This paper reports the results of formative and outcome evaluation of two ongoing community-based intervention programmes for integrated non-communicable disease (NCD) prevention and control in urban low-income settings of Ballabgarh near New Delhi, India, and in Depok, West Java Province of Indonesia. At both sites, a coalition of community members facilitated by academic institution and the World Health Organization, planned and implemented the intervention since 2004. The intervention consisted of advocacy and mediation with stakeholders, training of volunteers and school teachers, communication campaigns, risk assessment camps and reorientation of health services. The formative evaluation was based on the review of documents, and outcomes were assessed using the standardized surveys for NCD risk factors in 2003-2004 and 2006-2007. The baseline surveys showed that tobacco use, low intake of fruits and vegetable, suboptimal levels of physical activity and obesity were prevalent in both the communities. A frequent change in local administrators and lack of perceived priority for health and NCDs limited their involvement. Pre-existing engagement of community-based organizations and volunteers in health activities facilitated its implementation. The reach of the programme among the population was modest (25-32%). Health system interventions resulted in increased diagnosis and better management of NCDs at health facilities. Early outcome measures showed mixed results of change in different risk factors. The experiences gained are being used in both countries to expand and provide technical support to national efforts. This paper adds to the knowledge base on the feasibility of designing and implementing large-scale community-based interventions for integrated prevention of NCDs through modification of risk factors.
The occurrence of diarrhea in children under five years old (toddlers) is still a serious health problem because it can cause mortality and malnutrition in children. Diarrhea is one of the biggest causes of death in toddlers in the world. Data from the World Health Organization (WHO) reports that more than 10 million children under five years old die every year and around 20 percent of them die because of diarrhea. One etiology of diarrhea infection in children under five years old who often escapes attention is diarrhea caused by parasites. As a developing and tropical country, the incidence of diarrhea due to parasitic infections in Indonesia is quite high. Examination of diarrhea samples in children under five years old to identify the type of parasites that play a role in the incidence of diarrhea. Stool samples were collected from patients seeking treatment at several primary health care and hospitals in Jakarta, Banjarmasin and Makassar during 2015-2016. The stool specimens were collected in containers containing formaldehyde for microscopic examination. Blastocystis hominis was found to be the most prevalent parasite with an infection rate of 12.46% followed by Entamoeba coli 1.73%, Ascaris lumbrichoides 0.35%, Oxiuris vermicularis 0.35%, Endolomax nana 0.35%, and Hookworm (Ancylostoma sp and Necator americanus) 0.35%. Parasitic diarrhea increases susceptibility to other infections, should not be neglected, particularly in patients with chronic diarrhea. Accurate diagnosis decreases morbidity and mortality in patients with parasite infection.
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