Proceedings of the Global Public Health Conference

FACTORS ASSOCIATED WITH TUBERCULOSIS TREATMENT SUCCESS IN BANTUL, INDONESIA: SECONDARY DATA ANALYSIS OF TUBERCULOSIS INFORMATION SYSTEM 2020–2022

Soraya Isfandiary Iskandar — 2024-06-25

Indonesia has the world's second-highest number of tuberculosis (TB) patients. Patients with TB frequently experience boredom and a lack of medication adherence, resulting in lower treatment rates. This study was conducted to identify factors associated with successful TB treatment using a Tuberculosis Information System (SITB), the centralized system used to record and report TB cases. We conducted the cross-sectional study using secondary data from SITB for 2020-2022. Treatment success was the sum of cure and treatment completion. Loss to follow-up, death, and treatment failure were defined as unsuccessful treatment. Age, gender, contact investigation, type of TB diagnosis, anatomical site, treatment history, diabetes status, and HIV status were the independent variables. The dependent variable was the treatment outcome. Inclusion criteria include TB patients over the age of 15 with treatment results, whereas incomplete data was excluded. Total sampling was used. We applied multiple logistic regression to analyze the factors associated with treatment results. Only 421 of the 1377 data obtained were complete and analyzed. Most of them received standard therapy (92.53%), aged 15-64 years (95.03%), females (96.30%), and had contact investigation (97.45%). The significant factors for TB treatment success were age (aOR 5.61; 95% CI 2.42-12.99), gender (aOR 2.68; 95% CI 1.01-7.07), type of TB diagnosis (aOR 0.43; 95% CI 0.19-0.99), and contact investigation (aOR 3.37; 95% CI 1.09-10.39). TB patients of productive age, female, bacteriologically confirmed, and performing a contact investigation had a greater probability of successful therapy. Multisectoral collaboration is required for tuberculosis control; contact tracing should be encouraged to improve treatment outcomes for tuberculosis in index cases and other risk factors should be explored to establish a population-level intervention.

UNVEILING COMMUNITY-CENTRIC DYNAMICS FOR IMPROVED HEALTH AND NUTRITION OUTCOMES: EVALUATIVE INSIGHTS ON AN INTEGRATED NUTRITION AND HIV/AIDS PROGRAMME IN LESOTHO

Sonia Mairos Ferreira — 2024-06-25

From September 2019 to March 2023, UNICEF and the Government of Lesotho ran a three-year Integrated Nutrition and HIV/AIDS program across all districts. The main goal was to improve the health and nutrition of women and children, especially those affected by HIV/AIDS. The program aligned with global and regional directives, including the Sustainable Development Goals (SDGs) 2, 3, and 5, Africa's Agenda 2063, and various national health strategies of Lesotho. The evaluation used a theory-driven methodology, leveraging the program’s Theory of Change (ToC) and Logical Framework (LogFrame) to assess key outcomes and outputs. A mixed-method approach included reviewing 20 essential documents and collecting primary qualitative and quantitative data at national, district, and community levels. Three districts and six communities were randomly selected for a comprehensive evaluation. The qualitative methods involved key informant interviews (KIIs) and focus group discussions (FGDs), supplemented by quantitative surveys of 48 households and 21 supervisors. Despite some challenges, there were significant positive changes in community health behaviours and nutritional outcomes, supported by community engagement, local governance, and behaviour change strategies. Male engagement notably contributed to achieving the program’s objectives. These findings provide a deeper understanding of community-centred program dynamics and offer important lessons for future health and nutrition interventions in marginalized settings. They also contribute valuable insights to both practical and policy discussions on integrated health programs.

EMPOWERING LESOTHO'S TOMORROW: YOUTH-DRIVEN INNOVATION IN PREVENTIVE HEALTHCARE

Sonia Mairos Ferreira — 2024-06-25

This study is rooted in the imperative to incorporate the voices of youth into the development of programmes and policies, in Lesotho. The aim was to understand the health and well-being challenges they face and to highlight the need for innovative, preventive, and participatory interventions, which include their unique perspectives and contributions. The research involved 180 children, both boys and girls, from various ecological zones, using a qualitative approach to gather detailed insights. Data were collected using Participatory Learning Approach tools, including Social and Resource Mapping, Cause and Effect Analysis, which were supplemented by Key Informant Interviews. The study team also conducted 18 Focus Group Discussions, aimed to gain a more comprehensive understanding of the children’s perspectives, experiences and needs. The study unveils several health challenges that young people in Lesotho face, including malnutrition, limited access to healthcare, and gender-based violence. Despite these difficulties, the stories shared by the participants show a strong sense of resilience and a keen desire to be actively involved in policymaking and interventions related to their health and well-being. The findings have significant implications. They provide a framework for health professionals and policymakers to incorporate the perspectives of children and youth into preventive health strategies. Additionally, the study highlights the need for a shift in public health discussions, advocating for inclusive policy development that considers the unique needs and rights of young populations. These insights, though specific to Lesotho, could be valuable in similar contexts.

SCHOOL INTEGRATED MEDICAL OUTREACH:AN APPROACH TO ENHANCE HEALTH SERVICE DELIVERY IN TURKANA, KENYA

Rael Akoru — 2024-06-25

School integrated medical outreach ,is an approach that aims at delivering basic health care services to school going children by linking schools to catchment community health units and health facilities.The approach is in line with the Universal Health coverage strategy ,that puts communities at the center-stage of health care delivery services,with minimal delays and cost. In Turkana county,access to static health facilities is between 5 to 50 kilometers,this is a huge challenge to children as they are vulnerable to abuses,when they go to seek medical attention at static health facilities and at the health facilities,there are no specific services for children,even when they are in uniform,they are not given the attention they deserve,notwithstanding the fact that they have missed class hours ,impacting on their academic performance.Mapping and zoning of schools within 0-20 kilometers from the static health facility, and in a strategy dubbed #TakingHospitalstoschoolschallenge#,the link community units staff plan,organize and conduct schools dialogue days(SDAs) and School Action Days(SADs),where schools are recognized as School Health Units(SHUs).The link health facility in consultation with school management and community unit organize school medical outreach on agreed schedule.The focus of the approach is schools located in nomadic pastrolist areas and hard to reach areas,which form 65% of schools .From 2019 to 2023,the link facility health care workers have managed to visit 45 schools,with a population of 87,706,treating 76,364 ,and further referring 6,017 to the link health facility for more review