzania, applying a two-stage, stratified-cluster sampling design. The analysis included 1,162 women aged 15–49 years who attended ANC during their last pregnancy and had given birth not longer than two years prior to the survey. To account for inter- and intra-cluster variations, we used mixed-effect logistic regression to examine factors associated with receiving essential ANC components: counseling around birth preparedness and complication readiness (with presumed effects on knowledge about danger signs) and preventive measures. Results: About In 878 (76.1%) women preparedness for birth and its complications was observed to exist. Overall counseling was low where 902 (77.6%) women received adequate counseling. Overall knowledge of danger signs was low in 467 women (40.2%). Uptake of preventive measures was low, with presumptive malaria treatment in 828 (71.3%) and treatment of intestinal worms in 519 (44.7%) women. Screening test levels varied for HIV in 1,057 (91.2%), any blood pressure measurement in 803 (70.4%), syphilis in 367 (32.2%) and tuberculosis in 186 (16.3%) women. After adjusting for age, wealth and parity, the likelihood of receiving adequate counseling on essential topics was less in women without education versus primary education (aOR 0.64; 95% CI 0.42–0.96) and in women who had <4 ANC visits versus ≥4 visits (aOR 0.57; 95% CI 0.40–0.81). Receiving care in privacy or not (aOR 2.01; 95% CI 1.30–3.12) and having secondary education as compared to primary education (aOR 1.92; 95% CI 1.10–3.70) were associated with receiving adequate counseling. Odds of receiving adequate care in at least one ANC visit were lower in women with joint decision making on major purchases versus decision making by male partner or other family members alone (aOR 0.44; 95% CI 0.24–0.78), similar to being less knowledgeable on danger signs (aOR 0.70; 95% CI 0.51–0.96). Conclusion: Overall uptake of various essential ANC components was low. Frequent ANC visits and ensuring privacy are all essential to improve the uptake of ANC. [ABSTRACT FROM AUTHOR]

Introduction: Neonatal illnesses can prove to be fatal if not identified early and treated. This suggests that death occasioned as result of neonatal illness could be prevented. However, it has been observed that most mothers report to the hospital late with their newborns in critical state, making it difficult for professionals to salvage the problem often than not. This study sought to explore the knowledge and practices of home caregivers on neonatal danger signs pre-admission to Tamale Teaching Hospital a tertiary hospital in northern Ghana. Methods: An explorative descriptive qualitative design was used in this study. Purposive sampling technique was used to select fifteen caregivers of neonates on admission at the Neonatal Intensive Care Unit of Tamale Teaching Hospital. Data was collected using semi-structured interview guide. As part of data collection, audio recordings were used to audio tape interviews. All data collected were transcribed verbatim and subsequently analyzed manually using thematic content analysis. Results: Thematic analysis in the study demonstrated that caregivers had basic knowledge, describing neonatal illness with danger signs such as lethargy, convulsion, fever, fast breathing, poor feeding, vomiting and diarrhea. The study further found that the predominant practice to care seeking by caregivers was home/traditional herbal remedies. It also indicated that inexperience caring for neonates, severity of illness and non-availability of finances were factors that informed caregivers choice of treatment of neonatal illness. Conclusion: The study concludes that inexperience caring for neonate, severity of illness and non-availability of finances were factors that informed caregivers choice of treatment. There is a pressing need for health workers to strengthen the education of caregivers/mothers on neonatal danger signs and the need for prompt care seeking from skilled health care providers prior to discharge from the hospital. [ABSTRACT FROM AUTHOR]

Background: Rectal artesunate (RAS) is a World Health Organization (WHO) recommended intervention that can save lives of children 6 years and younger suffering from severe malaria and living in remote areas. Access to RAS and a referral system that ensures continuity of care remains a challenge in low resource countries, raising concerns around the value of this intervention. The objective of this study was to inform RAS programming, using practical tools to enhance severe malaria continuum of care when encountered at community level. Methods: A single country two-arm-controlled study was conducted in Malawi, where pre-referral interventions are provided by community health workers (CHWs). The study populations consisted of 9 and 14 village health clinics (VHCs) respectively, including all households with children 5 years and younger. CHWs in the intervention arm were trained using a field-tested toolkit and the community had access to information, education, and communication (IEC) mounted throughout the zone. The community in the control arm had access to routine care only. Both study arms were provided with a dedicated referral booklet for danger signs, as a standard of care. Results: The study identified five continuum of care criteria (5 CoC Framework) to reinforce RAS programming: (1) care transitions emerged as to be dependent on a strong cue to action and proximity to an operational VHC with a resident CHWs; (2) consistency of supplies assured the population of the VHC's functionality for severe danger signs management; (3) comprehensiveness care ensured correct assessment and dosing; (4) connectivity of care between all tiers using the referral slip was feasible and perceived positively by caregivers and CHWs and (5) communication between providers from different points of care. Compliance was high throughout but optimized when administered by a sensitized CHW. Over 93% experienced a rapid improvement in the status of their child post RAS. Conclusion: RAS cannot operate within a vacuum. The impact of this lifesaving intervention can be easily lost, unless administered as part of a system-based approach. Taken together, the 5CC Framework, identified in this study, provides a structure for future RAS practice guidelines. Trial registration number and date of registration PACTR201906720882512- June 20, 2019. [ABSTRACT FROM AUTHOR]

Background. World Health Organization estimates that 800 women die from pregnancy or childbirth-related complications around the world every day. With the assumption that "every pregnancy faces risk" women should be aware of the danger signs of obstetric complications during pregnancy, delivery, and postpartum. Indications on the prevalence of obstetric danger signs and risk factors were crucial in designing programs at different levels in reducing maternal morbidity and mortality. Objective. To assess the knowledge about obstetric danger signs and associated factors among pregnant women in Debre Tabor town, Northwest Ethiopia, 2021. Methods. A community-based cross-sectional study was conducted with 295 respondents to assess knowledge about obstetrical danger signs among pregnant women in Debre Tabor town from July to September 2021. Data were collected through self-administered questionnaires. Proportional followed by simple random sampling was used to select the study participants among the pregnant women in each of the six kebeles of the town. Adjusted odds ratios at 95% confidence interval and a value of p < 0.05 were used to identify the predictors. Results. From a total of 295 interviewed, 61% of them were poorly knowledgeable about obstetric danger signs, but 39% of them were knowledgeable. According to our study, maternal age less than or equal to 30 years (adjusted odds ratio = 5.44 ; 95% confidence interval: 3.26,9.10), no formal education (adjusted odds ratio = 9.488 ; 95% confidence interval: 4.73, 13.14), one-time gravidity (adjusted odds ratio = 7.81 ; 95% confidence interval: 4.79, 9.19), and frequency of antenatal follow-up less than 4 times (adjusted odds ratio = 4.10 ; 95% confidence interval: 1.88, 8.96) were factors which significantly associated with the poor knowledge of obstetric danger signs. Conclusion. As the knowledge of pregnant women towards obstetric danger signs was low, maternal age less than or equal to 30 years, no formal education, one-time gravidity, and less than 4 times the frequency of antenatal follow-up are associated factors for poor knowledge on obstetric danger signs. [ABSTRACT FROM AUTHOR]

Background: Danger signs in pregnancy can warn of maternal health problems. In developing African countries, including Ethiopia, the rate of maternal mortality is high. There is little knowledge of danger signs during pregnancy and their associated factors at the community level in the study area. Methods: A community-based, cross-sectional study was conducted to assess knowledge about danger signs among pregnant women in Hosanna Zuria Kebeles between 30 June and 30 July 2021. A simple random sampling method was used to select eligible pregnant women. The sample size was proportionally allocated based on the number of pregnant women in each kebele. Data were collected in face-to-face interviews using a pretested questionnaire. The descriptive results were presented as proportions, whereas the analytic results were presented as adjusted odds ratios (AOR). Results: The prevalence of good knowledge of danger signs in pregnancy was 259/410 (63.2%, 95% confidence interval (CI) 58.3-67.8). The most common known danger signs during pregnancy were severe vaginal bleeding (n = 227, 55.4%), followed by blurred vision (n = 224, 54.6%). In the multivariable analysis, the age of the respondent (AOR = 3.29, 95% CI 1.15-9.38), the tertiary education of the mother (AOR = 5.40, 95% CI 2.56-11.34), and the number of live births (AOR = 3.95, 95% CI 2.08-7.48) were statistically significant factors. Conclusion: There was an adequate prevalence of knowledge of danger signs in pregnancy among pregnant mothers compared with different studies in Ethiopia and different countries. Advanced maternal age, the respondent's level of education, and the number of live births were found to be independent determining factors for the level of knowledge on danger signs in pregnancy among pregnant mothers. Health facilities and healthcare providers should focus on antenatal care and the age and parity of the mother when giving information about danger signs in pregnancy. The Ministry of Health should provide reproductive health services in rural areas and encourage education for women. Further studies need to be conducted and include danger signs in the three trimesters using a qualitative study design. [ABSTRACT FROM AUTHOR]

Study Design: Cross sectional. Introduction: In developing countries like Saudi Arabia, most of the newborn deaths are reported to take place at home. Majority of such deaths have been caused due to lack of awareness, late detection of symptoms of critical infection by caregivers and mothers, and late decision-making in seeking healthcare services. Mothers' familiarity on symptoms recognized by the WHO is very important for health-seeking behavior of mothers. Objective: This study is aimed to investigate the awareness, health-seeking behavior and knowledge of caregivers and mothers about neonatal danger signs in Saudi Arabia. Methodology: A "community-based, cross-sectional study" was conducted on awareness level of mothers in Saudi Arabia on neonatal danger signs suggested by WHO. The sample size consists of 4518 mothers who have delivered the baby over the past two years and nurtured a baby. A self-structured questionnaire was designed to share online to gather the data. The data was analyzed through IBM SPSS v20.0 to evaluate awareness and experience of mothers about danger signs with one-sample t-test with confidence interval of 95%. Results: In this study, 1265 (28%) participants recognized yellow palms/sores as a danger sign in newborn child. Additionally, 19.4% and 18.8% women recognized fast breathing and convulsion as danger signs, respectively. Child not feeding since birth or stopped feeding is another sign recognized by 7.7% participants, weakness or lethargy was recognized by 4% participants, excess crying was recognized by 3.8% participants and weight gain was recognized by 2.3% participants. After performing one sample t-test with confidence interval of 95%, it was observed that there is a significant impact of participants' familiarity on recognizing "neonatal danger signs (p<0.05)". [ABSTRACT FROM AUTHOR]

Construction work includes the implementation of construction work and the community organizing the construction work itself. The implementation of this construction work must comply with the provisions regarding engineering, occupational safety and health, labor protection, and local environmental regulations to ensure the realization of an orderly implementation of construction work. The construction of the Kretek 2 Bridge in Bantul Regency, Special Region of Yogyakarta Province has its own challenges, because the location of the bridge is in an area prone to earthquakes and liquefaction or ground movement. With so many workers on this very high-risk project, there is a high probability of an accident occurring. The purpose of the study was to analyze (1) the risky work that could occur in bridge construction work, (2) the work that has the highest possible risk, (3) risk control, (4) the amount of investment costs required. The method used is the HIRADC method. The results of the study were (1) Risky work that can occur was a. High level of risk, including drowning, being dragged by the river current, being hit by heavy equipment maneuvers and falling from a height. b. Moderate risk level, including being crushed by formwork, falling material, scratched hands. c. Low level of risk, including landslides, heavy equipment maneuvers, iron puncture. (2) Work that has the highest possible risk is Pile Cap Excavation Work, Work Floor Work and Pier Head Ironing Work. (3) Risk control in bridge work consists of: Using a boat when measuring in rivers, Conducting briefings before starting activities, Using PPE life vests and placing life ring buoys on boats, Installing signs and placing officers in areas that intersect with roads, Installing guardrail of the project area, installing scaffolding as a working platform and inspecting its feasibility, communicating hazards through signs, conducting refresh training for workers. (4) The investment cost required for implementing K3 on the Kretek 2 Bridge work in Bantul Regency was Rp. 6,545,998,310 or 1.795% of the contract value. [ABSTRACT FROM AUTHOR]

Background: In India, neonatal mortality contributes to over 64% of infant deaths, mostly occurring during the first week of life. Mortality rate in second month of life is also higher than at later ages. Delay in identification of warning signs of neonatal illness naturally postpones the initiation of treatment and referral to hospital. Materials and Methods: The study aimed to explore the perception of care givers regarding danger signs of illness and practices followed in young infants. Care givers who cared for the sick young infants during last six months were recruited using a convenient sampling technique and qualitative research approach. Five semi-structured interviews and one FGD were conducted using an interview and FGD guide. Data was analyzed manually by reading and rereading the transcribed verbatim leading to the emergence of themes, subthemes, and codes. Results: Data explored that excessive crying was perceived as a danger sign by entire mothers, and many of them were unable to recognize important warning signs. The delay in decision making for medical care-seeking also shows dwindling awareness. Additionally, mothers were adapting few unhygienic practices as home remedies leading to worsening the symptoms and making a call for additional infections which needs to be addressed by the health authorities at community level. Conclusion: Pronounced efforts are expected to raise mindfulness of mothers toward the significance of early identification of neonatal danger signs to stave off the high magnitude of neonatal mortality. Inclusion of excessive crying as neonatal danger sign is recommended as well. [ABSTRACT FROM AUTHOR]

This paper focuses on the training of a deep neural network regarding danger sign detection and recognition in a substation. It involved applying the concepts of neural networks and computer vision to achieve results similar to traffic sign and number plate detection systems. The input data were captured in three distinct formats, i.e. grayscale, RGB, and YCbCr, which have been used as a base for comparison in this paper. The efficiency of the neural network was tested on a unique data set involving danger signs present in industrial and processing facilities. The data set was unique, consisting of four distinct symbols. The trained data were selected so that they would not facilitate overfitting and also would not be under fitted. The accuracy of the model varied with the input type and was tested with two distinct classifiers, CNN and SVM, and the results were compared. The model was designed to be fast and accurate, and it can be implemented on mobile devices. [ABSTRACT FROM AUTHOR]

Background: Globally, 2.5 million babies die in the first 28 days of life each year with most of these deaths occurring in low- and middle-income countries. Early recognition of newborn danger signs is important in prompting timely care seeking behaviour. Little is known about women's knowledge of newborn danger signs in Papua New Guinea. This study aims to assess this knowledge gap among a cohort of women in East New Britain Province. Methods: This study assessed knowledge of newborn danger signs (as defined by the World Health Organization) at three time points from a prospective cohort study of women in East New Britain Province, factors associated with knowledge of danger signs after childbirth were assessed using logistic regression. This study includes quantitative and qualitative interview data from 699 pregnant women enrolled at their first antenatal clinic visit, followed up after childbirth (n = 638) and again at one-month post-partum (n = 599). Results: Knowledge of newborn danger signs was very low. Among the 638 women, only 9.4% knew three newborn danger signs after childbirth and only one knew all four essential danger signs defined by Johns Hopkins University 'Birth Preparedness and Complication Readiness' Index. Higher knowledge scores were associated with higher gravidity, income level, partner involvement in antenatal care, and education. Conclusion: Low levels of knowledge of newborn danger signs among pregnant women are a potential obstacle to timely care-seeking in rural Papua New Guinea. Antenatal and postnatal education, and policies that support enhanced education and decision-making powers for women and their families, are urgently needed. [ABSTRACT FROM AUTHOR]

Background Most infants in southeastern Ethiopia are either born at home or discharged from the health facility early and families should be able to recognize signs of newborn illnesses and bring the sick newborn to a health facility to receive care. However, studies are limited and the available studies were conducted in urban areas and/or at an institution level. This study aimed to assess the determinants of maternal knowledge of neonatal danger signs and care-seeking practices. Methods A community-based cross-sectional study was conducted on 520 post-natal mothers using a multistage sampling method from 1 to 30 March 2019. The data were analysed using SPSS version 20 using binary logistic regression. Statistical significance was declared at p<0.05. Results Mothers' level of knowledge of neonatal danger signs was 50.2% (95% confidence interval [CI] 46.3 to 54.3) and 61% of them sought healthcare when they noticed danger signs. Maternal education level (adjusted odds ratio [AOR] 2.15 [95% CI 1.11 to 4.17]), husband's education level (AOR 2.05 [95% CI 1.07 to 3.94]), residency (AOR 5.83 [95% CI 2.77 to 12.24]), antenatal visits (AOR 2.10 [95% CI 1.13 to 3.90]), antenatal care (ANC) counselling (AOR 4.33 [95% CI 1.88 to 9.98]) and knowledge about essential newborn care (AOR 3.91 [95% CI 2.05 to 7.48]) were the determining factors. Conclusion The mothers' level of knowledge of neonatal danger signs was low and unsafe care-seeking practices were identified. The mothers' education level, husbands' education level, residence, ANC visits, counselling during ANC and knowledge about essential newborn care were found to be statistically significant determinants. Most of the mothers take their sick neonates to traditional healers and provide home remedies. Intervention modalities focusing on maternal counselling on the most common symptoms of illness in neonates are essential to increase mothers' recognition of illness and improve care-seeking practices. [ABSTRACT FROM AUTHOR]

Background: Home birth preference is the need of pregnant women to give birth at their home with the help of traditional (unskilled) birth attendants. Homebirth with unskilled birth attendants during childbirth is the main leading indicator for maternal and newborn death. In Ethiopia, numbers of women prefer homebirth which is assisted by unskilled personal. However, there is no information regarding the problem in the Arba Minch zuria woreda. Therefore, it is important to identify prevalence of preference of homebirth and associated factors. Objectives: This study aimed to assess the preference of home birth and associated factors among pregnant women in Arba Minch health and demographic surveillance site. Method and materials: A community-based cross-sectional study was conducted among pregnant women in Arba Minch health and demographic surveillance site, from May 1 to June 1, 2021. Using simple random sampling technique, 416 study samples were selected. Data were collected by interviewer-administered questionnaire. Data were coded and entered into Epi-Data version 4.4.2.1 computer software and exported to Statistical Package for Social Sciences software version 25 for analysis. Bi-variable binary logistic regression for the selection of potential candidate variables at p-value < 0.25 for multivariable analysis and multivariable binary logistic regression to identify the association between homebirth preference and independent variables were carried out. The level of statistical significance was declared at a p-value < 0.05. Result: In this study, in Arba Minch demographic health surveillance site, the prevalence of preference of pregnant women to give birth at their home was 24% [95%CI: (19.9%-28.2%)] The factors significantly associated with the preference of home birth were husband involvement in decision making [AOR: 0.14 (0.05–0.38)], no access of road for transportation [AOR: 2.4 (1.2–5.18)], not heard about the benefit of institutional birth [AOR: 5.3 (2.3–12.2)], poor knowledge about danger signs [AOR: 3 (1.16–7.6)], negative attitude toward services [AOR: 3.1 (1.19–8.02)], and high fear to give birth at institution [AOR: 5.12 (2.4–10.91)]. Conclusions: In Arba Minch demographic health surveillance site, the prevalence of preference of pregnant women to give birth at their home was 24%. Husband involvement in decision making, no access of road for transportation, not heard about the benefit of institutional birth, poor knowledge about danger signs, negative attitude toward services, and high fear to give birth at health institutions were factors significantly associated with the preference of home birth. [ABSTRACT FROM AUTHOR]