OBJECTIVE: The aim of this study is to assess the prevalence and determinants of folic acid supplementation among women referred to community health centers. METHODS: This was a cross-sectional study conducted in 325 women referred to community health centers. The subjects were selected from 8 community health centers, using a stratified sampling technique. Data regarding demographics, socioeconomic status, obstetrics, folic acid supplementation status, and household food security status were obtained via questionnaires. The data was analyzed in SPSS v22. RESULTS: The prevalence of folic acid supplementation both before and during pregnancy was 54.5%. The results of the study showed that folic acid supplementation had a significant positive association with education level (odds ratio [OR],0 .441; 95% confidence interval [CI], 0.199–0.977; P<0.05), being employed (OR, 0.353; 95% CI, 0.148–0.840; P<0.05), and planned pregnancy (OR, 18.113; 95% CI, 7.371–44.51; P<0.001). However, other variables, including age, husband's age, husband's education and employment status, the number of prior pregnancies, economic satisfaction, and household food security, were nonsignificant factors affecting folic acid supplementation. CONCLUSION: Women with lower socioeconomic status are less likely to take folic acid supplements, and more effort should be made to increase their awareness of the importance of supplementation. Unplanned pregnancy is another strong risk factor for not supplementing with folic acid, and thus should be avoided.
Community Health Centers ; Contraception ; Cross-Sectional Studies ; Demography ; Education ; Employment ; Family Characteristics ; Family Planning Services ; Female ; Folic Acid ; Food Supply ; Humans ; Obstetrics ; Pregnancy ; Pregnancy, Unplanned ; Prevalence ; Referral and Consultation ; Risk Factors ; Social Class

Objective: To assess the capacity of prevention and control on chronic non- communicable diseases (NCDs) in China. Methods: On-line questionnaire survey was adopted by 3 395 CDCs at provincial, municipal and county (district) levels and 3 000 primary health care units, and assess on capacity of policy, infrastructure, capacity of training and guidance, cooperation, surveillance, intervention and management, assessment and scientific research from September 2014 to March 2015. Results: (1) Capacity of policy: 23 (71.9%) provincial, 139 (40.6%) municipal and 919 (31.2%) county (district) governments or health administrative departments had existing plans for prevention and control of NCDs. (2) Capacity of infrastructure: 25 (78.1%) provincial, 136 (39.8%) municipal and 529 (18.0%) county (district) CDCs had set up departments dedicated to the prevention and control of NCDs, with 9 787 staff members, accounting for 5.0% of the total CDC personnel, working on NCDs prevention and control programs. 68.1% of the CDCs had special funding set for NCDs prevention and control. (3) Capacity of training and guidance: 2 485 CDCs (74.9%) held all kinds of training on prevention and control of NCDs. 2 571 (87.3%) CDCs at the county (district) level provided technical guidance for primary health care units. (4) Capacity of cooperation: 42.0% of the CDCs had experiences collaborating with the mass media. (5) Capacity of surveillance: 73.8% of the CDCs had set up programs for death registration while less than 50.0% of the CDCs had implemented surveillance programs on major NCDs and related risk factors. In terms of primary health care units, 32.4% of them had set up reporting system for newly developed stroke case and 29.9% of them having programs on myocardial infarction case reporting. (6) Capacity of intervention and management: 69.1% and 68.2% of the CDCs conducted individualized intervention programs on hypertension and diabetes, while less than 40.0% CDCs conducting intervention programs on other NCDs and risk factors. More than 90.0% of the primary health care units carried out follow-up surveys on hypertension and diabetes. However, only 17.4% and 13.7% of the CDCs working on hypertension and diabetes patient management programs while 83.7% and 80.4%, of them following the standardized guidelines for management, with successful rates of control as 59.2% and 55.2%, respectively. (7) Capacity of assessment: 32.4% of the CDCs or health administrations carried out evaluation programs related to the responses on NCDs. (8) Capacity of scientific research: the capacity on scientific research among provincial CDCs was apparently higher than that at the municipal or county (district) CDCs. Conclusions: Compared with the results of previous two surveys, the capacity on policies set for the prevention and control programs improved continuously, at all level NCDs, but remained relatively weak, especially at both county (district) and primary health care units.
China ; Chronic Disease/prevention & control* ; Community Health Services/organization & administration* ; Health Planning Organizations/organization & administration* ; Humans ; Noncommunicable Diseases/prevention & control* ; Public Health ; Risk Factors ; Surveys and Questionnaires ; Workforce

PURPOSE: We examined the effects of a community outreach program for maternal health in Tigray, Ethiopia, on women's knowledge about pregnancy, childbirth, postpartum care, and family planning, and assessed their participation in antenatal care, postpartum checkups, institutional childbirth, and contraceptive use. METHODS: We recruited Ethiopian women of reproductive age (15 to 49 years) in Tigray, Ethiopia. Two villages in Tigray, Kihen and Mesanu, which have similar population sizes and living environments, were chosen as the intervention and comparison groups, respectively. A two-group pretest-posttest design with cluster sampling was employed. We conducted self-report questionnaire surveys using face-to-face interviews. The 2.5-year community outreach program was developed based on Rogers' diffusion of innovation theory. It consisted of mass media use and health education for lay women in the community, along with training of health care providers, including nurses, midwives, and health extension workers, in maternal health care. RESULTS: The intervention group showed significant increases in knowledge and behaviors regarding maternal health and family planning compared to the comparison group (p < .001). In particular, there was a dramatic increase from 10.8% to 93.5% in the institutional birth rate in the intervention group. CONCLUSION: The community outreach program and health care professional training effectively improved knowledge and behaviors regarding maternal health in Ethiopian women. Mass media and interpersonal communication channels for health education may be useful health interventions in developing countries.
Birth Rate ; Community-Institutional Relations* ; Delivery of Health Care ; Developing Countries ; Diffusion of Innovation ; Ethiopia* ; Family Planning Services* ; Female ; Health Education ; Health Personnel ; Humans ; Mass Media ; Maternal Health* ; Midwifery ; Parturition ; Population Density ; Postnatal Care ; Pregnancy

The World Health Organization (WHO) have been in collaborative efforts with the Republic of Korea in keeping of and for better health for all for the past decades. From the control of parasites to building of community health system in rural places, the works has now resulted in healthier Korea than ever, and has transformed the role of engaging as the world leader in contribution of health and development. Seventy years of independence, war, and poverty, transforming from a recipient country of official development assistance to a significant donor to the global society, we have emphasized the importance of international cooperation and the role of WHO in the past years in Korea and neighboring countries. Looking back of the past is meaningful to diagnose the present problems, and to foresee the future of our world.
Community Health Planning ; Global Health* ; Humans ; International Cooperation ; Korea ; Parasites ; Poverty ; Public Health ; Publications* ; Republic of Korea* ; Tissue Donors ; World Health Organization*

BACKGROUND: Smoking increases the risk of diabetic complications, but the prevalence of smoking in diabetes is similar to non-diabetes. We aimed to investigate factors associated with smoking cessation intentions (SCI) in current smokers with diabetes. METHODS: In the 2013 Community Health Survey, information about current smokers has been collected among people who are over 30 years old with diabetes. Chi-squared test and logistic regression analysis were used to examine the association between socio-demographic indicators, health behaviors, comorbidities, smoking-related factors, diabetes-related factors and SCI. A total of 3,511 current smokers with diabetes were included in the final analysis. RESULTS: Among current smokers with diabetes, 13.4% reported having SCI (within six months). In multivariate logistic regression analysis, gender, education, marital status and occupation were found to be significantly related to SCI. Moreover, lower amounts of smoking, previous attempts to smoking cessation (odds ratio [OR] 3.66, 95% confidence interval [CI] 2.94–4.56), experience of smoking cessation recommendations from acquaintances (OR 1.87, 95% CI 1.38–2.52), experience of smoking cessation education (OR 1.57, 95% CI 1.12–2.20), and experience of diabetic education (OR 1.33, 95% CI 1.06–1.66) were significantly associated with SCI in current smokers with diabetes. CONCLUSION: In order to lower the smoking rate of community-dwelling adults with diabetes, effective anti-smoking interventions are needed, taking into account SCI-related factors, including smoking cessation education and diabetes education.
Adult ; Community Health Planning ; Comorbidity ; Diabetes Complications ; Diabetes Mellitus ; Education ; Friends ; Health Behavior ; Health Surveys* ; Humans ; Intention* ; Korea* ; Logistic Models ; Marital Status ; Occupations ; Prevalence ; Smoke* ; Smoking Cessation* ; Smoking*

PURPOSE: This study was conducted to evaluate the association between AR and mental health status in the general Korean adult population and to investigate the relative burden of AR on mental health using the Allergic Rhinitis and Its Impact on Asthma (ARIA) classification. METHODS: A cross-sectional study was performed by using data from 11,154 individuals, 19 years old or older in the Korean National Health and Nutrition Examination Survey 2011-2012. Univariate analysis was conducted in the healthy AR groups with weighted prevalence of demographic characteristics, socioeconomic status, and comorbid diseases. Subanalysis that classified AR severity according to the ARIA classification was carried out to evaluate the relationship of AR severity with mental health. The odds ratios (ORs) for each component representing mental health status were estimated by multiple logistic regression analysis with confounder adjustment. RESULTS: Univariate analysis with the chi-square test after adjustment for age, sex, body mass index, smoking status, alcohol use status, and exercise status, components representing mental health status showed a linear relationship with the severity of AR according to the ARIA classification. Stress, depressive mood, suicidal thoughts, and psychological consultation factors were correlated with AR after adjustment for demographic characteristics and socioeconomic status. Even after adjustment for comorbid allergic diseases, the correlation remained significant with stress, depressive mood, and psychological consultation factors (OR [95% CI]; 1.227 [1.042, 1.445], 1.368 [1.095, 1.71], 1.804 [1.096, 2.969], respectively). CONCLUSIONS: Patients with AR appear to be at higher risk of mental disorders in the general Korean adult population. Moreover, persistent or severe AR was correlated with poor mental health. Therefore, better control of AR may be conducive to better mental health, and more attention should be paid to the psychological status of AR patients.
Adult* ; Asthma ; Body Mass Index ; Classification ; Community Health Planning ; Cross-Sectional Studies ; Humans ; Logistic Models ; Mental Disorders ; Mental Health* ; Nutrition Surveys ; Odds Ratio ; Prevalence ; Rhinitis* ; Smoke ; Smoking ; Social Class

OBJECTIVES: The objective of the present study was to identify the factors that affect screening for diabetic complications by sex in the community. METHODS: This study used individual-level data from the 2013 Community Health Survey (CHS) for 20,806 (male, 9,958; female, 10,848) adults aged 30 years or older who were diagnosed with diabetes. Community-level data for 253 communities were derived from either CHS or national statistics. A chi-square test and multilevel logistic regression analysis was performed. RESULTS: There were significant differences in the rate of screening for diabetic complications according to individual-level and community-level variables. In the multilevel analysis, the community-level variance ratio of the null model was 7.4% and 9.2% for males and females, respectively. With regard to community-level variables, males were affected by the city type, number of physicians, and their living environment, while females were affected by number of physicians, natural and living environments, and public transportation. CONCLUSIONS: The factors that influenced individual willingness to undergo screening for diabetic complications differed slightly by sex; however, both males and females were more likely to undergo screening when they recognized their health status as poor or when they actively sought to manage their health conditions. Moreover, in terms of community-level variables, both males and females were affected by the number of physicians. It is essential to provide sufficient and ongoing opportunities for education on diabetes and its management through collaboration with local communities and primary care medical centers.
Adult ; Community Health Planning ; Cooperative Behavior ; Diabetes Complications* ; Education ; Female ; Health Surveys ; Humans ; Logistic Models ; Male ; Mass Screening* ; Multilevel Analysis* ; Primary Health Care ; Transportation

The importance of public healthcare system has been widely recognized since the current Middle East respiratory syndrome epidemic began. However, their capacities are not sufficient in both quantitative and qualitative perspective aspects. When a large-scale outbreak develops, public hospitals and community health centers should be primarily responsible for treatment of patients and isolation of individuals who are likely to infect other people, with the supplemented of private hospitals. Clearly, the central and municipal governments, and public healthcare system has failed to deal with the current Middle East respiratory syndrome epidemic, largely due to lack of expertise and professional staff. The governments at various levels and public hospitals should thoroughly and publicly review the work process and problems revealed in dealing with the current epidemic. Based on such evaluation, they should establish action plans for infectious disease control, and regular training and exercise should be done according to them. In addition, more public hospitals should be established under the regional health planning. It is important for public heathcare facilities to hire physicians on a stable and long-term employment contract, and to train them so that they could play a role in case of epidemic.
Communicable Diseases* ; Community Health Centers ; Delivery of Health Care* ; Employment ; Hospitals, Private ; Hospitals, Public ; Humans ; Middle East ; Regional Health Planning

Chronic Disease ; Communicable Diseases ; Community Health Planning ; Humans

PURPOSE: The objective of this study was to investigate the relationship between fatigue, sleep disturbance, and gestational stress in women during late stage of pregnancy. METHODS: This study was conducted with 113 healthy pregnant women at gestational age greater than 27 weeks who were registered at community health centers and received prenatal care. A structured questionnaire regarding fatigue, sleep disturbance, and gestational stress was used. The data was analyzed using a t-test, an ANOVA, and Pearson correlation coefficients. RESULTS: The subjects with unplanned pregnancies and irregular exercise patterns showed a higher level of fatigue than those with planned pregnancies and regular exercise patterns. Pregnant women with caffeine intake manifested higher levels of gestational stress and sleep disturbance than those without. The levels of sleep disturbance and gestational stress increased as the fatigue levels increased. The fatigue levels increased with increased levels of sleep disturbance. CONCLUSION: Planned pregnancy, regular exercise patterns, and caffeine intake were related with fatigue, sleep disturbance, and gestational stress in women during late stages of pregnancy. Fatigue, sleep disturbance, and gestational stress had close associations to each other. In the future, such results should guide development of nursing intervention programs for women in late stages of pregnancy.
Caffeine ; Community Health Centers ; Family Planning Services ; Fatigue* ; Female ; Gestational Age ; Humans ; Nursing ; Pregnancy ; Pregnancy, Unplanned ; Pregnant Women* ; Prenatal Care ; Surveys and Questionnaires ; Sleep Wake Disorders