American Journal of Health Research 

About: American Journal of Health Research is an academic journal published by Science Publishing Group. The journal publishes majorly in the area(s): Health care & Population. It has an ISSN identifier of 2330-8796. It is also open access. Over the lifetime, 314 publications have been published receiving 1832 citations. The journal is also known as: AJHR.

Health System in Bangladesh: Challenges and Opportunities

Abstract: The health system of Bangladesh relies heavily on the government or the public sector for financing and setting overall policies and service delivery mechanisms. Although the health system is faced with many intractable challenges, it seems to receive little priority in terms of national resource allocation. According to the World Health Organization (WHO 2010) only about 3% of the Gross Domestic Product (GDP) is spent on health services. However, government expenditure on health is only about 34% of the total health expenditure (THE), the rest (66%) being out-of-pocket (OOP) expenses. Inequity, therefore, is a serious problem affecting the health care system. Based on a review of secondary data, the paper assesses the current challenges and opportunities of the health system in Bangladesh. The findings suggest that although the health system faces multifaceted challenges such as lack of public health facilities, scarcity of skilled workforce, inadequate financial resource allocation and political instability; Bangladesh has demonstrated much progress in achieving the health-related Millennium Development Goals (MDGs) especially MDG 4 and MDG 5. Although the country has a growing private sector primarily providing tertiary level health care services, Bangladesh still does not have a comprehensive health policy to strengthen the entire health system. Clearly, the most crucial challenge is the absence of a dynamic and proactive stewardship able to design and enforce policies to further strengthen and enhance the overall health system. Such strong leadership could bring about meaningful and effective health system reform, which will work more efficiently for the betterment of the health of the people of Bangladesh, and would be built upon the values of equity and accountability.

Prevalence and Determinant Factors of Intestinal Parasites among School Children in Arba Minch Town, Southern Ethiopia

Abstract: Back ground: Intestinal parasitic infections are still quite common in developing countries including Ethiopia, particularly in children. They are mostly associated with unsafe and low quality of drinking water, poor personal and environmental sanitation. Thus, the objective of this study was to assess the prevalence and determinant factors of intestinal parasites among school children. Methods: A cross sectional study was conducted in March, 2014, among 498 students selected from three governmental elementary schools in Arbaminch- town, Southern Ethiopia using stratified multistage sampling method. Structured questionnaire was used to identify environmental, socio demographic and behavioral factors. Stool specimens were collected from all study subjects and were examined for intestinal parasites using direct smear (mount examination) and Formal-ether concentration techniques. Finally, data entry and analysis was done using Epi-info and SPSS statistical soft ware respectively. A bivariate and multivariate logistic regression analysis was done. P value less than 0.05 was considered as statistically significant. Results: A total of nine parasites were detected .The overall prevalence of intestinal parasites was 27.7% (95% confidence interval (CI): (23.8-31.6%)). The predominant parasite was E.histolytica/dispar 64(12.9%) followed by A.lumboricoids 53(10.6%), H.nana 21 (4.2%) and G.lamblia 21 (4.2%). Hand washing practice before meal [AOR = 5.7; 95% CI (3.4, 9.7)], nail hygiene [AOR= 2.6; 95% CI (1.5, 4.4)], and children's mother educational level [ A OR =3.5; 95% CI (1.01, 11.4)] showed statistically significant association with high rates of intestinal parasitic infections. Conclusion and recommendations: The prevalence of intestinal parasites is high in the study area among school children .Thus, it indicates the need of interventions like health education regarding to personal hygiene and mass treatment.

The Place of Traditional Medicine in the African Society: The Science, Acceptance and Support

Abstract: Traditional medicine (TM) has been described by the World Health Organisation (WHO) as one of the surest alternative means to achieve total health care coverage of the world’s population. In most African societies, traditional medicine plays an important role in the lives of millions who cannot access western medicine. In some areas, TM is part of the first set of response mechanisms for medical emergencies whilst in others the whole health system of the community is hinged on medicines rooted in local practice and belief. Although the relevance and values of TM is begining to gain recognition, African traditional medicine (ATM) still faces some challenges which underscore its scrutiny. This paper thus analyses the issue of science, acceptance and support for successful implementation of ATM and present the contemporary measures that are being taken to raise its standard to the level of western medicine.

Prevalence of Chronic Kidney Disease and Associated Risk Factors among Diabetic Patients in Southern Ethiopia

Abstract: Background: Chronic kidney disease (CKD) in diabetes is associated with an increased risk of premature mortality, kidney failure and cardiovascular disease. No studies are available on the prevalence of CKD among diabetics in Ethiopia. The aim of this study was to determine the prevalence of CKD and its associated risk factors among diabetic adults attending Butajira hospital of Southern Ethiopia based on estimated glomerular filtration rate (GFR). Methods: A facility based cross sectional study was conducted in Butajira hospital, southern Ethiopia among 214 randomly selected diabetic adults. Demographic, clinical, and laboratory data were collected from September 1, 2013 to October 31, 2013. The simplified Modification of Diet in Renal Disease (MDRD) and Cockroft-Gault (CG) equations were used to estimate GFR (eGFR) from serum creatinine value. SPSS 20.0 Software was used for data analysis. Results: 39 (18.2%) and 51 (23.8%) of the study participants were found to have CKD, as defined by eGFR < 60 ml/min/1.73 m2, according to the MDRD and Cockroft-Gault equations, respectively. Of these; 17.3 and 22.9% have stage 3 CKD, and 0.9% have stage 4 CKD, respectively. Significant risk factors for CKD in the study subjects when using either the MDRD or C-G equation were older age, longer duration of diabetes, family history of kidney disease, and poor glucose control (P < 0.05). Additionally, female sex (P < 0.008) and obesity (P < 0.038) were independent risk factors for CKD when defined by the MDRD, and type 2 diabetes was when defined by C–G (P < 0.03). Conclusion: CKD was present in not less than 18.2% diabetic adults attending the follow up clinic at Butajira hospital, in southern Ethiopia. Risk factors for CKD were similar to those reported in developed country studies. Using the MDRD equation led to a lower prevalence of CKD and a better risk categorization than did by C-G equation, thus contributing to better management of clinical outcomes in diabetic care.

Knowledge of Obstetric Danger Signs and its Associated Factors in Arba Minch Town, Ethiopia

Abstract: Background: In many developing countries including Ethiopia, maternal morbidity and mortality still pose a substantial burden even if various programs are undertaken by public sectors as well as the non-governmental organizations (NGOs). Majority of maternal health sectors in developing countries consider knowledge of women about the obstetric danger signs as the first essential step in order to accept appropriate and timely referral to obstetric care. However, in Ethiopia little is known about the knowledge level of mothers about obstetric danger signs. Objective: To assess the level of knowledge about obstetrics danger signs among mothers who gave birth in the last three years prior to the survey in Arba Minch town, Ethiopia. Methods: A Community based cross-sectional study was conducted from December 20, 2013 to June 30, 2014 on a randomly selected sample of 390 women who had at least one delivery in the past three years. Multistage sampling technique was employed to select the study participants. A pre-tested structured questionnaire was used to collect quantitative data. Bivariate and multivariate data analysis was performed using SPSS version 20.0 statistical software. Result: Three hundred ninety mothers participated in the study making a response rate of 100%. From all respondents, 24.1% of them were knowledgeable while 75.9% were not knowledgeable about obstetric danger signs that occurred during pregnancy, labor and postnatal period. Conclusion: Educational status, age, monthly income, and decision making power were independently associated with knowledge of obstetric danger signs. Thus, provision of information, education, facilitate income generating mechanisms , and communication targeting women, family and the community on danger signs of pregnancy and childbirth was recommended.