BackgroundA community-based malaria intervention was introduced through fixed and mobile clinics in rural Myanmar. This study attempted to identify treatment-seeking behaviour of caregivers for children under five and the determinants of appropriate treatment-seeking behaviour in mobile clinic villages (MV) and non-mobile clinic villages (NMV) in malaria-endemic rural areas in Myanmar.MethodsA cross-sectional study was conducted in 23 MV and 25 NMV in Ingapu Township, Myanmar. Appropriate treatment-seeking behaviour was operationally defined as seeking treatment from trained personnel or at a health facility within 24 hours after the onset of fever. Multiple logistic regression analyses were conducted to identify the determinants of appropriate treatment-seeking behaviour.ResultsAmong the 597 participants in both types of villages, 166 (35.3%) caregivers sought appropriate treatment. No significant difference in appropriate treatment-seeking behaviour was found between the two types of villages (adjusted odds ratio (AOR), 0.80; 95% confidence interval (CI), 0.51-1.24). Determinants of behaviour include proximity to public health facilities (AOR, 5.86; 95% CI, 3.43-10.02), knowledge of malaria (AOR, 1.90; 95% CI, 1.14-3.17), malaria prevention behaviour (AOR, 1.76; 95% CI, 1.13-2.76), treatment at home (AOR, 0.26; 95% CI, 0.15-0.45), and treatment and transportation costs (AOR, 0.52; 95% CI, 0.33-0.83).ConclusionsCaregivers’ treatment-seeking behaviour was poor for fever cases among children under age five, and did not differ significantly between MV and NMV. It is necessary to educate caregivers, particularly for early treatment seeking and appropriate use of health care options for fever, and catering to their medical needs. These findings can help promote awareness and prevention, and improve the quality of interventions at the community level.

To clarify mechanisms linking deforestation, anopheline ecology, and malaria epidemiology, this study draws together 60 examples of changes in anopheline ecology and malaria incidence as a consequence of deforestation and agricultural development. The deforestation projects were classified based on subsequent land use and were reviewed in terms of their impact on anopheline density and malaria incidence. To further examine different anopheline responses to land transformation, two major ecological characteristics of 31 anopheline species were tested for their associations with changes in their densities and malaria incidence. Although niche width of anopheline species was not associated with density changes, sun preference was significantly associated with an increase in density. This study suggests the possibility of predicting potential impacts of future deforestation on vector density by using information on types of planned agricultural development and the ecology of local anopheline species.

BackgroundSlow progress has been made in achieving the Millennium Development Goals 4 and 5 in Ghana. Ensuring continuum of care (at least four antenatal visits; skilled birth attendance; postnatal care within 48 hours, at two weeks, and six weeks) for mother and newborn is crucial in helping Ghana achieve these goals and beyond. This study examined the levels and factors associated with continuum of care (CoC) completion among Ghanaian women aged 15–49.MethodsA retrospective cross-sectional survey was conducted among women who experienced live births between January 2011 and April 2013 in three regions of Ghana. In a two-stage random sampling method, 1,500 women with infants were selected and interviewed about maternal and newborn service usage in line with CoC. Multiple logistic regression models were used to assess factors associated with CoC completion.ResultsOnly 8.0% had CoC completion; the greatest gap and contributor to the low CoC was detected between delivery and postnatal care within 48 hours postpartum. About 95% of women had a minimum of four antenatal visits and postnatal care at six weeks postpartum. A total of 75% had skilled assisted delivery and 25% received postnatal care within 48 hours. Factors associated with CoC completion at 95% CI were geographical location (OR = 0.35, CI 0.13–0.39), marital status (OR = 0.45; CI 0.22–0.95), education (OR = 2.71; CI 1.11–6.57), transportation (OR = 1.97; CI 1.07–3.62), and beliefs about childhood illnesses (OR = 0.34; CI0.21–0.61).ConclusionThe continuum of care completion rate is low in the study site. Efforts should focus on increasing postnatal care within 48 hours and overcoming the known obstacles to increasing the continuum of care completion rate.

BackgroundEvidence is available on the potential efficacy of interprofessional education (IPE) to foster interprofessional cooperation, improve professional satisfaction, and improve patient care. While the intention of the World Health Organization (WHO) is to implement IPE in all countries, evidence comes from developed countries about its efficiency, challenges, and barriers to planning and implementing IPE. We therefore conducted this review to examine challenges of implementing IPE to suggest possible pathways to overcome the anticipated challenges in developing countries.MethodsWe searched for literatures on IPE in PubMed/MEDLINE, CINAHL, PsycINFO, and ERIC databases. We examined challenges or barriers and initiatives to overcome them so as to suggest methods to solve the anticipated challenges in developing countries. We could not conduct a meta-analysis because of the qualitative nature of the research question and the data; instead we conducted a meta-narrative of evidence.ResultsA total of 40 out of 2,146 articles were eligible for analyses in the current review. Only two articles were available from developing countries. Despite the known benefits of IPE, a total of ten challenges or barriers were common based on the retrieved evidence. They included curriculum, leadership, resources, stereotypes and attitudes, variety of students, IPE concept, teaching, enthusiasm, professional jargons, and accreditation. Out of ten, three had already been reported in developing countries: IPE curriculum, resource limitations, and stereotypes.ConclusionThis study found ten important challenges on implementing IPE. They are curriculum, leadership, resources, stereotypes, students' diversity, IPE concept, teaching, enthusiasm, professional jargons, and accreditation. Although only three of them are already experienced in developing countries, the remaining seven are potentially important for developing countries, too. By knowing these challenges and barriers in advance, those who implement IPE programs in developing countries will be much more prepared, and can enhance the program's potential success.

BackgroundIn many developing countries, intimate partner violence (IPV) training is not available for health providers. As a pioneer among developing countries, in 2009, the Sri Lankan Ministry of Health trained a group of community health providers known as public health midwives (PHMs) on IPV. We evaluated that training program’s efficacy in improving PHMs’ identification and management of IPV sufferers in Kandy, Sri Lanka.MethodsWe conducted this study from August 2009 to September 2010. We used a self-administered structured questionnaire to examine the following variables among 408 PHMs: self-reported IPV practices, IPV knowledge, perceived barriers, perceived responsibility, and self-confidence in identifying and assisting IPV sufferers. We used McNemar’s test to compare PHMs’ pre- and post-intervention IPV practices. Using the Wilcoxon signed-rank test, we compared PHMs’ pre-and post-intervention IPV knowledge, as well as their perceived barriers, responsibility, and self-confidence scores.ResultsThe IPV training program improved PHMs’ IPV practices significantly. Six months after the intervention, 98.5% (n = 402) of the 408 PHMs identified at least one IPV sufferer in the previous three months, compared to 73.3% (n = 299) in the pre-intervention (p < 0.001). At post-intervention, 96.5% (n = 387) of the PHMs discussed IPV with identified sufferers and suggested solutions; only 67.3% (n = 201) did so at the pre-intervention (p < 0.001). In addition, after the intervention, there were significant increases (p < 0.001) in the median total scores of PHMs’ IPV knowledge (0.62 vs. 0.88), perceived responsibility (3.20 vs. 4.60), and self-confidence (1.81 vs. 2.75). PHMs’ perceived barriers decreased from 2.43 to 1.14 (p < 0.001).ConclusionsAn IPV training program for PHMs improved identification and assistance of IPV sufferers in Kandy, Sri Lanka. This training program has the potential to improve PHMs’ skills in preventing IPV and supporting sufferers in other regions of Sri Lanka. Other developing countries might learn lessons from Sri Lanka’s IPV training.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1674-9) contains supplementary material, which is available to authorized users.