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1
Masud, Abdullah Al, Md Shahoriar Ahmed, Mst Rebeka Sultana, S. M. Iftekhar Alam, Russell Kabir, S. M. Yasir Arafat, and Konstantinos Papadopoulos. "Health Problems and Health Care Seeking Behaviour of Rohingya Refugees." Journal of Medical Research and Innovation 1, no. 1 (March 3, 2017): 21–29. http://dx.doi.org/10.15419/jmri.27.
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Background: Rohingya refugees are one of the most vulnerable group due to lack of health care system, personal hygiene, shelter, sanitation and violence.
Aim: The present study aims to find out the health problems and health care seeking behavior of rohingya refugees, to identify the socio-demographic information for such exposure group in relation to age, sex, occupation, living areas, to explore the patient’s physical, emotional, perceptions, attitudes and environmental health problems and to bring out health care seeking behavior of refugees.
Methodology: A cross-sectional study was conducted. A total of 149 samples were selected conveniently for this study from the refugee camps. Data was collected by using mixed type of questionnaire. Descriptive statistic was used for data analysis which has depicted through tables, pie chart and bar chart.
Results: The finding of the study showed that 45.6% participants had multiple problems, followed by 16.8% participants who had other specific problems like musculoskeletal pain, visual problems and peptic ulcer. Urinary tract infection was the leading individual health problem with 11.4% of the sample group having it. 10.7% participants had hypertension, 6% had respiratory tract infection, 3.4% had nutrition deficiency, 4.75% had diabetes mellitus and 1.3% had sanitation & hygiene problems. Among the participants, 68.4% age ranged between 15-59 years. The study showed that, only 16.1% participants were satisfied with the quality of service they received while 37.6% participants said that they needed better services such as more laboratory test, radiological imaging, more medicine and more doctors.
Conclusion: It is clear that refugees suffered from a variety of health problems, because their living condition and environmental situation were not similar like an independent nation. Further, basic amenities like medicines and other services were not available.
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Allahi, Fahimeh, Amirreza Fateh, Roberto Revetria, and Roberto Cianci. "The COVID-19 epidemic and evaluating the corresponding responses to crisis management in refugees: a system dynamic approach." Journal of Humanitarian Logistics and Supply Chain Management 11, no. 2 (January 25, 2021): 347–66. http://dx.doi.org/10.1108/jhlscm-09-2020-0077.
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PurposeThe COVID-19 pandemic is a new crisis in the world that caused many restrictions, from personal life to social and business. In this situation, the most vulnerable groups such as refugees who are living in the camps are faced with more serious problems. Therefore, a system dynamic approach has been developed to evaluate the effect of applying different scenarios to find out the best response to COVID-19 to improve refugees’ health and education.Design/methodology/approachThe interaction of several health and education factors during an epidemic crisis among refugees leads to behavioral responses that consequently make the crisis control a complex problem. This research has developed an SD model based on the SIER model that responds to the public health and education system of Syrian refugees in Turkey affected by the COVID-19 virus and considered three policies of isolation, social distance/hygiene behavior and financial aid using the available data from various references.FindingsThe findings from the SD simulation results of applying three different policies identify that public health and education systems can increase much more by implementing the policy of social distance/hygiene behavior, and it has a significant impact on the control of the epidemic in comparison with the other two responses.Originality/valueThis paper contributes to humanitarian organizations, governments and refugees by discussing useful insights. Implementing the policy of social distance and hygiene behavior policies would help in a sharp reduction of death in refugees group. and public financial support has improved distance education during this pandemic.
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Park, Jason H., Lawrence Mwananyanda, Maria Servidone, Jean Sichone, Susan E. Coffin, and Davidson H. Hamer. "Hygiene practices of mothers of hospitalized neonates at a tertiary care neonatal intensive care unit in Zambia." Journal of Water, Sanitation and Hygiene for Development 9, no. 4 (October 3, 2019): 662–70. http://dx.doi.org/10.2166/washdev.2019.140.
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Abstract Risk of neonatal mortality secondary to infections such as pneumonia and diarrhoeal diseases can be influenced by maternal hygiene, but little information is known about current maternal hygiene practices in low- and middle-income countries. This study aimed to assess the hygiene practices of mothers of neonatal intensive care unit (NICU) patients in Lusaka, Zambia and associated epidemiological factors. A cross-sectional survey of the mothers of hospitalized neonates at the University Teaching Hospital (UTH) in Lusaka was conducted. Study nurses orally administered questionnaires to mothers in their local languages about their hygiene practices related to newborn care. Of the 201 mothers surveyed, self-reported hygiene practice was associated with literacy (p = 0.013) and income (p < 0.0001). In contrast, adherence to recommended hygienic newborn care was less common, with only 36% of mothers practising recommended cord care practices. Forgetfulness (32%) and lack of hygiene resources (13%) were the major barriers to hygienic behaviours. Surveyed Zambian women who delivered babies requiring NICU care self-reported adequate hygienic practices and apparently faced difficulty practising them due to forgetfulness and a lack of hygiene resources. Future efforts should focus on improving cord care education, reinforcement of the importance of hygienic behaviours, and the supply of affordable antiseptic tools.
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Chisembele, Maureen, Violeta J. Rodriguez, Megan R. Brown, Deborah L. Jones, and Maria L. Alcaide. "Intravaginal practices among young HIV-infected women in Lusaka, Zambia." International Journal of STD & AIDS 29, no. 2 (July 12, 2017): 164–71. http://dx.doi.org/10.1177/0956462417721438.
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Intravaginal practices (IVP) are linked to bacterial vaginosis (BV), obstetric/gynecological complications, and HIV. Late adolescent and young adult (LAYA) women in Zambia have high rates of HIV. Adult and mature (AM) HIV-infected women in Zambia engage in IVP for hygiene, health, and sexuality reasons; however, to our knowledge, IVP use among LAYA women has not been examined. This study compares IVP use between LAYA and AM women to identify age-specific factors to target when developing IVP reduction interventions for LAYA women. LAYA (≤25 years; n = 24) and AM (>25 years; n=124) HIV-infected women completed self-administered demographic, HIV history, sexual risk factor, and IVP measures. LAYA and AM women were then compared. Number of sexual partners, sexual activity, or condom use did not differ between groups. Rates of IVP in the prior month with different products were similar, though LAYA women used soap more frequently (96% versus 74.2%, p = 0.034). LAYA women were more likely to use products for hygiene reasons (soap 83% versus 43%; cloth, paper, or wipes 50% versus 17%, p < 0.05); and AM women to use products to please sexual partners (cloth 20% versus 56%, p = 0.074). Interventions tailored to LAYA women may be needed to reduce IVP and subsequent BV as LAYA women may have different reasons for engaging in IVP, in comparison with AM women. Reduced IVP among LAYA women may decrease the risk for HIV transmission to sexual partners and newborns and is urgently needed in settings with high prevalence of IVP, BV, and HIV infections, such as Zambia.
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Oladimeji, Olanrewaju, Bamidele Paul Atiba, Jabu A Mbokazi, and Francis Leonard Mpotte Hyera. "The Homeless, Inmates and Refugees in Africa in the Face of COVID-19 Outbreak." Open Public Health Journal 13, no. 1 (June 28, 2020): 306–8. http://dx.doi.org/10.2174/1874944502013010306.
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Total well-being and care for the vulnerable, especially the homeless, inmates, and refugees during the COVID-19 pandemic, is one of the barometers to measure Africa's response. Hence in the light of this scenario, our comment is on their care during this devastating period. We compared what is currently being done in the western world with what the African countries are doing. We have posed particular challenges with the welfare packages, the implementation of physical distances, good hygiene practices, limited access to screening and testing of COVID-19, as the outbreak invasion could be overwhelming if there is no intervention to bridge this gap. There is, therefore, an urgent need to consider welfare packages, an optimum hygiene environment, decongestion, and mass screening and testing for these groups of individuals, as they also have equal human rights to be protected during this pandemic.
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Namara, Frank, Hilbert Mendoza, Gloria Tumukunde, and Solomon Tsebeni Wafula. "Access to Functional Handwashing Facilities and Associated Factors among South Sudanese Refugees in Rhino Camp Settlement, Northwestern Uganda." Journal of Environmental and Public Health 2020 (March 30, 2020): 1–7. http://dx.doi.org/10.1155/2020/3089063.
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Background. Hand hygiene in refugee camp settlements remains an important measure against diarrhoeal infections. Refugee settings are characterised by overcrowding and inadequate access to water and hygiene facilities which favour proliferation of faecal-oral diseases. Handwashing with soap and water is therefore an effective way of preventing such diseases. Despite this knowledge, there is limited information about access to functional handwashing facilities in these settings and associated factors in Uganda. Methods. Quantitative data were collected from 312 refugee households in Rhino Camp Settlement, Northwestern Uganda, using a semistructured interviewer-administered questionnaire. A modified Poisson regression was used to obtain prevalence ratios (PRs) and 95% confidence intervals (CIs) for the determinants of access to a functional handwashing facility among refugee households. All analyses were performed using STATA 14.0 statistical software. Results. Of the 312 households, 123 (39.4%) had access to a handwashing facility, but only 72 (23.1%) of households had handwashing facilities that were functional. Duration of stay in the camp exceeding 3 years (adjusted PR = 2.63; 95% CI (1.73–4.00)) and history of receiving home-based education on hand hygiene (adjusted PR = 9.44; 95% CI (1.40–63.86)) were independent predictors of access to a functional handwashing facility. Conclusion. Access to functional handwashing facilities among the refugee households was low. Our findings highlight the need for more and continued handwashing promotional programs, most especially among newly arrived refugees in the camp.
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Hsan, Kamrul, Shabnam Naher, Mark D. Griffiths, Hakimul Hasan Shamol, and Mohammad Azizur Rahman. "Factors associated with the practice of water, sanitation, and hygiene (WASH) among the Rohingya refugees in Bangladesh." Journal of Water, Sanitation and Hygiene for Development 9, no. 4 (October 21, 2019): 794–800. http://dx.doi.org/10.2166/washdev.2019.038.
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Abstract The Rohingya people are now living in overcrowded refugee camps and makeshift settlements with low standards of water, sanitation, and hygiene (WASH). This study was conducted to examine WASH practices and associated risk factors among the Rohingya refugees in Bangladesh. The present study comprised 350 participants with data collected via a semi-structured questionnaire. Most respondents (84%) did not have good knowledge concerning WASH. Furthermore, 50.3% had unsafe WASH practices, 38.6% had fair WASH practices, and 11.1% had safe WASH practices. WASH practices were significantly associated with age, education, marital status, and WASH knowledge. The implementation of an effective WASH awareness program is required along with improved water supply and sanitation to improve WASH practices among Rohingya refugees in Bangladesh.
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Lahme, Anne Mutunda, Ruth Stern, and Diane Cooper. "Factors impacting on menstrual hygiene and their implications for health promotion." Global Health Promotion 25, no. 1 (July 5, 2016): 54–62. http://dx.doi.org/10.1177/1757975916648301.
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Background: In the lives of women, puberty is marked by the onset of menarche. From this stage onwards until menopause, reproductive health and menstrual hygiene are important aspects of women’s lives. In Zambia’s Western Province, the natural process of menstruation is a taboo and dealt with secretly. Information and knowledge about menstruation and menstrual hygiene among adolescent girls is inadequate. This paper explores the factors influencing the understanding, experiences and practices of menstrual hygiene among adolescent girls in Mongu District, Western Province of Zambia. Methods: An explorative study design was used by means of six focus group discussions conducted with 51 respondents, aged 13–20 years, from three secondary schools. Their age at menarche was 11–15. For data analysis thematic content analysis was used. Results: The paper shows that the girls suffer from poor menstrual hygiene, originating from lack of knowledge, culture and tradition, and socio-economic and environmental constraints, leading to inconveniences, humiliation and stress. This leads to reduced school attendance and poor academic performance, or even drop outs, and ultimately infringes upon the girls’ human rights. Conclusion: To address these shortcomings, a ‘super setting approach’ is recommended, in which a Health Promoting School could improve the girls’ individual and group needs, and a community setting which would address the broader socio-economic, cultural and environmental conditions. This would enable creating a supportive environment for the girls to manage their periods. To successfully utilize the approach, all stakeholders (parents, teachers, children, governments and communities) should cooperate to generate context-specific solutions for creating safe menstrual care, and better and dignified conditions for adolescent girls. Therefore, this calls for comprehensive, strident advocacy for policy changes at national level, and mediation and involvement at community level.
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Ur Rehman, Atta, Rubeena Zakar, Muhammad Zakria Zakar, Ume Hani, and Florian Fischer. "Protocol for a cross-sectional study on factors affecting health-related quality of life among Afghan refugees in Pakistan." F1000Research 10 (September 27, 2021): 971. http://dx.doi.org/10.12688/f1000research.73005.1.
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Background: Pakistan served as a host for more than 1.4 million Afghan refugees for more than 40 years. Access to health care is the most important issue faced by refugees, because they might be at a higher risk for certain diseases. This risk can be attributed to a lack of awareness of health care facilities, health beliefs, inadequate hygiene, cultural differences, and malnutrition. Health of individuals is closely associated with their quality of life. Quality of life over the whole lifespan is pivotal to overall life satisfaction. It includes physical wellbeing, mental health, education, occupation, income, personal safety, as well as (religious) freedom. Until now, the health status of Afghan refugees has never been comprehensively investigated in Pakistan. Therefore, an assessment in this regard is needed to explore their health-related quality of life, for securing their human right to health. Methods: A cross-sectional study has been designed to describe and explain the health-related quality of life of Afghan refugees in Pakistan. Multistage cluster sampling was applied for selection of study participants. The number of respondents from two regions in Pakistan was drawn through a proportionate sampling technique. A quantitative research method using pre-validated questionnaires was used for data collection. The questionnaire included items to assess well-being, mental health, health literacy, and factors affecting health and health care. Descriptive analysis was used, whereas inferential statistical tests (binary logistic regression model) was also performed. The study received ethically permission by the Advanced Studies and Research Board of the University of the Punjab, Lahore, Pakistan. Discussion: The assessment of Afghan refugee’s quality of life in Pakistan should lead to recommendations disseminated to public and health care officials. This evidence is needed for policymaking related to adequate measures for improving health conditions of Afghan refugees in Pakistan.
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Rodriguez, Violeta J., Maureen Chisembele, Deborah L. Jones, Ryan Cook, Stephen M. Weiss, and Maria L. Alcaide. "Influencing the importance of health, partners, and hygiene among Zambian women." International Journal of STD & AIDS 29, no. 3 (August 1, 2017): 259–65. http://dx.doi.org/10.1177/0956462417723546.
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Intravaginal practices (IVPs) are common in Zambia and are usually practiced for hygiene, partner pleasure, and health. IVPs are associated with HIV acquisition, changes in the vaginal flora, and bacterial vaginosis (BV), making it important to understand the decision-making process behind IVP engagement. The Women’s and Sexual Health (WASH) intervention decreased IVP engagement among HIV-infected Zambian women, though change in reasons for engagement has not been assessed. We used conjoint analysis (CA) to quantify the decision-making process of IVP engagement and evaluated how the WASH intervention impacted these factors. Participants were N = 84 women (37 ± 8 years old) randomized to WASH (n = 46) or standard of care plus (SOC+; n = 38) who completed demographic measures and a CA questionnaire at baseline, six months, and 12 months to quantify the importance placed on hygiene, partner pleasure, and health. The importance placed on health increased from baseline to six months (15.5 versus 25.1; p < 0.001) and from baseline to 12 months (15.5 versus 50.5; p < 0.001), and was higher in SOC+ at six months (19.9 versus 30.3; p = 0.003). Hygiene importance decreased from baseline (63.6) to six months (50.3), and from baseline to 12 months (26.1), and was higher in the experimental arm at six months (56.1) compared to SOC+ (44.6; p = 0.029). Importance placed on partner pleasure did not change over time in either group. Findings suggest that both groups exhibited an increase in the importance placed on health and a decrease on hygiene importance for IVP engagement, suggesting that SOC+ may be sufficient to promote attitude changes that may facilitate IVP discontinuation and may prove to be more cost effective by using fewer monetary resources. Findings highlight the potential of interventions to influence attitudes toward IVPs and provide novel avenues for research to improve the design and conduct of interventions aimed at reducing IVPs among Zambian women and contribute to HIV prevention efforts.
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Ndimurwimo, Leah A., and Molya Vundamina. "The Protection of Refugee Children in Africa: Post-Convention on The Rights of The Child." Fundamina 2021, no. 1 (2021): 33–66. http://dx.doi.org/10.47348/fund/v27/i1a2.
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The plight of refugees is currently one of the concerning global human rights issues. The refugee population is largely comprised of women and children who become displaced during armed conflicts; this is because the majority of persons killed or who become victims of forced disappearance are men. Forcibly displaced children face direct physical threats, as well as a variety of health-related problems. Although forcibly displaced children generally include those who are not refugees, this contribution is only concerned with refugee children. Refugee children are vulnerable to different types of abuse and exploitation, and often become the target of discrimination, sexual exploitation and social marginalisation in the refugee transit camps and countries of exile. Although the Convention on the Rights of Child, 1989 was adopted to protect children’s rights worldwide, the true impact of these provisions remains uncertain. This contribution examines the extent to which the adherence to the Convention on the Rights of the Child is promoted in Africa. This study compares the situation in South Africa, Tanzania and Zambia to pinpoint the legal and practical challenges that face refugee children in those countries. The contribution concludes with recommended solutions for effectively protecting and promoting refugee children’s rights in Africa.
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Agol, Dorice, Peter Harvey, and Javier Maíllo. "Sanitation and water supply in schools and girls' educational progression in Zambia." Journal of Water, Sanitation and Hygiene for Development 8, no. 1 (November 21, 2017): 53–61. http://dx.doi.org/10.2166/washdev.2017.032.
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Abstract There is much anecdotal evidence related to the importance of Water, Sanitation and Hygiene (WASH) in schools for girls' educational progression, yet a lack of comprehensive quantitative studies on linkages between WASH and educational indicators disaggregated by gender and grade. This paper aims to fill that gap by testing the hypothesis that the presence of water and sanitation facilities in schools can increase female-to-male enrolment ratios and reduce repetition and drop-out-ratios for girls, especially at ages when they menstruate. Quantitative analyses were undertaken of Education Management Information System (EMIS) data collected from over 10,000 schools in Zambia, to explore relationships between WASH facility provision in schools and enrolment, repetition and drop-out ratios disaggregated by gender and grade. Results indicated that improved sanitation provision in schools was correlated with high female-to-male enrolment ratios, and reduced repetition and drop-out ratios, especially for girls. A t-test revealed significant gender differences in grades 5–8 when many girls start to experience their menstrual cycle. Improved water supply in schools, however, did not reveal the same relationship. The findings confirm possible linkages between adequate toilets in schools and educational progression of girls.
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Morgan, Camille, Michael Bowling, Jamie Bartram, and Georgia Lyn Kayser. "Water, sanitation, and hygiene in schools: Status and implications of low coverage in Ethiopia, Kenya, Mozambique, Rwanda, Uganda, and Zambia." International Journal of Hygiene and Environmental Health 220, no. 6 (August 2017): 950–59. http://dx.doi.org/10.1016/j.ijheh.2017.03.015.
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Qadir, Syed Abdul, Shahzad Muhammad, Maria Ishaq Khattak, Zohaib Khan, Muslim Khan, and Zia Ul Haq. "Self-reported oral health status and associated factors among Afghan refugees in Peshawar Pakistan; a pilot study." Rehman Journal of Health Sciences 2, no. 2 (February 9, 2021): 40–45. http://dx.doi.org/10.52442/rjhs.v2i2.72.
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Introduction: Afghan refugees in Pakistan is the third largest refugee community in the world. However, till date, information about their oral health and disease burden is very limited. The current is aimed to assess self-reported oral health status, practices, dental care access and associated factors among Afghan refugees in district Peshawar, Pakistan. Material & Methods: This pilot, cross sectional study was conducted on 644 adult Afghan refugees residing in district Peshawar from June to September 2020. Socio-demographic characteristics and data on selfreported oral health status, oral hygiene habits and dental care access was collected using self-reported oral health questionnaire. Statistical tests were applied to determine association between self-reported oral health status and participants characteristics using SPSS. Results: Of all the respondents, majority (79.3%) were Pashtun by ethnicity and 41.6% did not obtain any formal education. Nearly all (97.2%) of them reported cleaning their teeth regularly, at least once a day with tooth brush and tooth paste being the commonest cleansing agents. More than half participants (58.1%) rated their oral health good/very good and 68.0% were satisfied with their dental appearance. Tooth ache and sensitivity were the most commonly reported oral problems. 28.7% of the participants never visited dentist in their life. Most of the participants (82.6%) felt need of dental care in the past one year but could not get it due to financial constraints. Significant association were found between self-rated oral health and age, marital status, country of birth, formal education and dentist visit (p < 0.05). Conclusion: Afghan refugees in Pakistan have poor self-reported oral health status. Access to dental care and oral health promotion and educations programs are crucial to improve oral health of this vulnerable population.
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Russpatrick, Scott, Amy Tiwari, Laurie Markle, Engervell Musonda, Anne Mutunda, Nicolas Osbert, John Pinfold, Anna Winters, Benjamin Winters, and David A. Larsen. "Mobility up the sanitation ladder following community-led total sanitation in rural Zambia." Journal of Water, Sanitation and Hygiene for Development 7, no. 3 (April 29, 2017): 436–44. http://dx.doi.org/10.2166/washdev.2017.111.
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Scaling the sanitation ladder decreases exposure to various illnesses including diarrheal disease, soil-transmitted helminths and trachoma. In rural Zambia, community-led total sanitation (CLTS) has been deployed to help Zambians scale the sanitation ladder. Analysis of monthly routine surveillance data of village-level sanitation coverage of 13,688 villages shows that villages moved up the sanitation ladder following CLTS intervention with more than one third of villages achieving 100% coverage of adequate sanitation. Villages also moved down the sanitation ladder – approximately half of those achieving 100% coverage of adequate sanitation also dropped from that coverage at some point during monitoring. Larger villages were less likely to achieve 100% coverage, and more likely to drop if they did achieve 100% coverage. Drops were more likely to occur during the wet season. Of those villages dropping from 100% coverage, more than half rebounded to 100% coverage. The adequate latrine components most likely to drop off from 100% coverage were handwashing stations and lids to cover holes, both key components in preventing disease transmission. These results have implications for water, sanitation and hygiene (WASH) programming – sustained support may be required to ensure villages move up the sanitation ladder and stay there.
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Smith Darr, Jordan, and David Bruce Conn. "Importation and Transmission of Parasitic and Other Infectious Diseases Associated with International Adoptees and Refugees Immigrating into the United States of America." BioMed Research International 2015 (2015): 1–7. http://dx.doi.org/10.1155/2015/763715.
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Each year, hundreds of millions of people travel across international borders or even oceans, and up to 230 million may remain for long periods. Among these, 3–5 million settle permanently in their new homes, with about 1 million migrating permanently to the United States of America. This may result in transport of parasites and other pathogens, which might become established, infecting individuals in the new location. Beyond concern of disease spread, the health of migrants is of concern since the rigors, circumstances, and living conditions surrounding migrations may increase the vulnerability of migrants to infections. International adoptees and refugees are a small subset of these migrants but are of special significance inasmuch as adoptees may be more vulnerable to infection due to their immature immune status, and refugees may be more vulnerable due to substandard living conditions. Both originate from diverse regions, but often from environments of low hygiene and health care standards. This review examines recent examples of infections reported from adoptees and refugees entering the USA through 2010, highlighting the most common origin countries and the diseases most frequently involved, including Chagas disease,Balamuthiaamebic meningoencephalitis, giardiasis, microsporidiosis, hepatitis, measles, pertussis, tuberculosis, malaria, intestinal helminths, and syphilis.
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Chikwanda, Musonda, Nosiku Munyinda, Consity Mwale, Prince Mbanefo, Tikulirekuti Chileshe Banda, and Patricia Mubita. "An association between water, sanitation, and hygiene (WASH) and prevalence of trachoma in Monze district of Southern Province, Zambia." Journal of Water, Sanitation and Hygiene for Development 11, no. 3 (March 31, 2021): 453–60. http://dx.doi.org/10.2166/washdev.2021.255.
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Abstract This study aims to determine the association between water, sanitation, and hygiene, and the prevalence of trachoma in Monze district, Zambia. The overall prevalence of trachoma among residents of Monze district is 2.0% disaggregated as 3.4% for 1–9 age group and 1.1% for ≥10 age group. The findings reveal an association between trachoma eye infection and drinking water source from protected well/spring, and piped water. After adjusting for other variables, there was an association of drinking water from a protected well/spring (AOR 8.343, CI 1.126–61.803), piped water (AOR 4.127, CI 1.088–15.648), and piped water for washing (AOR 0.172, 95% CI 0.031–0.944.439). The presence of a hand wash facility was very low at 2.9% while hand washing agents were even lower at 0.41%. The study concludes that children are at a higher risk of trachoma prevalence. Other WASH aspects, such as adequacy of water, might be more important than the presence of potable water. The prevalence of trachoma in Monze is WASH focused.
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Tidwell, James B., Jenala Chipungu, Roma Chilengi, and Robert Aunger. "Assessing peri-urban sanitation quality using a theoretically derived composite measure in Lusaka, Zambia." Journal of Water, Sanitation and Hygiene for Development 8, no. 4 (July 27, 2018): 668–78. http://dx.doi.org/10.2166/washdev.2018.029.
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Abstract Despite ongoing debates about what constitutes adequate sanitation, there is a lack of sanitation quality measures that are theoretically grounded in ways that allow empirical comparisons of quality across different types of sanitation. The Healthy Sanitation Framework (HSF) was developed to capture universal aspects of sanitation quality from a public health perspective. From this, the Peri-Urban Healthy Toilet Index (PUHTI) was created for measuring on-site, peri-urban sanitation quality. This PUHTI score was used to assess sanitation quality in a peri-urban area in Lusaka, Zambia. The HSF identified five categories for capturing sanitation quality: hygiene, use, sustainability, desirability, and accessibility. A composite index derived from these categories had high reliability and plausible validity, despite barriers to rigorously evaluating validity. Applying the PUHTI tool showed that while 87% of toilets were classified as ‘improved, but shared,’ there were frequent concerns about doors that could not be locked, dirty user interfaces, unhygienic containment, limited emptyability, and lack of handwashing facilities. The HSF allows granular measures of sanitation quality to be developed in any setting using a reproducible and theoretically grounded process. However, lack of a unified basis on which to compare different types of sanitation overall or evidence to compare within narrower categories currently limits comparisons across types of sanitation.
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Bwire, Godfrey, Christopher Garimoi Orach, Freda Loy Aceng, Sam Emmanuel Arianitwe, David Matseketse, Edson Tumusherure, Issa Makumbi, et al. "Refugee Settlements and Cholera Risks in Uganda, 2016–2019." American Journal of Tropical Medicine and Hygiene 104, no. 4 (April 7, 2021): 1225–31. http://dx.doi.org/10.4269/ajtmh.20-0741.
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ABSTRACTDuring 2016 to 2019, cholera outbreaks were reported commonly to the Ministry of Health from refugee settlements. To further understand the risks cholera posed to refugees, a review of surveillance data on cholera in Uganda for the period 2016–2019 was carried out. During this 4-year period, there were seven such outbreaks with 1,495 cases and 30 deaths in five refugee settlements and one refugee reception center. Most deaths occurred early in the outbreak, often in the settlements or before arrival at a treatment center rather than after arrival at a treatment center. During the different years, these outbreaks occurred during different times of the year but simultaneously in settlements that were geographically separated and affected all ages and genders. Some outbreaks spread to the local populations within Uganda. Cholera control prevention measures are currently being implemented; however, additional measures are needed to reduce the risk of cholera among refugees including oral cholera vaccination and a water, sanitation and hygiene package during the refugee registration process. A standardized protocol is needed to quickly conduct case–control studies to generate information to guide future cholera outbreak prevention in refugees and the host population.
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Guo, Amy, Georgia Kayser, Jamie Bartram, and J. Michael Bowling. "Water, Sanitation, and Hygiene in Rural Health-Care Facilities: A Cross-Sectional Study in Ethiopia, Kenya, Mozambique, Rwanda, Uganda, and Zambia." American Journal of Tropical Medicine and Hygiene 97, no. 4 (October 11, 2017): 1033–42. http://dx.doi.org/10.4269/ajtmh.17-0208.
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Kuehne, Anna, Elburg van Boetzelaer, Prince Alfani, Adolphe Fotso, Hitham Elhammali, Tom Khamala, Trygve Thorson, et al. "Health of migrants, refugees and asylum seekers in detention in Tripoli, Libya, 2018-2019: Retrospective analysis of routine medical programme data." PLOS ONE 16, no. 6 (June 4, 2021): e0252460. http://dx.doi.org/10.1371/journal.pone.0252460.
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Libya is a major transit and destination country for international migration. UN agencies estimates 571,464 migrants, refugees and asylum seekers in Libya in 2021; among these, 3,934 people are held in detention. We aimed to describe morbidities and water, hygiene, and sanitation (WHS) conditions in detention in Tripoli, Libya. We conducted a retrospective analysis of data collected between July 2018 and December 2019, as part of routine monitoring within an Médecins Sans Frontières (MSF) project providing healthcare and WHS support for migrants, refugees and asylum seekers in some of the official detention centres (DC) in Tripoli. MSF had access to 1,630 detainees in eight different DCs on average per month. Only one DC was accessible to MSF every single month. The size of wall openings permitting cell ventilation failed to meet minimum standards in all DCs. Minimum standards for floor space, availability of water, toilets and showers were frequently not met. The most frequent diseases were acute respiratory tract infections (26.9%; 6,775/25,135), musculoskeletal diseases (24.1%; 6,058/25,135), skin diseases (14.1%; 3,538/25,135) and heartburn and reflux (10.0%; 2,502/25,135). Additionally, MSF recorded 190 cases of violence-induced wounds and 55 cases of sexual and gender-based violence. During an exhaustive nutrition screening in one DC, linear regression showed a reduction in mid-upper arm circumference (MUAC) of 2.5mm per month in detention (95%-CI 1.3–3.7, p<0.001). Detention of men, women and children continues to take place in Tripoli. Living conditions failed to meet minimum requirements. Health problems diagnosed at MSF consultations reflect the living conditions and consist largely of diseases related to overcrowding, lack of water and ventilation, and poor diet. Furthermore, every month that people stay in detention increases their risk of malnutrition. The documented living conditions and health problems call for an end of detention and better protection of migrants, refugees and asylum seekers in Libya.
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Baijayanti Ghosh. "Gandhian philosophy of health and hygeine in an era of pandemic." International Journal on Integrated Education 3, no. 8 (August 5, 2020): 1–5. http://dx.doi.org/10.31149/ijie.v3i8.518.
Full textAbstract:
Challenges faced by the world today aren’t limited to a single sphere. Multiple avenues pose threats like never before; global warming with melting of arctic ice, raging fires in Amazon and Australia, humanitarian crisis of refugees, civil war in Libya and other parts of the world pose threats to the very Human existence. The very ecology is threatened on multiple frontiers due to these challenges. None the less, associated with this Health crisis of humongous proportions is causing catastrophe in various ways. As the world advances and countries strive to keep pace with development, the cut throat competition has worsened the health crisis more than ever. Imbalances brought by humans are no longer sustained by Mother Nature. As the environment changes rapidly Nature is unleashing its fury on us, and what could be truer in today’s world gripped by a Pandemic that’s unleashing its wrath. Looking back, we will see Gandhiji’s simplicity in laying down models for health and hygiene are more realistic and true than ever. As we move forward in post pandemic era, Gandhiji’s simple measures almost a century old, holds more value than ever before
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Mahamud, Abdirahman Sheikh, Jamal A. Ahmed, Raymond Nyoka, Erick Auko, Vincet Kahi, James Ndirangu, Margaret Nguhi, et al. "Epidemic cholera in Kakuma Refugee Camp, Kenya, 2009: the importance of sanitation and soap." Journal of Infection in Developing Countries 6, no. 03 (November 30, 2011): 234–41. http://dx.doi.org/10.3855/jidc.1966.
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Introduction: Cholera remains a major public health problem that causes substantial morbidity and mortality in displaced populations due to inadequate or unprotected water supplies, poor sanitation and hygiene, overcrowding, and limited resources. A cholera outbreak with 224 cases and four deaths occurred in Kakuma Refugee Camp in Kenya from September to December 2009. Methodology: We conducted a case-control study to characterize the epidemiology of the outbreak. Cases were identified by reviewing the hospital registry for patients meeting the World Health Organization (WHO) case definition for cholera. For each case a matched control was selected. A questionnaire focusing on potential risk factors was administered to cases and controls. Results: From 18 September to 15 December 2009, a total of 224 cases were identified and were hospitalised at Kakuma IRC hospital. Three refugees and one Kenyan national died of cholera. V. cholerae O1, serotype Inaba was isolated in 44 (42%) out of 104 stool specimens collected. A total of 93 cases and 93 matched controls were enrolled in the study. In a multivariate model, washing hands with soap was protective against cholera (adjusted odds ratio [AOR] =0.25[0.09-0.71]; p < 0.01), while presence of dirty water storage containers was a risk factor (AOR=4.39[1.12-17.14]; p=0.03). Conclusion: Provision of soap, along with education on hand hygiene and cleaning water storage containers, may be an affordable intervention to prevent cholera.
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Chiluba, Brian Chanda, and Hastings Shula. "Zambia: Editorial Comment -COVID-19 -Epidemiological Thought on Why Politics and Religion are Compromising the Fight." Journal of Preventive and Rehabilitative Medicine 2, no. 1 (November 24, 2020): 1–4. http://dx.doi.org/10.21617/jprm2020.211.
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One of the good tenets of epidemiology is the fact that it offers skeptical disposition. Institutionalized skepticism is important in science and policymaking.In the case of Zambia,skepticism questions why the proponents of COVID-19guidelines and prescriptions have become the ardent violators of the guidelines they espouse. Such practices among political leaders is paralyzing, especially in contexts of information and messages from WHO at this critical juncture that call for pragmatism-especially with the peak of a pandemic curve and surging infection rate, considering that we do not have additional alternative interventions apart from adhering to non-pharmaceutical interventions such as social distancing, staying at home, wearing masks and hand hygiene. Deliberate and unnecessary political and religious gatherings inaction carries the risk of dire consequences, some of which have already led to suspected COVID-19 deaths of members of parliament and hospitalization of a size able number of political leaders.Despite all these the proceedings of parliament remained active as though COVID-19 is history.Such reckless political gatherings question the governance ethos of public health epidemiology instituted by the same people violating them. Religious leaders are not immune to this vice-a number of COVID-19-related deaths have passed through churches with body viewings being conducted. It should be mentioned that such behaviors have led to preventing action against COVID-19 outrunning evidence, or at least helping evidence to catch up.A myopic continued action of ignoring COVID-19 guidelines by politicians and religious leaders isa disservice to epidemiology.
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Cronin, A. A., D. Shrestha, N. Cornier, F. Abdalla, N. Ezard, and C. Aramburu. "A review of water and sanitation provision in refugee camps in association with selected health and nutrition indicators – the need for integrated service provision." Journal of Water and Health 6, no. 1 (November 1, 2007): 1–13. http://dx.doi.org/10.2166/wh.2007.019.
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The first global overview of basic water and sanitation indicators in refugee camps is presented (using data from 2003–2006) and compared with selected health and nutrition indicators. This demonstrates that average levels of water and sanitation provision are acceptable at camp level but many refugee operations are suffering from gaps that cross-cut these sectors; e.g. typically poor sanitation provision is corresponding with low per capita availability of water. These findings were confirmed at household level with two household surveys undertaken in African refugee camps; households reporting a case of diarrhoea within the previous 24 hours collect on average 26% less water than those not reporting any cases. In addition, typically higher levels of morbidity of one infectious agent are also reflected across other infectious agents; this is reinforced by comparing the relationship between morbidity and nutrition status from selected camps. The importance that hygiene, environmental conditions and local settings have on health (both of refugees and also local communities) is underlined. Interventions to improve indicators across the water, sanitation, health and nutrition sectors rely not only on increased and sustained resources but must entail an integrated approach to simultaneously tackle short-comings across all these vital sectors.
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Kabali, T. M., and E. G. Mumghamba. "Knowledge of Periodontal Diseases, Oral Hygiene Practices, and Self-Reported Periodontal Problems among Pregnant Women and Postnatal Mothers Attending Reproductive and Child Health Clinics in Rural Zambia." International Journal of Dentistry 2018 (August 7, 2018): 1–9. http://dx.doi.org/10.1155/2018/9782092.
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Aim. To determine the level of knowledge of periodontal diseases, practices regarding oral hygiene, and self-perceived periodontal problems among pregnant and postnatal women attending reproductive and child health clinics in rural districts of Zambia. Methodology. This was a quantitative, questionnaire-based, descriptive, and cross-sectional study that recruited 410 women aged 15 to 43 years. Data were analyzed using SPSS v19.0 computer program. Results. Participants knowledgeable of periodontal diseases were 62%; gingivitis signs included gum swelling (87.4%) and bleeding (93.3%). Of all participants, 95.6% practiced tooth brushing: twice/day (38.5%), using plastic toothbrush (95.6%), chewing stick (12.2%), toothpick (10.7%), dental floss (2.0%), and tongue cleaning (55.4%). Self-reported periodontal problems were bleeding gums (23.2%), gums that were reddish (10.5%), swollen (11.0%), painful (15.9%), and mobile teeth (3.4%). In logistic regression analysis, painful gums, reddish gums, and toothpick use were 21.9, 4.7, and 4.3 respectively, significantly more likely to cause gum bleeding on tooth brushing. Conclusions. Most studied women had general knowledge of periodontal diseases but only few knew the cause. All participants performed tooth cleaning; however, majority did not know appropriate practices, and only few had periodontal problems. Integration of oral health to general health promotion and periodontal therapy to pregnant women at high risk is recommended.
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Milanovic, Jasmina, and Jelena Jovanovic-Simic. "Female physicians and physicians’ wives - members of the Women’s Society (1875-1915)." Srpski arhiv za celokupno lekarstvo 148, no. 9-10 (2020): 648–54. http://dx.doi.org/10.2298/sarh191106078m.
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Prior to the Herzegovina Uprising (1875) and the First Serbian? Turkish War (1876?1877), two associations were established in Serbia with humane work goals that provided great assistance to the health service throughout the war conflicts in which the Serbian people participated. The first of these was the Women?s Society, established in May 1875, and the second one was the Serbian Red Cross Society, established in February 1876. Shortly before the wars, they organized training courses for voluntary paramedics and nurses, during the wars they established reserve hospitals, collected money, medical supplies, and clothing for the wounded and the refugees. In peacetime, among other activities, they worked to raise public awareness of the importance of hygiene and proper nutrition. Female physicians and physicians? wives were particularly active in the Women?s Society, and were followed by women around them. The work of the female members of the Women?s Society was especially invaluable in the subcommittees, as they worked together with their husbands to promote health education in culturally primitive rural areas.
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Memory Rumbidzai V. Mandikiana, Yogesh Awasthi, and Isaac Ignatius Dambudzo. "COVID- 19 and its Effects on Refugee, Asylum Seeker and Migrant Children Aged 12-17 Years at Tongogara Refugee Camp in Zimbabwe." PanAfrican Journal of Governance and Development (PJGD) 2, no. 2 (August 30, 2021): 170–205. http://dx.doi.org/10.46404/panjogov.v2i2.3235.
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Refugee, asylum seekers, and migrant (displaced) children are at protracted vulnerability levels, and COVID-19 has exacerbated the situation. Zimbabwe accepts refugees but enforces an encampment policy, and displaced populations are encamped at Tongogara Refugee Camp (TRC). The research gap is that there is very little literature on refugees in Zimbabwe. The research objectives for the study were to explore the challenges that refugees, asylum seekers, and displaced children at TRC face, ascertain how COVID-19 has affected children at TRC, and propose solutions to these challenges. This research relied upon a mixed method of quantitative and qualitative approach considering the immediacy of the COVID-19 pandemic. Secondary data is referred from published articles and organizational reports. The population size of 2,304 children aged 12 to 17 was obtained through the United Nations refugee agency (UNHCR)’s January 2021 population statistics for TRC. A 10% sample of 230 respondents was selected. Non-probability sampling techniques were used in administering a questionnaire through individual and focus group interviews, which were fed into KoBo Toolbox. Data cleaning and analysis were conducted, with SPSS and NViVo for quantitative and qualitative data analysis, respectively. Ethical considerations of consent, confidentiality, do no harm, and statements to withdraw from the study were employed. The process involved strict observance of World Health Organization (WHO) guidelines on COVID-19. The research was conducted between April 2020 and February 2021. Results showed that displaced children suffered a spectrum of challenges before COVID-19. During the COVID-19 period, respondents had limited access to child protection services, experienced increased conflicts at home, and limited access to formal learning and entertainment: their already dire situation was exacerbated by COVID-19. The study recommends the upgrade of the local secondary school to advanced level status, adoption of educational innovations in lieu of the COVID-19 pandemic, including radio, television, and virtual learning platforms; improved child protection mechanisms; accommodation; dietary diversity; access to water and sanitation hygiene; provision of electricity; adequate street lighting; activities for entertainment; and increasing awareness against child abuse and gender-based violence (GBV).
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Gueron, Laura Janet Pizer, Arobogust Amoyi, Winnie Chao, Justine Chepngetich, Jepkemoi Joanne Kibet, Stephen Nyambok, and Joseph Wesonga. "Group physiotherapy with survivors of torture in urban and camp settings in Jordan and Kenya." Torture Journal 30, no. 3 (February 10, 2021): 27–42. http://dx.doi.org/10.7146/torture.v30i3.121785.
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Introduction: In this paper we report provisional field results on the impact of CVT’s (the Center for Victims of Torture) interdisciplinary group treatment on physiotherapy indicators in refugees living in urban and camp settings in Kenya and Jordan. The physiotherapy component of this model includes pain neuroscience education, sleep hygiene, posture and body mechanics instruction and healing of pain and trauma from a biopsychosocial perspective, in a program of ten weekly sessions. This program is supported by a clinical assessment that records a broad set of indicators of participant experience and functioning. In addition, some survivors report having pelvic floor dysfunction and data will be offered about a subset of survivors looking at prevalence of these issues.
Methods: Survivors are identified through referral systems, community education and sensitization campaigns, contacts and trainings with other NGOs and health care providers. Prospective survivors are screened into CVT services or referred to other agencies that can better meet their needs. CVT focuses its services on refugees with physical and emotional difficulties that may be effectively treated through its interdisciplinary treatment model and who have survived torture or related human rights violations. Following an informed consent process, survivors participate in a comprehensive individual assessment and then progress to the 10-week program. Wherever possible, follow-up assessments are conducted 2 weeks after the sessions end, and at 3, and 9 months following completion of the 10-week long intervention.
Results: On average, participants who completed 3-month follow-up assessments showed statistically and clinically significant improvements on physiotherapy indicators.
Discussion: Provisional results are encouraging and suggest that the model is adaptable to the needs of different populations and settings. As nearly all participants receive both counseling and physiotherapy, it is difficult to know which benefits can be attributed to physiotherapy alone.
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Mahmood, Iftikher, Nrinmoy Biswas, Fahmida Akter, Johanna Hansing, Arman Mahmood, Ashley Pugh, Jessica Love, and Steven Arrowsmith. "Burden of Obstetric Fistula on the Rohingya Community in Cox's Bazar, Bangladesh." Nepal Journal of Obstetrics and Gynaecology 13, no. 2 (November 18, 2018): 47–51. http://dx.doi.org/10.3126/njog.v13i2.21715.
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Since August 2017, a massive influx of over 800,000 Rohingya refugees have arrived in Cox’s Bazar, Bangladesh. The Rohingya state is one the poorest states in Myanmar, with ghetto-like camps and a lack of basic services and opportunities. In 1982, a new citizenship law was passed, effectively rendering the Rohingya stateless. As a result of this law, their rights to access health services have been restricted.
Now, many Rohingya are living in Cox’s Bazar in tent-based refugee camps under extremely poor conditions without access to proper medical care, hygiene, sanitation, food or education. Lack of proper maternal health care, together with early marriage, malnutrition, poverty and the physical characteristics of the women in this community (small body shapes), exposes Rohingya women to a very dangerous position with high chances of developing obstetric fistula during childbirth.
HOPE Hospital provides clinical care for women affected with obstetric fistula and is the only provider and referral center of fistula care in the region. Since the influx began, many fistula repairs have been carried out on Rohingya women at HOPE Hospital. This paper looks at fistula care and the psychosocial impact of fistula on victims in the refugee population, amid a massive humanitarian crisis.
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Phiri, Timothy Kamuzu. "Relevance of Education for Sustainable Development to Zambian High School Geography: A Survey of High Schools in Lusaka City." Journal of Law and Social Sciences 1, no. 1 (March 31, 2012): 67–85. http://dx.doi.org/10.53974/unza.jlss.1.1.369.
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Geography is one of the subjects offered in all high schools in Zambia. At the time this
study was conducted in the year 2010, five years after the declaration of the Decade
of Education for Sustainable Development (ESD) (2005-2014), ESD had not yet been
incorporated at high school level. The study hence sought to determine the aspects
of Geography that were compatible with ESD to ascertain the attitude of high school
pupils towards Geography and determine ways in which the Geography syllabus
could be improved vis-à-vis the need for pupils to be empowered to thrive in their
local environments. A descriptive survey research design was used and information
was gathered through group discussions (for the pupils) and questionnaires (for the
pupils and Geography Heads of Section). The study found that ESD could make a
contribution to Geography in the areas of field projects, personal hygiene and health,
sexual education, intergenerational transmission of knowledge, use of indigenous
knowledge and localisation of the Geography syllabus. The study found that though
pupils were interested in Geography as reflected by their general good performance in
examinations, nonetheless negative attitudes existed towards Geography because of
its detachment from pupils’ personal environments, excessive use of teacher-centred
methods and the bulky nature of the Geography syllabus.
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Zalashik, Rakefet, and Nadav Davidovitch. "Measuring Adaptability: Psychological Examinations of Jewish Detainees in Cyprus Internment Camps." Science in Context 19, no. 3 (September 2006): 419–41. http://dx.doi.org/10.1017/s0269889706001001.
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ArgumentTwo medical delegations, one from Palestine and one from the United States, were sent to detainment camps in Cyprus in the summer of 1947. The British Mandatory government had set up these camps in the summer of 1946 to stem the flow of Jewish immigrants into Palestine after World War II. The purpose of the medical delegations was to screen the camps' inhabitants and to propose a mental-health program for their life in Palestine. We examine the activities of these two delegations within the context of their scientific interest in the psycho-pathology of displaced persons after World War II and as part of a broader project of mental hygiene. According to the delegations, the detainees would be a potential source of strength for building a new society if they adapted to life in Palestine. However, they would become a burden if they failed to be absorbed. At the same time, the medical delegations also saw the detainee camps as a potential “living laboratory” for scientific exploration. The case of the two medical delegations in Cyprus is also a story about constructing and transgressing medical borders. Apart from the obvious fact that this case study deals with movement of people, refugees as well as health-care workers, it is also about the transmission of knowledge and professions across the ocean.
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Rakotomanana, Hasina, Joel J. Komakech, Christine N. Walters, and Barbara J. Stoecker. "The WHO and UNICEF Joint Monitoring Programme (JMP) Indicators for Water Supply, Sanitation and Hygiene and Their Association with Linear Growth in Children 6 to 23 Months in East Africa." International Journal of Environmental Research and Public Health 17, no. 17 (August 28, 2020): 6262. http://dx.doi.org/10.3390/ijerph17176262.
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The slow decrease in child stunting rates in East Africa warrants further research to identify the influence of contributing factors such as water, sanitation, and hygiene (WASH). This study investigated the association between child length and WASH conditions using the recently revised WHO and UNICEF (United Nations Children’s Fund) Joint Monitoring Programme (JMP) indicators. Data from households with infants and young children aged 6–23 months from the Demographic and Health Surveys in Burundi, Ethiopia, Kenya, Malawi, Rwanda, Tanzania, Uganda, and Zambia were used. Associations for each country between WASH conditions and length-for-age z-scores (LAZ) were analyzed using linear regression. Stunting rates were high (>20%) reaching 45% in Burundi. At the time of the most recent Demographic and Health Survey (DHS), more than half of the households in most countries did not have basic or safely managed WASH indicators. Models predicted significantly higher LAZ for children living in households with safely managed drinking water compared to those living in households drinking from surface water in Kenya (β = 0.13, p < 0.01) and Tanzania (β = 0.08, p < 0.05) after adjustment with child, maternal, and household covariates. Children living in households with improved sanitation facilities not shared with other households were also taller than children living in households practicing open defecation in Ethiopia (β = 0.07, p < 0.01) and Tanzania (β = 0.08, p < 0.01) in the adjusted models. All countries need improved WASH conditions to reduce pathogen and helminth contamination. Targeting adherence to the highest JMP indicators would support efforts to reduce child stunting in East Africa.
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Boigues Corbalan Tebar, Wellington, and Edinilson Donisete Machado. "OS MIGRANTES E REFUGIADOS, OS IMPACTOS DA COVID-19: RESPOSTA, POR MEIO DE PLANOS E DADOS." Colloquium Socialis 4, no. 4 (February 18, 2021): 148–62. http://dx.doi.org/10.5747/cs.2020.v4.n4.s118.
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This paper aimed to analyze, in general, the situation of migrants and refugees in the face of the adversities generated by the pandemic of COVID-19. During this period, the vulnerability of these groups of people was noted, either by the exclusionary behaviors of the society in which they are inserted, or by the measures taken by the governments to contain the impacts of the disease, as well as mitigation of its effects. To this end, data were presented, referring to the main impacts generated by the health crisis, as well as recommendations for National States to develop adequate response plans. It was found that the situation in the refugee camps is also worrying. The confinement of several people, in the same place, whose number often exceeds the occupation capacity, added to the precarious conditions of health, hygiene and basic sanitation, facilitates the spread of the virus, becoming easy targets of the disease. That is why it was concluded that, as the situation of vulnerability worsens, due to the evolution of the pandemic, so much more effective must be the responses to be given by national governments to guarantee human rights to this group of people. The research took, as a reference, official documents prepared by international organizations (global and regional level) for the protection of human rights. And the exploratory-descriptive method was used, with a qualitative approach, as official documents were analyzed, prepared by international organizations (at global and regional level) for the protection of human rights.
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Kay, Ariel, Eva Leidman, Velma Lopez, Caroline Wilkinson, Melody Tondeur, and Oleg Bilukha. "The burden of anaemia among displaced women and children in refugee settings worldwide, 2013–2016." BMJ Global Health 4, no. 6 (November 2019): e001837. http://dx.doi.org/10.1136/bmjgh-2019-001837.
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IntroductionDisplaced persons have a unique risk for developing anaemia due to often limited diets, overcrowding, new infections and inadequate sanitation and hygiene. The lack of anaemia prevalence estimates among the displaced inhibit global planning for anaemia reduction.MethodsWe analysed population representative, cross-sectional nutrition surveys from 2013 to 2016 conducted by the United Nations High Commissioner for Refugees and partner agencies. Included surveys measured haemoglobin concentration among children 6–59 months, non-pregnant women 15–49 years, or both groups. For each survey, we calculated mean haemoglobin and prevalence of total anaemia (<110 g/L in children, <120 g/L in women), and classified public health severity following WHO guidelines. Pearson correlations between indicators from women and children surveys were calculated where both subpopulations were measured.ResultsAnalysis included 196 surveys among children and 184 surveys among women from 121 unique refugee settings in 24 countries. The median prevalence of total anaemia in children and women was 44% and 28%, respectively. Sixty-one per cent of child surveys indicated a problem of severe public health importance compared with 25% of surveys in women. The prevalence of total anaemia in children and women was strongly correlated (ρ=0.80). Median prevalence of total anaemia was approximately 55% greater and mean haemoglobin was 6 g/L lower among children age 6–23 months compared with children 24–59 months. West and Central Africa region had the highest median prevalence of anaemia both in women and children.ConclusionWhile the burden of anaemia is high among the displaced, it mirrors that of the general population. Haemoglobin should continue to be measured in nutrition surveys in refugee settings. Sustained, multisectoral efforts to reduce anaemia are needed, with specific focus on children under 2 years of age and refugee settings in the West and Central Africa region.
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Messenger, Louisa Alexandra, Joanna Furnival-Adams, Bethanie Pelloquin, and Mark Rowland. "Vector control for malaria prevention during humanitarian emergencies: protocol for a systematic review and meta-analysis." BMJ Open 11, no. 7 (July 2021): e046325. http://dx.doi.org/10.1136/bmjopen-2020-046325.
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IntroductionHumanitarian emergencies, of either natural or anthropogenic origins, are equivalent to major disasters, which can lead to population displacement, food insecurity and health system disruptions. Almost two-thirds of people affected by humanitarian emergencies inhabit malaria endemic regions, particularly the WHO African Region, which currently accounts for 93% and 94% of malaria cases and deaths, respectively. As of late 2020, the United Nations Refugee Agency estimates that there are globally 79.5 million forcibly displaced people, including 45.7 million internally displaced people, 26 million refugees, 4.2 million asylum-seekers and 3.6 million Venezuelans displaced abroad.Methods and analysesA systematic review and meta-analysis will be conducted to evaluate the impact of different vector control interventions on malaria disease burden during humanitarian emergencies. Published and grey literatures will be systematically retrieved from 10 electronic databases and 3 clinical trials registries. A systematic approach to screening, reviewing and data extraction will be applied based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Two review authors will independently assess full-text copies of potentially relevant articles based on inclusion criteria. Included studies will be assessed for risk of bias according to Cochrane and certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Eligible studies with reported or measurable risk ratios or ORs with 95% CIs will be included in a meta-analysis. Subgroup analyses, including per study design, emergency phase and primary mode of intervention, may be performed if substantial heterogeneity is encountered.Ethics and disseminationEthical approval is not required by the London School of Hygiene and Tropical Medicine to perform secondary analyses of existing anonymous data. Study findings will be disseminated via open-access publications in peer-reviewed journals, presentations to stakeholders and international policy makers, and will contribute to the latest WHO guidelines for malaria control during humanitarian emergencies.PROSPERO registration numberCRD42020214961.
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Mwanamwambwa, Victor, and Basil Joseph Pillay. "Posttraumatic stress disorder and psychological distress in Rwandan refugees living in Zambia." South African Journal of Psychology, July 12, 2021, 008124632110318. http://dx.doi.org/10.1177/00812463211031812.
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The present study investigated posttraumatic stress disorder and psychological distress among Rwandan refugees living in the townships of Lusaka, Zambia. Refugees are often exposed to trauma and violence which leads to a wide range of psychological distress and mental disorders. Two hundred and sixty-seven refugees participated in the study. The sample consisted of older and younger adult refugees, 128 (47.9%) males and 139 (52.1%) females, from Lusaka. The Impact of Event Scale–Revised and the General Health Questionnaire-28 were administered to all participants. The study found that a significant number of participants reported posttraumatic stress disorder and psychological distress. About 76.8% endorsed posttraumatic stress disorder symptoms. In addition, 31.8% reported somatic symptoms, 36.7% anxiety or insomnia, 27.3% social dysfunction, and 22.8% severe depression. Lower education ( p < .01), larger family size ( p < .001), lack of financial support ( p < .05), and being unemployed ( p < .001) were positively associated with posttraumatic stress disorder and psychological distress. Intervention strategies aimed at improving the lives of refugees should be ongoing and must encompass a well-articulated, structured refugee policy that emphasizes mental health and psychological needs.
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Josephin, Shary, Selestine Nzala, and Kumar S. Baboo. "Evaluation of oral hygiene services in selected public health facilities in Lusaka district of Zambia." Journal of Public Health in Africa, October 1, 2018. http://dx.doi.org/10.4081/jphia.2018.820.
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Around the globe many people are suffering from oral pain and other problems of the mouth or teeth. This public health problem is growing rapidly in developing countries where oral health services are limited. This study was conducted in the public health centers and first level hospitals with dental units (DUs) in Lusaka district. Adequacy of dental equipment, instruments and materials required for scaling and polishing (S&P) and oral hygiene instructions (OHI) was evaluated. Challenges faced by the dental therapists (DTs) in the entire DUs were also evaluated. This was a mixed method study; quantitative data was collected using a structured questionnaire which contained a standard facility assessment check list. Qualitative data was collected by conducting in-depth interviews. The study results showed that the oral hygiene services offered by the selected DUs in Lusaka district were inadequate. A fully functional dental chair was available only in fifty percent of the DUs, only twenty percent of the facilities had fully functional ultrasonic scaling unit, none of the facilities had all the instruments for polishing. The DTs work under stressful conditions as sixty percent of the facilities were understaffed; the supply of dental instruments and materials was poor; delay in repairing faulty equipment; risk of exposure to air borne infections as most of the facilities have space and ventilation problems. Recommendations of this study point towards an urgent need to improve and coordinate the oral health care system.
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Chatila, Hani, Christian Fischer, Godfred Amankwaa, and Troy Sternberg. "From emergency to durable water, sanitation and hygiene (WASH) interventions: insights from the protracted Syrian refugee situation in Lebanon." Journal of Water, Sanitation and Hygiene for Development, July 7, 2021. http://dx.doi.org/10.2166/washdev.2021.242.
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Abstract Emergency water, sanitation and hygiene (WASH) programming often fails to meet defined humanitarian or sectoral standards and the needs of those affected by crises. There have been calls to shift toward more resilient, durable and sustainable WASH interventions. Drawing on a mix of qualitative methods, this paper traces the nature and evolution of the factors affecting different kinds of WASH interventions in Lebanon. Factors contributing to a slow uptake of durable WASH solutions include Lebanon not being a signatory of the 1951 Refugee Convention, a ‘no camp’ policy adopted by the Government of Lebanon, aid agencies under pressure to cater for lifesaving WASH needs of the Syrian refugees, a lack of sufficient funds, Syrian refugee migration to Europe in 2014, limited Syrian refugee resettlement options, terrorism at the Lebanese border in 2014, as well as fears of nationalization of Syrian refugees – rooted in experiences from the Palestinian refugees in Lebanon. The paper demonstrates that the overall WASH response to Syrian refugees in Lebanon mirrors the interplay between aid agencies, the donor community and the Government of Lebanon. We argue that the Lebanese Government should have acted much earlier and devised a strategy flexible enough to turn a challenge into an opportunity by advocating for funds that allow for durable solutions and sustainable impact on the lives of the Syrian refugees and Lebanese hosting communities. We conclude by highlighting policy and practical lessons for refugee-hosting countries and donor agencies. HIGHLIGHT Aid policy, humanitarian–development nexus, protracted refugee situations, durable WASH interventions.
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Nyambe, Sikopo, and Taro Yamauchi. "Peri-urban water, sanitation and hygiene in Lusaka, Zambia: photovoice empowering local assessment via ecological theory." Global Health Promotion, March 6, 2021, 175797592199571. http://dx.doi.org/10.1177/1757975921995713.
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Water, sanitation and hygiene (WASH) factors are responsible for 11.4% of deaths in Zambia, making WASH a key public health concern. Despite annual waterborne disease outbreaks in the nation’s peri-urban (slum) settlements being linked to poor WASH, few studies have proactively analysed and conceptualised peri-urban WASH and its maintaining factors. Our study aimed to (a) establish residents’ definition of peri-urban WASH and their WASH priorities; and (b) use ecological theory to analyse the peri-urban WASH ecosystem, highlighting maintaining factors. Our study incorporated 16 young people (aged 17–24) residing in peri-urban Lusaka, Zambia in a photovoice exercise. Participants took photographs answering the framing question, ‘What is WASH in your community?’ Then, through contextualisation and basic codifying, participants told the stories of their photographs and made posters to summarise problems and WASH priorities. Participant contextualisation and codifying further underwent theoretical thematic analysis to pinpoint causal factors alongside key players, dissecting the peri-urban WASH ecosystem via the five-tier ecological theory ranging from intrapersonal to public policy levels. Via ecological theory, peri-urban WASH was defined as: (a) poor practice (intrapersonal, interpersonal); (b) a health hazard (community norm); (c) substandard and unregulated (public policy, organisational); and (d) offering hope for change (intrapersonal, interpersonal). Linked to these themes, participant findings revealed a community level gap, with public policy level standards, regulations and implementation having minimal impact on overall peri-urban WASH and public health due to shallow community engagement and poor acknowledgement of the WASH realities of high-density locations. Rather than a top-down approach, participants recommended increased government–resident collaboration, offering residents more ownership and empowerment for intervention, implementation and defending of preferred peri-urban WASH standards.
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Gona, Philimon N., Clara M. Gona, Vasco Chikwasha, Clara Haruzivishe, Sowmya R. Rao, and Chabila C. Mapoma. "Oral rehydration solution coverage in under 5 children with diarrhea: a tri-country, subnational, cross-sectional comparative analysis of two demographic health surveys cycles." BMC Public Health 20, no. 1 (November 16, 2020). http://dx.doi.org/10.1186/s12889-020-09811-1.
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Abstract Background More than 3 million children under 5 years in developing countries die from dehydration due to diarrhea, a preventable and treatable disease. We conducted a comparative analysis of two Demographic Health Survey (DHS) cycles to examine changes in ORS coverage in Zimbabwe, Zambia and Malawi. These surveys are cross-sectional conducted on a representative sample of the non-institutionalized individuals. Methods The sample is drawn using a stratified two-stage cluster sampling design with census enumeration areas, typically, selected first as primary sampling units (PSUs) and then a fixed number of households from each PSU. We examined national and sub-regional prevalence of ORS use during a recent episode of diarrhea (within 2 weeks of survey) using DHSs for 2007–2010 (1st Period), and 2013–2016 (2nd Period). Weighted proportions of ORS were obtained and multivariable- design-adjusted logistic regression analysis was used to obtain Odds Ratios (aORs) and 95% confidence intervals (CIs) and weighted proportions of ORS coverage. Results Crude ORS coverage increased from 21.0% (95% CI: 17.4–24.9) in 1st Period to 40.5% (36.5–44.6) in 2nd Period in Zimbabwe; increased from 60.8% (56.1–65.3) to 64.7% (61.8–67.5) in Zambia; and decreased from 72.3% (68.4–75.9) to 64.6% (60.9–68.1) in Malawi. The rates of change in coverage among provinces in Zimbabwe ranged from 10.3% over the three cycles (approximately 10 years) in Midlands to 44.2% in Matabeleland South; in Zambia from − 9.5% in Eastern Province to 24.4% in Luapula; and in Malawi from − 16.5% in the Northern Province to − 3.2% in Southern Province. The aORs for ORS use was 3.95(2.66–5.86) for Zimbabwe, 2.83 (2.35–3.40) for Zambia, and, 0.71(0.59–0.87) for Malawi. Conclusion ORS coverage increased in Zimbabwe, stagnated in Zambia, but declined in Malawi. Monitoring national and province-level trends of ORS use illuminates geographic inequalities and helps identify priority areas for targeting resource allocation.. Provision of safe drinking-water, adequate sanitation and hygiene will help reduce the causes and the incidence of diarrhea. Health policies to strengthen access to appropriate treatments such as vaccines for rotavirus and cholera and promoting use of ORS to reduce the burden of diarrhea should be developed and implemented.
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Chinyama, Joyce, Jenala Chipungu, Cheryl Rudd, Mercy Mwale, Lavuun Verstraete, Charity Sikamo, Wilbroad Mutale, Roma Chilengi, and Anjali Sharma. "Menstrual hygiene management in rural schools of Zambia: a descriptive study of knowledge, experiences and challenges faced by schoolgirls." BMC Public Health 19, no. 1 (January 5, 2019). http://dx.doi.org/10.1186/s12889-018-6360-2.
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Momic, Jovana, and Ruchi Sharan. "Primary health care of marginalized and refugee populations." University of Western Ontario Medical Journal, October 10, 2019. http://dx.doi.org/10.5206/uwomj.v88i1.6236.
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Dr. Allison Henderson is a local family physician with a passion for refugee healthcare and treating London’s most marginalized populations. After completing her medical training and pursuing additional studies at the London School of Hygiene and Tropical Medicine in the UK, she spent over four years working as a physician in rural communities in subSaharan Africa. Since returning to London in 2016, she has been working at the London Intercommunity Health Center (LIHC) and Cross Cultural Learner Center (CCLC), where she treats newly arrived Syrian and Yazidi refugees and some of London’s most disadvantaged populations. We had the privilege of meeting Dr. Henderson at the LIHC to discuss her work with refugee populations who have experienced severe trauma and ways that her team is helping them cope and start to heal.
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Mellou, Kassiani, Anthi Chrisostomou, Theologia Sideroglou, Theano Georgakopoulou, Maria Kyritsi, Christos Hadjichristodoulou, and Sotirios Tsiodras. "Hepatitis A among refugees, asylum seekers and migrants living in hosting facilities, Greece, April to December 2016." Eurosurveillance 22, no. 4 (January 26, 2017). http://dx.doi.org/10.2807/1560-7917.es.2017.22.4.30448.
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An increased number of hepatitis A cases among refugees, asylum seekers and migrants residing in hosting facilities in Greece were recorded between April and December 2016. In total, 177 laboratory-confirmed symptomatic cases were reported; of these, 149 (84%) occurred in hosting camps mostly among Syrian children under 15 years. All cases reported symptom onset after their entry into the country. Public health interventions focused on hygiene measures and vaccination.
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Alawa, Jude, Nawara Alawa, Adam Coutts, Richard Sullivan, Kaveh Khoshnood, and Fouad M. Fouad. "Addressing COVID-19 in humanitarian settings: a call to action." Conflict and Health 14, no. 1 (September 10, 2020). http://dx.doi.org/10.1186/s13031-020-00307-8.
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Abstract Refugees and internally displaced persons in humanitarian settings are particularly susceptible to the spread of infectious illnesses such as COVID-19 due to overcrowding and inadequate access to clean water, sanitation, and hygiene facilities. Countries facing conflict or humanitarian emergencies often have damaged or fragmented health systems and little to no capacity to test, isolate, and treat COVID-19 cases. Without a plan to address COVID-19 in humanitarian settings, host governments, aid agencies, and international organizations risk prolonging the spread of the virus across borders, threatening global health security, and devastating vulnerable populations. Stakeholders must coordinate a multifaceted response to address COVID-19 in humanitarian settings that incorporates appropriate communication of risks, sets forth resource-stratified guidelines for the use of limited testing, provides resources to treat affected patients, and engages displaced populations.
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Muma, J., Martin Simuunza, K. Mwachalimba, M. Munyeme, B. Namangala, C. Hankanga, G. Sijumbila, et al. "Development of a curriculum for training in One Health analytical epidemiology at the University of Zambia." Onderstepoort J Vet Res 79, no. 2 (June 26, 2012). http://dx.doi.org/10.4102/ojvr.v79i2.475.
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Recently, the world has witnessed emergence of novel diseases such as avian influenza, HIV and AIDS, West Nile Virus and Ebola. The evolution of these pathogens has been facilitated mainly by a constantly evolving animal-human interface. Whilst infectious disease control was previously conceptualised as either public health or animal health related issues, the distinction between disciplinary foci have been blurred by multiple causal factors that clearly traverse traditional disciplinary divides. These multiple evolutionary pressures have included changes in land use, ecosystems, human-livestock-wildlife interactions and antibiotic use, representing novel routes for pathogen emergence. With the growing realisation that pathogens do not respect traditional epistemological divides, the ‘One Health’ initiative has emerged to advocate for closer collaboration across the health disciplines and has provided a new agenda for health education. Against this background, the One Health Analytical Epidemiology course was developed under the auspices of the Southern African Centre for Infectious Diseases Surveillance by staff from the University of Zambia with collaborators from the London School of Hygiene and Tropical Medicine and the Royal Veterinary College in London. The course is aimed at equipping scientists with multidisciplinary skill sets to match the contemporary challenges of human, animal and zoonotic disease prevention and control. Epidemiology is an important discipline for both public and animal health. Therefore, this two-year programme has been developed to generate a cadre of epidemiologists with a broad understanding of disease control and prevention and will be able to conceptualise and design holistic programs for informing health and disease control policy decisions.
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Rakotomanana, Hasina, Joel Komakech, Christine Walters, and Barbara Stoecker. "Water, Sanitation, and Hygiene (WASH) Indicators and Their Association with Child Linear Growth: A Multi-Country DHS Analysis in East Africa (P10-013-19)." Current Developments in Nutrition 3, Supplement_1 (June 1, 2019). http://dx.doi.org/10.1093/cdn/nzz034.p10-013-19.
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Abstract Objectives The reduction of child stunting in the East African region remains slow, emphasizing the need to examine the contributions of less commonly studied determinants of linear growth faltering. The purpose of this study was to determine the association between the newly issued WHO and UNICEF Joint Monitoring Programme WASH indicators and child length in East Africa. Methods The most recent Demographic and Health Survey (DHS) nationally representative data from Burundi, Ethiopia, Kenya, Malawi, Rwanda, Tanzania, Uganda, and Zambia were used. Data from young children aged 6–23 months were included in the analyses. The association between individual water, sanitation and hygiene indicators and length-for-age (LAZ) was analyzed using linear regression models while controlling for the known child, maternal, and household characteristics for each country. Results Stunting rates were very high in all countries (more than 25%) reaching 44.6% in Burundi. In most of the countries, more than half of the population did not have improved WASH indicators. Better drinking water was significantly associated with higher LAZ in Burundi (b = 0.05, P < 0.05, R2 = 0.24), Kenya (b = 0.04, P < 0.01, R2 = 0.14), Tanzania (b = 0.06, P < 0.01, R2 = 0.21), and Zambia (b = 0.05, P < 0.05, R2 = 0.19) in the adjusted models. Improved sanitation facilities were associated with LAZ in Ethiopia (b = 0.20, P < 0.001, R2 = 0.24) and Uganda (b = 0.12, P < 0.05, R2 = 0.20). Lastly, the positive association between LAZ and hygiene practices remained significant after adjustments only in Ethiopia (b = 0.04, P < 0.01, R2 = 0.23). Conclusions Improved water quality was associated with better LAZ in most countries. Integrating nutrition interventions with WASH components for young children might be effective in reducing high child stunting rates in East Africa. Funding Sources None.
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Halwiindi, H., O. Hatwiinda, and M. Lisulo. "Community Perspectives on Worm Infections in a Peri-Urban Area of Lusaka, Zambia." Journal of Advances in Medicine and Medical Research, April 22, 2020, 83–96. http://dx.doi.org/10.9734/jammr/2020/v32i530418.
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Soil transmitted helminths (STH) known as worm infections are more than a technical or biomedical problem. They can be linked directly to specific human behaviour in relation to sanitation and hygiene practices. Although these infections are prevalent in Zambia, There is paucity of data on community perceptions and beliefs with respect to STH infections. Therefore, this study sought to understand this aspect from a peri-urban point of view. Qualitative interviews were conducted on fifty-seven participants from Ngombe compound; a peri-urban area within Lusaka, Zambia. The study was carried out between August and December 2015 using semi-structured interviews and analysed by means of question analysis. Wide spread knowledge about the various types of worms was found in the community, although most of it was generally folk knowledge. However, this did not mean that the study population recognized STH as serious health problem as some participants considered having worms as normal. While consumption of food was commonly cited as cause of STH, most participants failed to give empirical evidence linking soil or faecal contaminated food items as direct cause of STH. Although the findings cannot be generalized, the study provides informative reference in understanding beliefs and perceptions regarding STH in Zambian peri-urban communities. There is need for concentrated efforts that are bio-medically relevant as well as beneficial to the targeted population.
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Kangwa, Jonathan. "“Don’t Let God Step In Human Waste”: Interpretation Of Deuteronomy 23:14–15 In The Context Of Cholera In Zambia." Expository Times, June 17, 2021, 001452462110198. http://dx.doi.org/10.1177/00145246211019869.
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Climate change and health challenges such as the HIV and AIDS have motivated religious leaders to rethink their beliefs and practices, considering how to apply these to health crises. Christian theologians and biblical scholars have risen to the occasion and developed new ways of interpreting the bible that offer a response to current situations. The new ways of interpreting the bible include approaching the text with a degree of wariness and traditional readings of the bible are often transgressed. The experience of the marginalised or the dismembered is used as a starting point for bible interpretation and theological reflection. This paper contributes to the shifts in bible interpretation and theological reflection by offering an eco-theological interpretation of Deuteronomy 23:14–15 in the context of cholera. The paper shows that, in the context of cholera in Zambia, an eco-theological interpretation of the biblical text can foster hygiene and proper management of human waste which would be an important contribution to the prevention of cholera outbreaks.
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Rakhshanda, Shagoofa, Sahlil Ahmed, Samuel Saidu, Christine Nderitu, Basanta Thapa, Abdul Awal, Nadia Farnaz, Atiya Rahman, Bachera Aktar, and A. S. G. Faruque. "Knowledge and practice regarding menstrual hygiene management among the Rohingya refugee adolescent girls in Cox’s Bazar, Bangladesh: a mixed method study." International Journal of Human Rights in Healthcare ahead-of-print, ahead-of-print (May 15, 2021). http://dx.doi.org/10.1108/ijhrh-10-2020-0096.
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Purpose About half of the 16% adolescents in the world experience menstruation. Menstrual hygiene management (MHM) is a health concern and challenge especially in humanitarian situations as experienced by Myanmar Rohingya refugees living in Cox’s Bazar, Bangladesh. This study aims to assess knowledge, practice and influencing factors for MHM among Rohingya refugee adolescent girls of 14–18 years. Design/methodology/approach The study used both quantitative (a cross-sectional survey with 340 adolescent girls through a structured questionnaire) and qualitative (7 in-depth interviews with adolescent girls and 2 focus group discussions with the mothers) approaches. Quantitative data, analyzed using STATA version 13.0, were supported by qualitative data, grouped into themes and presented as matrix. Findings Around 51% adolescent girls learned about menstruation after menarche, at the mean age of 12 years, from their mothers and older sisters. About 75% used sanitary pads as absorbents which they got mostly as relief material or bought from local stores (83%); the rest used cloths and other materials (25%). About 57% of the respondents disposed of their absorbent by burying. Those who used reusable absorbents washed them with soap and water (40%) and mostly dried them indoors (17%). Factors influencing healthy MHM practice included the use of absorbent, privacy, disposal, washing and drying of clothes, physical activities, hygiene and pain management. Adolescents with secondary or higher education were four times more likely to have better MHM practice (odds ratio = 4.27; confidence interval = 1.19–15.31) than those with no formal schooling. Originality/value This paper is based on a research undertaken as part of academic requirement.