Master of Public Health

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A Case-Control Study of Caregiver’s Feeding Knowledge and Practices, in Relation to Etiology of Diarrhea Among Children Aged 0-23 Months in Gokwe North District, Zimbabwe
(Adventist University of Africa, 2023-03) Chiketa Takudzwanashe Moses
Diarrhea prevalence among children under-five in Gokwe North district was estimated at 16.5% in 2018, surpassing the national average of 10% in the same period. The World Health Organization confirms that 54% of deaths due to diarrhea and other causes in under-fives have malnutrition as an underlying factor. The current study sought to investigate the possible relationship between the high diarrhea burden and Nutrition by examining the knowledge and practices of primary caregivers in the feeding of infants. The research followed a matched case-control study design. A Case was defined as the mother of a child who had had one or more episodes of diarrhea two weeks before the interview date. The selection of seven clinic catchment areas, 149 cases, and 149 controls was done through multi-stage sampling. Chi-Square tests for association and a binomial logistic regression model were conducted using SPSS version 16. Controls tended to be more knowledgeable than cases on the recommended IYCF practices. In the 0 to 5-month age group, practices that were significantly associated with diarrhea were mixed feeding (p=0.001), exclusively breastfeeding (p=0.000), and IYCF knowledge (p=0.001). For the 6 to 23 months age group significant associations were noted with the number of handwashing times (p=0.035), access to improved pit latrine (p=0.022), source of water for household use (p=0.007), type of container used (p=0.040), Mid Upper Arm Circumference (p=0.000) and IYCF Knowledge (p=0.001). Significant predictors of diarrhea in children of 0-5 months of age were IYCF knowledge [AOR 1.15, (CI 1.06; 1.24) P = 0.001], water source [AOR 20.9, (CI 1.77; 28.4) P = 0.016]. as well as the use of a nipple bottle [AOR 0.057, (CI 0.01, 0.48) P = 0.009]. For the 6 to 23-month age group significant predictors were IYCF Knowledge [AOR 1.034, (CI 1.01; 1.06) P = 0.001] and meal frequency [AOR 0.254, (CI 0.09; 0.71) P = 0.010]. Both IYCF and WASH practices were found to be having an association with diarrhea incidence in under-five children, particularly the 0-23-month age group. IYCF practices mostly affected the 0-5 months age range whereas as the child grows further into the 6-23 months range WASH-related factors have the greater influence in determining diarrhea.
A comparative analysis of knowledge, attitudes and practices on occupational safety and health compliance among small-scale bakeries in Harare, Zimbabwe
(Adventist University of Africa, 2023-04) Busangavanye, Gelien
This study sought to analyze the knowledge, attitudes, and practices on Occupational Safety and Health compliance among small-scale bakeries. Data were collected from 137 participants from the small-scale bakeries in Willowvale industrial area, Harare, Zimbabwe period (September to October 2021). Questionnaires, interviews, observation checklists and heat and light measurements were used for data collection. Negative binomial regression was used to assist in establishing the strength of the relationship between variables and know which independent variable was a significant predictor of compliance with OSH standards. Statistical Package for Social Sciences SPSS, version 23 was used for data analysis. The majority of the participants were males 99% and their age range was 19-30 years. The study revealed that 83% of small-scale bakeries functioned outside the requirements of the Zimbabwean OSH legislation and regulations by failing to register their operations under the Factories and Works Act Chapter 14:08. OSH management structures were essentially not there and OSH programs implementation was very poor and minimum. Employees were unprotected from several hazards including heat exposure and poor lighting. The findings obtained from the study are not statistically significant. This is shown by the P values (P > | z |) obtained which are all greater than 0.05. In conclusion, several recommendations were made for improved OSH knowledge, attitude, practices and compliance in the small-scale bakery industry. These include, management taking responsibility of the employee’s safety and health through implementation of occupational safety and health programs including OSH training. Employees need to develop a positive attitude towards OSH and implement daily safety practices. The legislators should offer tailor made and considerate interventions for such operations with main thrust on awareness and training promotions to develop and foster the essential knowledge, attitudes as well as positive practices that will result in sustainable OSH compliance in small-scale bakery industry.
A comparative analysis of knowledge, attitudes and practices on occupational safety and health compliance among small-scale bakeries in Harare, Zimbabwe
(Adventist University of Africa, 2023-04) Busangavanye, Gelien
This study sought to analyze the knowledge, attitudes, and practices on Occupational Safety and Health compliance among small-scale bakeries. Data were collected from 137 participants from the small-scale bakeries in Willowvale industrial area, Harare, Zimbabwe period (September to October 2021). Questionnaires, interviews, observation checklists and heat and light measurements were used for data collection. Negative binomial regression was used to assist in establishing the strength of the relationship between variables and know which independent variable was a significant predictor of compliance with OSH standards. Statistical Package for Social Sciences SPSS, version 23 was used for data analysis. The majority of the participants were males 99% and their age range was 19-30 years. The study revealed that 83% of small-scale bakeries functioned outside the requirements of the Zimbabwean OSH legislation and regulations by failing to register their operations under the Factories and Works Act Chapter 14:08. OSH management structures were essentially not there and OSH programs implementation was very poor and minimum. Employees were unprotected from several hazards including heat exposure and poor lighting. The findings obtained from the study are not statistically significant. This is shown by the P values (P > | z |) obtained which are all greater than 0.05. In conclusion, several recommendations were made for improved OSH knowledge, attitude, practices and compliance in the small-scale bakery industry. These include, management taking responsibility of the employee’s safety and health through implementation of occupational safety and health programs including OSH training. Employees need to develop a positive attitude towards OSH and implement daily safety practices. The legislators should offer tailor made and considerate interventions for such operations with main thrust on awareness and training promotions to develop and foster the essential knowledge, attitudes as well as positive practices that will result in sustainable OSH compliance in small-scale bakery industry.
Assessment of exclusive breastfeeding knowledge and practices among post-natal mothers attending Ashaiman Polyclinic in the greater Accra region of Ghana
(Adventist University of Africa, School of Postgraduate Studies, 2019-04) Ofosuhene, Frank
It is expected that every country promotes, protects and supports breastfeeding program for infants and the mother’s health (WHO 1990). This study was designed to assess the knowledge and the extent to which breastfeeding was practiced among postnatal mothers who accessed Ashaiman Polyclinic in the Greater Accra Region of Ghana. The study utilized a survey as a research design by employing structured questionnaire as data collection technique. A sample size of 422 breastfeeding mothers whose children were less than two years old was used for the study. The data was analyzed using the Statistical Package for Social Sciences (SPSS version 21). The results were presented in frequency, percentages and inferences were made using a paired sample test. The significant values were computed to check for the relationship between the participants’ knowledge and the practice of exclusive breastfeeding and the P-value was set at 0.05.The exclusive breastfeeding rate according to WHOs recommendation was found to be 71%. Although there were considerably variations in the exclusive breastfeeding duration, the mothers generally had good knowledge (98%) and practices (96%) regarding exclusive breastfeeding.
Assessment of knowledge, perception, and infrastructure as determinants of waste management practices among selected communities in Montserrado County, Liberia
(Adventist University of Africa, 2025-05) Zayzay, Amelia Joe
Waste management in Montserrado County, particularly Monrovia, remains a critical challenge despite regulatory efforts. Over 90% of waste is improperly disposed of, exacerbated by rapid urbanization, inadequate infrastructure, and gaps in public knowledge and perception regarding waste disposal risks. This study investigates the relationship between knowledge, perception, and infrastructure as determinants of waste management behavior. The study aims to assess the influence of knowledge, perception, and infrastructure on waste management practices in Montserrado County. A quantitative, cross-sectional design was used, surveying 383 households in Monrovia (20.78%) and Paynesville (79.22%). Quota sampling ensured representation across socioeconomic groups. Data were collected via structured questionnaires. The findings reveal that waste management knowledge and infrastructure have a significant relationship with and do influence residents’ waste management practices, while perception does not have a statistically significant impact. The combination of knowledge, perception, and infrastructure shows a strong predictive relationship with waste management practices. These results highlight the critical role of education and infrastructure availability in promoting effective waste management behaviors. Strengthening infrastructure is key to improving waste management Practices. Authorities should invest in waste collection points, recycling facilities, and regular waste disposal schedules to enhance community participation and environmental sustainability.
Customer Perceptions of Quality in Selected Healthcare Franchises in Kenya
(Adventist University of Africa, 2023-04) Osiemo, Alice Kwamboka
This thesis investigated customer perceptions of healthcare quality in selected healthcare franchises in Kenya, concentrating on sociodemographic characteristics and perceptions of reliability, assurance, tangibles, empathy, and responsiveness, including aspects such as ambience, equipment, staff appearance, and staff knowledge and courtesy. The study employed a cross-sectional design using a semi-structured telephone questionnaire, with a purposive sample of 302 customers from four franchises. Data analysis using SPSS version 28 revealed significant differences in customer perceptions of reliability quality (F(3,298)=4.56, p<0.01) and tangibles (F(3,298)=3.27, p<0.05) across age groups, with customers aged 31-40 years having the highest ratings (M=4.12, SD=0.68 and M=4.20, SD=0.71, respectively). Differences were also observed in perceptions of reliability (t(300)=2.36, p<0.05) and assurance (t(300)=2.12, p<0.05) between male and female customers, with males rating higher (M=4.08, SD=0.66 and M=4.17, SD=0.69, respectively). Responsiveness significantly differed among customers with different marital statuses (F(2,299)=3.83, p<0.05), with single customers having higher ratings (M=4.19, SD=0.72) compared to married and divorced/widowed/separated customers. Additionally, differences were identified in the assurance dimension among customers with varying education levels (F(2,299)=4.17, p<0.05), with bachelor's degree holders rating highest (M=4.21, SD=0.70). However, no significant differences were found across different residences (F(2,299)=1.25, p>0.05). The study recommends that healthcare franchise providers prioritize delivering quality healthcare services and tailor their practices to the diverse needs of different customer segments. The findings have implications for healthcare providers in Kenya seeking to improve service quality and customer satisfaction, contributing to the knowledge on healthcare franchising and offering valuable insights for healthcare franchise providers.
Customer perceptions of quality in selected healthcare franchises in Kenya
(Adventist University of Africa, 2023-04) Osiemo, Alice Kwamboka
This thesis investigated customer perceptions of healthcare quality in selected healthcare franchises in Kenya, concentrating on sociodemographic characteristics and perceptions of reliability, assurance, tangibles, empathy, and responsiveness, including aspects such as ambience, equipment, staff appearance, and staff knowledge and courtesy. The study employed a cross-sectional design using a semi-structured telephone questionnaire, with a purposive sample of 302 customers from four franchises. Data analysis using SPSS version 28 revealed significant differences in customer perceptions of reliability quality (F(3,298)=4.56, p<0.01) and tangibles (F(3,298)=3.27, p<0.05) across age groups, with customers aged 31-40 years having the highest ratings (M=4.12, SD=0.68 and M=4.20, SD=0.71, respectively). Differences were also observed in perceptions of reliability (t(300)=2.36, p<0.05) and assurance (t(300)=2.12, p<0.05) between male and female customers, with males rating higher (M=4.08, SD=0.66 and M=4.17, SD=0.69, respectively). Responsiveness significantly differed among customers with different marital statuses (F(2,299)=3.83, p<0.05), with single customers having higher ratings (M=4.19, SD=0.72) compared to married and divorced/widowed/separated customers. Additionally, differences were identified in the assurance dimension among customers with varying education levels (F(2,299)=4.17, p<0.05), with bachelor's degree holders rating highest (M=4.21, SD=0.70). However, no significant differences were found across different residences (F(2,299)=1.25, p>0.05). The study recommends that healthcare franchise providers prioritize delivering quality healthcare services and tailor their practices to the diverse needs of different customer segments. The findings have implications for healthcare providers in Kenya seeking to improve service quality and customer satisfaction, contributing to the knowledge on healthcare franchising and offering valuable insights for healthcare franchise providers.
Determinants of breast cancer awareness and screening practices of women within Tamale, Ghana
(Adventist University of Africa, School of Postgraduate Studies, 2019-04) Adams, Patsy Ago
Breast cancer is now ranked the most common cancer worldwide, increasing from 1.7 million incident cases in 2005 to 2.4 million cases in 2015. Both early detection and treatment have been shown to be the most effective methods to address the impact of this devastating disease. This study assessed the determinants of breast cancer awareness and practice of breast cancer screening among women in the Tamale, Ghana. A cross-sectional survey of 396 adult women, chosen by stratified random sampling was undertaken using a questionnaire. Results showed that the majority of the respondents were below 40 years of age (75.5%). Almost all participants (99.0%) had heard of breast cancer (awareness). Interestingly, the majority (51.3%) knows the cause of breast cancer to be bacteria. The most practiced method of screening was breast self-examination (86.4%), clinical breast examination and mammogram had 77.3%. We found that 93.4% of the population respectively never practiced either. Age, religious affiliations and ethnicities were seen to have statistically significant relations to awareness and practice.
Determinants Of diarrhoea among under-five children in Umzingwane District, Zimbabwe: a case-control study
(Adventist University of Africa, School of Postgraduate studies, 2018-03) Mkandla, Sifelani
Diarrhoeal disease remains a leading cause of mortality and morbidity among children less than five years old in the developing world. The average annual incidence rate of diarrhoea in children less than five years of age (under-fives) is estimated to be 2.6 episodes in developing countries. It is also estimated that there are 100 million episodes and 3.3 million deaths occurring each year among under-fives globally. In Africa, a child typically experiences five episodes of diarrhoea per year, and 800,000 children die each year from diarrhoea and dehydration. In Zimbabwe diarrhoea is the fourth highest cause of death for children under five and is the reason for 12% of child hospital admission (Zimbabwe Maternal and Child Health Integrated Programme, 2014). According to World Bank Collection of Development Indicators, 2014 the prevalence of diarrhoea in under-fives in Zimbabwe was 16%. Umzingwane District recorded a high number of diarrhoea cases in underfives in 2016. The total number of diarrhoea cases from under- fives was 1 018 andconstituted 40% of the total number of diarrhoea cases in the district. The figure constitutes an overrepresentation of morbidity among this age group since the underfives make up 13.7% of the total population. The cause for the upsurge of diarrhoea cases was not documented by epidemiological studies or the literature. The aim of this study was to examine or discover context-specific conditions in Umzingwane district that may have led to an uptick in diarrhoea cases among under-fives in 2016. The study was a 1:1 unmatched case-control study. The research surveyed 200 cases and 200 controls. The cases were under-fives in Umzingwane District who had diarrhoea in 2016. The researcher used the standard case definition for diarrhoea as cited in the literature. The controls were under-fives who did not have diarrhoea in 2016 and came from the same neighbourhood as cases. A pre-tested, interviewer-administered questionnaire, was used to collect data from caregivers of cases and controls and under-fives. The questionnaire was filled by trained research assistants. Sanitary inspections were conducted through visual assessment of the infrastructures and the sanitary state surrounding the household water supply, water-holding containers, household sanitary conditions, food storage, personal hygiene, kitchen hygiene and vaccination status of the children as these factors have a potential risk to health and wellbeing of the child. Water samples were collected from boreholes and shallow unprotected wells to check for Escherichia Coli (E. coli) contamination and turbidity Data were analyzed using Epi Info 7.2.1.0 version. Odds ratios and Chi-square tests at 5% significant levels and 95% confidence intervals were generated using the software. Forward stepwise logistic regression analysis was used to control for confounding and effect modification. The adjusted odds ratios were calculated toquantify the strength of association between risk factors and outcome and factors with a p-value less than 0.05 were considered significant. Out of 35 borehole water samples tested, 33(94.29%) were below the threshold limit for contamination with Escherichia coli and 2 of the 35 (5.71%) borehole water samples tested were above the threshold for contamination with Escherichia coli. Out of 50 unprotected shallow wells water samples tested 9(18%) were below the threshold limit for contamination with Escherichia coli and 41(82%) unprotected shallow wells water samples tested were above the threshold for contamination with Escherichia coli. Independent risk factors for contracting diarrhoea were: source of water [OR=2.2457, CI=1.0924-4.6164, p-value=0.0278], disposal of solid waste [OR=4.62, CI=1.9380-11.0330, p-value=0.0006], sanitary state of the kitchen [OR=2.2307, CI=1.0185-4.8854, p-value=0.0449]. Independent protective factors for contracting diarrhoea were: household income [OR=0.2273, CI= 0.1180-0.4378, pvalue=0.0000], caregiver knowledge on diarrhoea prevention and control [OR=0.2940, CI=0.1316-0.6566, p-value=0.0028], washing hands by caregivers at all critical times [OR=0.0461, CI=0.0227-0.0937, p-value=0.0000] The study has highlighted the disaggregated household level risk factors for diarrhoea in under-fives in Umzingwane District. The environmental risk factors were drinking water from contaminated sources, indiscriminate disposal of waste around the home and unsanitary status of the kitchen where food is prepared. This clearly indicates the importance of environmental health as a determinant of child health. Therefore, there is a need for effective measures to enhance universal access to safe water, improved food hygiene practices and appropriate waste management strategies at the household level. The socioeconomic protective factors were knowledge of diarrhoea prevention and economic stability of the caregivers. The behavioural protective factor was washing of hands at all critical times by caregivers. This implies that hygiene promotion interventions should prioritise protective factors such as increasing caregiver knowledge of diarrhoea prevention, establishment and use of hygienic hand washing facilities and improving socioeconomic status of households.
Determinants of dietary diversity among children aged 6–23 months in Mwenezi District, Zimbabwe
(Adventist University of Africa, 2022-04) Huturume, Tarusenga
Poor dietary diversity during the complementary feeding period has detrimental effects on children’s growth, health, and development. During this period, a lack of a diverse diet increases the risk of malnutrition, morbidity, and mortality. Ensuring dietary diversity is critical to promoting child survival, adequate growth, and development. The study aimed to identify determinants of dietary diversity among children aged 6-23 months in Mwenezi district of Zimbabwe. The study examined determinants of dietary diversity at the child, caregiver, household, and community levels. The study was a quantitative cross-sectional design with a sample size of 417 children selected through multi-stage random sampling. As children are not able to report their food intake, their caregivers responded on their behalf. Data was gathered by five trained field assistants using an interviewer-administered questionnaire and was analyzed using Statistical Package for Social Sciences (SPSS 20 for windows). The study established a very low minimum dietary diversity, (21.3%) in Mwenezi district. Except for staples (grains, roots, and tubers), the consumption of other food groups was below 50%. Consumption of vitamin A-rich fruits, eggs, and dairy products were least consumed by children, ranging from 7-16%. Determinants at the child level were age, sex, and birth weight. Caregiver knowledge of IYCF was the only caregiver level determinant identified. Household level determinants included poultry possession, possession of a nutrition garden, and joint decision-making by both spouses while community level determinants were presence of child growth monitoring services and village savings and lending associations. Interventions to improve the quality of diets consumed by children ought to target child, caregiver, household and community levels for synergy and greater impact. These interventions should purpose to increase caregivers’ knowledge of age specific child feeding practices while also creating a conducive and supportive socio-economic environment for caregivers to plan and prepare diverse diets. A comprehensive social and behaviour change program using the care group model, employing a ‘‘whole of family approach’’ to improve feeding behaviors and practices, empowering women and engaging men to support joint decision making, production of a wide range of crops and vegetables and small animals will improve consumption of diverse diets by children in Mwenezi district.
Exploratory descriptive qualitative research of factors influencing male involvement in antenatal care services at Mangochi District Hospital, Malawi
(Adventist University of Africa, 2025-05) Gwengwe, Ida
Male involvement in antenatal care services is currently being encouraged in most Sub-Saharan countries, including Malawi, as an approach to address maternal mortality. Despite the benefits associated with men attending ANC services, in Sub-Saharan Africa, the involvement of male spouses in ANC services is low, with attendance rates ranging from 5% to 31%. About two-thirds of men in the region (61.7%) visit the clinics only once. Malawian men also rarely attend ANC services with their partners ranging from 3.2% to 19%. However, documentation on the reasons for the low male involvement in the country is scanty. The purpose of this research is to explore factors influencing male attendance in antenatal care services during pregnancy at Mangochi District Hospital, Malawi. An exploratory descriptive qualitative research design was employed to explore factors influencing the involvement of male partners in antenatal care services during pregnancy. Using purposive sampling, the research recruited 40 participants which included couples attending ANC services, pregnant women whose male spouses were not attending ANC services and staff nurses providing ANC services. Focus group discussions, in-depth interviews, and key-informant interviews were used to collect data, using semi-structured interview guides with probes. The research used thematic analysis to analyse data by emerging themes and their sub-themes. Among others, the research findings revealed that social and structural factors including men’s perceived benefits of their spouses’ ANC attendance, societal and cultural expectations, socioeconomic barriers special treatment which women receive when they are escorted by their male spouses, attitude of health care providers prior ANC preparations, distance to the antenatal clinic, time spent at ANC clinic and unfriendly facility environment are key factors influencing male partner participation in ANC. These factors either promote or hinders men from attending their spouses’ ANC visits, as they would directly and indirectly affect men’s attitudes and subjective norms towards their participation in ANC services. However, the special treatment which women receive when they are escorted by their male spouses greatly motivate men to be attending ANC services at Mangochi district hospital. The research then recommends that addressing these social and structural factors would improve pregnancy outcomes and ultimately reducing preventable maternal deaths.
Factors associated with overweight/obesity among children of Mogoditshane Adventist School children in Botswana
(Adventist University of Africa, School of Postgraduate Studies, 2020-05) Mponwane, Mpho
The epidemic of childhood overweight/obesity, which in the developed world is mainly found in rural areas, has increased the incidence of plaguing cities and towns of the developing world. This is particularly the case in developing nations that are also experiencing nutritional transition, such as Botswana. The hypothesis of this study stated that there is no statistically significant association between demographic profiles/eating behavior/activity habits/parental factors with overweight/obesity status amongst children of the Mogoditshane Adventist School in Botswana. Both the questionnaires for the teachers and the parents were mainly interviewer-administered, although there were instances where some participants took the questionnaire and filled it independently. A certified Tanita scale was used to measure BMI for validity and reliability. Scales were calibrated and checked by the Botswana Bureau of Standards and certified to be appropriate for use in this study. Height measurements for the children were taken by trained measurers with thechildren standing in a standardized position of up straight with their legs and feet together and head vertical for precision. Both quantitative and qualitative data were analyzed. Chi-square was used for testing the socio-demographic variables, as well as the factors, eating behavior, and activity habits for association with overweight/obesity status (BMI z scores). Furthermore, multivariate logistic regressions were used to assess the independent factors associated with overweight/obesity. Data were collected from 152 parents of children 6-13 years of age to describe the aforementioned factors. Mothers were the majority at 63.6% of the sample. Batswana comprised 81.6 % of the sample. Child male participants were 42.8% while females comprised 57.2%. The children’s weight status was categorized using BMI z scores. 14.5% had BMI z scores > +2SD (Obesity), 19.1% had BMI z scores > +1SD (Overweight), 63.2% had BMI z scores between +1 and -2 (Normal), 2.6% had BMI z scores of <-2 (Underweight), and 0.7% had BMI z scores <-3 (Severe underweight). There was only one statistically significant variable (factor) found to be associated with overweight/obesity: Parental concern for child’s body weight [PV = 0.000; AOR = 4.659 (2.207-9.955)]. Additionally, whether the child eats fast food weekly [PV = 0.007; AOR = 0.207 (0.066-0.649)], whether child eats breakfast in the morning before school [PV = 0.048; AOR = 2.790 (1.008-7.727)], education of participant parent [PV = 0.036; AOR = 0.155 (0.027-0.886)] were the three statistically significant variables (factors) found to be associated with children’s obesity status. Therefore, we failed to reject the null hypothesis. The recommendations of the study show that consideration of the socio-demographics, healthy diet and activity factors is needed in developing child overweight and obesity prevention programs.
Factors associated with utilization of cervical cancer screening services among sexually active women in Gutu District, Zimbabwe
(Adventist University of Africa, 2022-10) Moyo Theresa Avilla Diana
Cervical cancer is a prevalent type of cancer that ranks fourth among women and eighth overall. It disproportionately affects individuals residing in developing countries, where inadequate screening programs and poor uptake of traditional diagnostic methods such as pap smears or pelvic examinations are common. Early detection and timely treatment significantly improve the chances of a complete cure. In Zimbabwe, despite the availability of free cervical cancer screening services to all eligible women, rural women from the Gutu district exhibit low utilization rates. This research aims to investigate the underlying factors contributing to the inadequate uptake of cervical cancer screening services by rural women in the Gutu District. A cross-sectional study design with an exploratory approach was employed to investigate the subject matter at hand. Quantitative data was collected in May 2021 through a self-administered questionnaire. The sample size of 450 participants was acquired using a multistage stratified random sampling method. Findings from this investigation have revealed that rural women residing in the Gutu district lack fundamental knowledge regarding cervical cancer, where only half of the participants demonstrated awareness of its signs and symptoms. Furthermore, risk perception among the study's respondents remained limited, with only 36.7% acknowledging high susceptibility to developing cervical cancer. The outcomes of this research also indicate that multiple factors, including age, outreach availability, proximity to the VIAC centre, perceived severity of cervical cancer, and spousal support, independently influence the uptake of cervical cancer screening among rural women in the Gutu district. The study concludes that accessibility to cervical cancer screening services remains inadequate within the area of interest. To address this issue, measures such as enhancing risk communication, expanding screening sites, and increasing outreach activities are necessary to bring the service closer to individuals who require it. Additionally, there should be a concerted effort to prioritize rural women in cervical cancer screening programs, dispel any myths or misconceptions, and eliminate gender and cultural barriers.
Factors Contributing to Compliance of COVID-19 Safety Protocols among Students in Ikageng JSS, (Metsimotlhabe)
(Adventist University of Africa, 2023-05) Nkadile, Emang Mmaboipuso
Noncompliance with COVID-19 safety protocols has been associated with poor health outcomes. The COVID-19 pandemic has had a profound impact on the education system, with schools around the world implementing various safety protocols to reduce the spread of the virus. Compliance with these protocols, such as wearing masks, practising social distancing, and frequent hand washing, is crucial to protecting the health and safety of students, teachers, and staff. However, compliance with these protocols among students has been a challenge in many educational settings. This paper explores the factors that contribute to compliance with COVID-19 safety protocols among students. The literature review suggests that several factors influence compliance with safety protocols, including individual factors, such as knowledge, attitudes, and beliefs, as well as contextual factors, such as social norms and information dissemination. Descriptive statistics were used to describe the factors that contribute to noncompliance. Studies indicate that students who have higher levels of knowledge about COVID-19 and its transmission are more likely to comply with safety protocols. Additionally, positive attitudes and beliefs towards safety protocols, as well as a sense of personal responsibility, have been associated with increased compliance. Social norms and information also play a significant role, as students are more likely to comply with safety protocols when they perceive that the information they have is sufficient. School support, such as well-laid infrastructure, clear communication of safety protocols and adequate resources for compliance, can also contribute to increased compliance. In conclusion, compliance with COVID-19 safety protocols among 55 students aged 12-17 years was influenced by various factors, including individual knowledge, attitudes, and beliefs, social norms and information dissemination, and institutional support. Understanding these factors can help educators and policymakers develop effective strategies to promote compliance with safety protocols and protect the health and well-being of students and staff.
Healthcare workers’ perception of pandemic preparedness at a tertiary hospital in Southern Malawi
(Adventist University of Africa, 2025-05) Manda Rose Bubily Kamanga
The occurrence of pandemics has highlighted the need for early response and hospital preparedness in order to avert overwhelming consequences for countries with low and high economies. human immunodeficiency virus (HIV), and Coronavirus disease have devastating effects on humanity. The Coronavirus pandemic took countries with low and high economies by storm, exposing serious deficiencies in the handling of outbreaks. Similarly, in countries with a low economy, the pandemic exposed their dependency on countries with high economies, lack of preparedness as well as resources to handle outbreaks. The absence of proper infrastructure, staff, resources such as equipment, and guidelines were prominent, and every government swiftly tried to come up with specific guidance for containing it. Many countries in the Sub-Saharan African region including Malawi, and across the globe have adopted checklist in an effort to manage the pandemic. The measures implemented in one way or the other brought some relief to health institutions and the whole country. The study examined hospital preparedness and response to pandemics at one of the tertiary hospitals in Malawi. Healthcare workers (HCWs) who were or are assigned to the pandemic unit managing cases using a questionnaire adopted from the WHO preparedness checklist. Data was collected in April 2024, cleaned and by STATA version 17.0. Descriptive statistics characterize populations. Frequencies, percentages were used to determine the hospital’s level of preparedness. This was essential for better solutions to potential future pandemics to save lives.
Occupational hazards and mitigating measures among healthcare workers in Shinyanga Regional Referral Hospital, Tanzania
(Adventist University of Africa, 2023-04) Muhoja, Joel James
This study sought to identify occupational hazards and mitigating measures among Healthcare Workers in Shinyanga Regional Referral Hospital. The objective of the study was to assess risks associated with occupational health, identify factors (causes) of occupational health hazards among HCWs, and build the capacity of healthcare workers on measures to mitigate health hazards in their workplace. The study engaged 105 HCWs all from Shinyanga regional hospital. The study project imparted knowledge through lectures, discussions, questions and answers, and one-on-one consultations. Data were gathered through questionnaires and observation. The project’s data were analyzed about planned target objectives. All data were analyzed by using descriptive statistics comprising frequencies and percentages. This was done to examine participants’ knowledge of occupational health hazards and mitigating measures. The study found that HCWs in Shinyanga are at higher risk of being exposed to health risk factors due to insufficient and uneven provision of personal protective equipment. In addition, poor hospital waste management and disposal might accelerate needle-stick injuries by that Hepatitis B, Hepatitis C, and HIV to mention a few are spread from patients to HCWs. Moreover, the reporting on OHHs and new infections was too low. HCWs are the potential for national development and are well educated but not protected to play their roles effectively to constitute national economic development. Some HWCs including health facility in-charge, heads of departments, and specialists are more exposed to health risk factors than others due to overworking. Besides, the study found that the knowledge of HCWs on health risk factors is too low. This calls for external health development stakeholders to intervene in improving safety, health, and well-being.
Practices and barriers to healthcare worker compliance with guidelines preventing nosocomial infections among severely acutely malnourished children at a national referral hospital nutrition unit in Uganda
(Adventist University of Africa, 2023-05) Asiimwe Kyoma Lydia
Globally, malnutrition is a rapidly growing public health concern that is associated with high costs of healthcare and increased mortality. Undernutrition is associated with an overwhelming percentage of child deaths aged 5 years and below. The stakes are even higher when it comes to Severely acutely malnourished children. The condition is further complicated by nosocomial infection attacks hence increasing the risk of death. Nosocomial infections are common occurrence in facilities in Sub-Saharan Africa like Uganda and prevention measures and guidelines have been put in place for them. Nonetheless, nosocomial infections continue to be a difficulty in the management of severe acute malnutrition. There remains scanty information on the practices and barriers to the prevention of Nosocomial Infections among severely acutely malnourished children in Ugandan nutrition rehabilitation units. While there are standard recommendations on practices, the prevalence of nosocomial infections remains a concern. This study, therefore, looked into which practices are employed in the nutrition unit. How well and consistently the practices are carried out since poor execution and lapse in behaviour create a gap that hinders the success of nosocomial infection control. For this study 18 eligible healthcare workers employed by the nutrition unit were recruited to participate in this study as respondents since they interact with patients daily and are custodians of patients’ health. Informed consent was obtained from all participants before responding to any questions on the interview protocol. Additional information was obtained by observation with the guidance of an observation checklist. Document analysis of the IMAM and MIYCAN guidelines was carried out and the findings added to those of interviews and observation. Interview data and document analysis data were analyzed using the interactive model of data analysis. While observation data were analyzed using attached numeric scores that are interpreted on a Likert scale. The themes developed that informed the results and implications of the study were proper use of personal protective equipment, proper hygiene, health education, presence of environmental cues and routine surveillance were the practices mentioned. The themes under predisposing factors were skills gap, and poor knowledge while themes under barriers to a nosocomial-free hospital stay were limited financial and human resources as well as infrastructural setup. Results of the study indicate that despite some prevention practices being known, they are neither practised well nor consistently in the cases were they are well done and therefore are not effective. There is a lot of room for improvement. Practices such as cohorting patients according to arrival, giving systemic antibiotics to all patients and an active surveillance system are important prevention practices that were not mentioned and respondents. Recommendations following the finding of the study are for caretakers to heed advice and guidance offered during health education and to ask for help when needed to bridge the knowledge and skills gap. Healthcare workers carry out routine health education for patients and caretakers while on the ward and acquaint themselves with the guidelines used by the nutrition unit. Hospital authorities to avail appropriate environmental cues, ensure reliable access to supplies used in infection prevention, and offer training and retaining of health care workers on Infection prevent Control measures. To carry out IPC audits and put in place surveillance systems to monitor occurrence, actions taken and the prevalence of NIs. For future research, interventions and investigations of IPC behaviour change with a focus on consistence is ideal. Planning interventions in key areas such as hand washing and health education. Future surveillance studies through laboratory investigations to find out the prevalence of NIs among SAM children in nutrition units around Uganda.
Prevalence and determinants of tobacco smoking among college students in Bobo-Dioulasso, Burkina Faso
(Adventist University of Africa, 2025-05) Kambou, Marcellin Ollo
Globally, tobacco consumption represents a critical threat to public health, contributing to a range of preventable diseases (WHO). In Burkina Faso, as many nations with limited economic resources, tobacco use among young people, particularly college students, is an emerging issue with serious implications for public health (STEPS). This research seeks to examine the rate of tobacco use and explore the key factors influencing smoking behavior among college students in Bobo-Dioulasso, Burkina Faso. By examining the factors related with the uptake of tobacco in this population, the study seeks to provide insights that could inform targeted health interventions. A survey was conducted among students enrolled in four higher education institutions in Bobo-Dioulasso. Authorization was granted by the schools and from respondents themselves to conduct the study. To ensure representativeness, a stratified random sampling technique was utilized to recruit participants, and data collection was conducted using self-completed questionnaires, by a total of 387 college students, which gathered information on family and environmental influence, demographic factors, and potential determinants such as peer influence, and exposure to tobacco advertising. Descriptive statistics, chi-square tests, and logistic regression were employed to analyze the collected data. The findings revealed a smoking prevalence of 6.2% among college students in Bobo-Dioulasso, with boys smoking more than girls, suggesting the situation is alarming. Factors such as peer pressure and living with smoker in a family were identified as key factors influencing smoking behavior among college students. Tobacco smoking among college students in Bobo-Dioulasso represents a growing public health challenge. The findings underscore the importance of implementing targeted interventions that focus on the specific factors identified in the study, such as peer influence and family influence. Comprehensive tobacco control strategies, including education campaigns and policy implementation, are essential to reduce smoking prevalence and its associated health risks in this population.
Prevalence of Hypertension and Associated Risks Among Gospel Workers of the Seventh-Day Adventist Church in Northern Ghana Union Mission
(Adventist University of Africa, School of Postgraduate studies, 2017-04) Amponsem-Boateng, Cecilia
This study was conducted on 200 gospel workers who were mainly Seventhday Adventists from the South Central, Ashanti South, Ashanti Central and the Central Ghana Conferences of Ghana, as means of addressing hypertension and its associated risks. It had a broad objective of determining the prevalence of hypertension and its associated risks, among Gospel workers of the Northern Ghana Union Mission (NOGH) of the Seventh-day Adventist Church, and specific objectives of firstly determining the level of knowledge on hypertension among them; secondly to identify the nature of management of hypertension among gospel workers; and lastly, to determine the risk factors associated with hypertension among the gospel workers. The study adopted the mixed method approach by using a combination of cross-sectional, descriptive and non-experimental survey design. Data was collected by using both quantitative and qualitative approaches. These were questionnaires,interviews, documentary analysis and field survey. The questionnaires which contributed the larger part were analyzed by using SPSS, while interviews response were interpreted as the respondents meant them. The results of the study discovered that the majority of the gospel workers had adequate knowledge about the causes and symptoms of hypertensive disease. Regardless of this high knowledge, there was a high prevalence rate (38%) of hypertension. Though some gospel workers claimed they were aware of being hypertensive and had adopted various anti-hypertension management and prevention measures, there was still a poor health behavior and lifestyle among the gospel workers leading to the prevalence of hypertension. It was therefore concluded that, in the case of Gospel workers such as pastors, elders of churches and church financial officers where most activities are taken to be more spiritual in nature, less attention is typically paid to the prevention and management of lifestyle/medical conditions like hypertension. Based on the findings of the study and the conclusions, it is recommended that various measures, such as effective nutrition/health education on topics such as Myplate guidelines, as well as enlightenment on the causes and symptoms of hypertension, will be a step toward the reduction in the prevalence of hypertension. General improvement of the lifestyle and health behavior of gospel workers such as engaging in good dieting system, exercising regularly, and having enough rest. Part of a good prevention intervention would also include visiting the hospitals, clinics, and other health centers regularly to assess health status. Of course, it is also vital to report cases of hypertension to the health centers as another method to manage and prevent the prevalence of hypertension.
Prevalence of Hypertension and Associated Risks among Gospel Workers of the Seventh-day Adventist Church in Northern Ghana Union Mission
(Adventist University of Africa, 2017-04) Amponsem-Boateng, Cecilia
This study was conducted on 200 gospel workers who were mainly Seventh-day Adventists from the South Central, Ashanti South, Ashanti Central and the Central Ghana Conferences of Ghana, as means of addressing hypertension and its associated risks. It had a broad objective of determining the prevalence of hypertension and its associated risks, among Gospel workers of the Northern Ghana Union Mission (NOGH) of the Seventh-day Adventist Church, and specific objectives of firstly determining the level of knowledge on hypertension among them; secondly to identify the nature of management of hypertension among gospel workers; and lastly, to determine the risk factors associated with hypertension among the gospel workers. The study adopted the mixed method approach by using a combination of cross-sectional, descriptive and non-experimental survey design. Data was collected by using both quantitative and qualitative approaches. These were questionnaires, interviews, documentary analysis and field survey. The questionnaires which contributed the larger part were analyzed by using SPSS, while interviews response were interpreted as the respondents meant them. The results of the study discovered that the majority of the gospel workers had adequate knowledge about the causes and symptoms of hypertensive disease. Regardless of this high knowledge, there was a high prevalence rate (38%) of hypertension. Though some gospel workers claimed they were aware of being hypertensive and had adopted various anti-hypertension management and prevention measures, there was still a poor health behavior and lifestyle among the gospel workers leading to the prevalence of hypertension. It was therefore concluded that, in the case of Gospel workers such as pastors, elders of churches and church financial officers where most activities are taken to be more spiritual in nature, less attention is typically paid to the prevention and management of lifestyle/medical conditions like hypertension. Based on the findings of the study and the conclusions, it is recommended that various measures, such as effective nutrition/health education on topics such as My-plate guidelines, as well as enlightenment on the causes and symptoms of hypertension, will be a step toward the reduction in the prevalence of hypertension. General improvement of the lifestyle and health behavior of gospel workers such as engaging in good dieting system, exercising regularly, and having enough rest. Part of a good prevention intervention would also include visiting the hospitals, clinics, and other health centers regularly to assess health status. Of course, it is also vital to report cases of hypertension to the health centers as another method to manage and prevent the prevalence of hypertension.

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