Scientific Program

Day 1 :

  • Healthcare and Primary Care
Speaker
Biography:

Hiroshi Bando is a Physician with specialties in “primary care medicine, diabetes, life style-related disease and psychosomatic medicine”. He has more than 2000 Japanese publication articles, 30 books, 150 English medical publications, 800 lectures. He was the chairman of Annual Congress of 8th Japanese Primary Care Association (2017) and Editor of several medical journals on diabetes, endocrinology and metabolism. He has been the chairman of Shikoku Island division of Integrative Medicine Japan and was the chairman of annual Congress of 9th Japanese Music Therapy Association (2009). He is also a pianist and won the silver prize in 3rd European International Piano Concours in Japan (EIPIC) (2012). Furthermore, he has been an athlete in baseball, speed skating and athletics, and can run 100m for 13 seconds for half century. Thus, he continues to control the body and mind, which may become the reference for primary care medicine. 

 

Abstract:

In the 1960s, there was some dissatisfaction for the medical situation. They included increased depersonalization of medicine and fragmentation of care. Millis Report of 1966 was presented the recommendation for new medical system, which focuses not upon individual organs and systems but upon the whole man. After that, primary care medicine and family medicine were developed. On the other hand, in Japan, we have had a most respectable and well-known physician, Dr. Shigeaki HINOHARA (1911-2017). He had been working in St. Luke’s International Hospital, Tokyo, and been abroad in US. Then he came to know Sir Osler / Oslerism, and modern medicine at that time. After coming back Japan, he has changed the medicine in Japan. He has firstly introduced and developed in Japan, such as primary care medicine, annual medical checkups, health education system for many people, problem-oriented system (POS) for medical chart, education system for nurse and co-medicals, life style related disease, music therapy, New Elderly Association (NEA) movement and so on. Consequently, he has been called “The Father of Primary Care” and “The Father of Music therapy”. He lived up to 105 years with continuous activity, and his remarkable achievements have still lead many people. The author has majored in primary care medicine, music therapy, psychosomatic medicine, sports medicine, life style related disease and developed these activities with Dr. Hinohara for long. Recently, we have broaden Oslerism and Hinohara-ism through NEA and other opportunities. The author has been 1) physician, 2) pianist, 3) athlete, 4) essayist with more than 40 books and 2000 publications. In the key note speech, a variety of contents would be presented such as primary care, music therapy, anti-aging medicine, low carbohydrate diet (LCD), sports activities and others for the beneficial and positive effects for healthier body/soul/mind/spirit. 

Speaker
Biography:

Abstract:

Hospice is a model of care that offers significant benefits to patients at the end of their lives, their families, and also to the primary care physicians (PCPs) who have diligently cared for their patients.  As comprehensive care physicians, PCPs can benefit from a strong understanding of hospice and palliative care.  Participants will understand the clinical appropriateness of a hospice patient to ensure a timely referral.  They will understand the relationship between the primary care physician and the hospice provider to ensure collaboration in care of hospice patients.  Finally they will understand how they can reimbursed for the services as they continue to care for patients on hospice.

 

Biography:

Demet Karadenizli, MD has her expertise and passion through health and wellness. Her COMPACTLY SRUCTURED Health Screening model allows a comprehensive systematic patient oriented and evidence based evaluation of the current medical status which gives a chance for executing all the diagnosis and risk factors simultaneously for each and every patient. She has built this model after eleven years of experience with four hospital implementations. Her previous background composed of teaching clinical skills to preclinical students and creating a geriatrics curriculum in a non-geriatrician faculty) as an assistant professor, and ruling a branch for “National study on Assesment of the Nature and Extent of Drug Abuse in Turkey” project; (Project No. AD/TUR/02/G02 UNODC-GAP/Turkey, 2002-2003, ANKARA)  These were the previous multidisciplinary projects she inspired in developing this compact model for health screening. This approach has approved itself with an international patient loyalty and early diagnosis rates which should be the key performance indicators for a comprehensive health screening.

Abstract:

Statement of the Problem: There is lack of a comprehensive algorithym in patient oriented health screening in accordance with an evidence based paradigm. The previous point of view has its own limitations. This approach has stable and flexible parts which allows customization and are all based on but not limited to highest level of evidence. This approach has proved its reliability by international patient loyalty, the early diagnosis rates, and the self, early diagnosis of a breast cancer of the doctor whom held the approach.

C: CUSTOMIZED ( Evidence based customization)

O: ORGANISED (pre and post process organisation scheme)

M: MATRÄ°X (multiple interrelated decision trees)

 P: PATÄ°ENT ORIENTED

A: ADULT

C: COST-EFFECTIVE  (clinically and financially)

T: TIME EFFICIENT (in terms of the process and the disease-free period )

L: LEGAL

Y: YEARLY

S: SYSTEMATÄ°C 

T: TRACKED (allows a patient to be tracked)

R: RESPONSÄ°BÄ°LÄ°TY SHARING (takes place between phisicians and the patient with an informed consent)

U: ULTIMATE ( A very high quality approach proves itself with international patient loyalty and early diagnosis rates for many cancers)

 C: COHERENT (between the other disciplines and the coaching)

T: TRAINING (necessary for everybody in the process)

U: UPWARDS (the patients’ health status moves upwards.)

C: CIRCLE (interrelated circles of sessions)

E: EVIDENCE BASED (relies on the highest evidence)

D: DIAGNOSTIC ACCURACY AND DÄ°VERSÄ°TY (allows concrete and  multiple diagnosis simultaneously)

The main success for COMPACTLY STRUCTURED Health Screening is  international patient loyalty and the early cancer diagnosis rates.

Biography:

Abstract:

Background: Time and again evidence coming on development of multidrug resistant tuberculosis has emphasized focus on drugs, patients, their compliance and lab support. In our study we have tried to incorporate the role of health care providers as well, a major cog in the health system. We assessed their existing knowledge  , capacity building, and execution in terms of programmatic components.

Methods: The study was carried out in TB Sanatorium ITKI, Sadar Hospital Ranchi and RIMS Ranchi. The interview of various health personnel including SAHIYAs was taken using a semi-structured questionnaire based on programmatic management of multi drug resistant tuberculosis guidelines -2016.

Results: Among Doctors knowledge level was good compared to other health personnel which had mean value 7.33 (±2.79), laboratory technician 3.45 (±2.64), STS 4.67 (±1.59), Sahiya 2.1 (±0.73). Regarding capacity enhancement level all health personnel needed refresher trainings in which doctors got 4.67 (±1.58), laboratory technician 3.45±2.64, STS 1.72±0.34, and Sahiya 0.5±0.52. Specially sahiya needs training regarding MDR-TB because they are the connecting link between health system and community. Regarding execution level, Doctors got 1.86 (±0.74), laboratory technician 1.64 (±0.56), STS 1.64 (±0.56) and Sahiya (ASHA) 2.2 (±0.44). Sahiya were better than other health personnel at execution level.

Conclusions: Advocacy, communication, and social mobilization are important aspects of TB control, Policy makers and administrators should be sensitized for need of adequate and sustained funding for TB control to ensure quality capacity building. They need to provide continuous and quality training of staff at different levels and retention of trained staff and periodic reviews to identify gaps and take corrective steps.

 

Speaker
Biography:

Josephine Ozioma Ezekwesili-Ofili is a lecturer and researcher in Pharmacological Biochemistry at the Department of Applied Biochemistry, Nnamdi Azikiwe University, Awka, Nigeria. She has special research interest in ethnomedicine and medicinal plant pharmacology and toxicology. She is also involved in validation of folkloric claims of medicinal plant action. She is a member of the Association of Scientific Investigation, Conservation and Utilization of Medicinal Plants of Nigeria (ASICUMPON) wherein she interacts with traditional healers and professionals with interest in curative and esoteric effects of plants. She is also a member of the Nigerian Fields Society. She has contributed a book chapter on African traditional medicine in herbal medicine.

Abstract:

Statement of the Problem: Primary Health Care (PHC) is provided for individuals within a community with a broad range of services from health promotion and prevention to treatment and management of acute and chronic conditions, especially in rural areas. The principles of PHC include accessibility, affordability and equity.  However, most parts of Africa still face shortage of basic health care. This inequity in health care delivery, coupled with low literacy, low income level and high cost of modern medicine, amongst others, are the major constraints to achieving the WHO mandate of health for all. People, therefore continue to rely on traditional medicine which is based on locally available resources, and cultural knowledge. This work investigated the extent and role of African traditional medicine in primary health care in selected African countries, including Nigeria. Methodology and Theoretical Orientation: The materials and methods used included books, journals, databases, interviews and questionnaires to primary healthcare providers, traditional healers and individuals in different communities. Findings: There was evidence of increased interest in herbal medicine among urban and rural dwellers due to improved scientific knowledge, promotional advertisements and trade fairs. Approaches differed according to region and cultural beliefs. Patronage of herbal medicine did not exclude the use of primary health care services where available, but very chronic illnesses were considered to be better handled by traditional healers. Conclusions and significance: Although Western medicine is generally accepted in Africa and can be accessed by many, it cannot completely replace indigenous health care but exists in tandem with it. Thus African traditional medicine remains central to the lives of many in both rural and urban areas. Due to the increasing popularity of traditional medicine, it is imperative that a healthy collaboration be established between the PHC practitioners and traditional healers, to augment primary health care services.  

  • Physical and Mental Health

Session Introduction

Alejandra Martinez Maldonado

Anahuac University, Mexico

Title: Diabetes Mellitus as a Risk Factor for Dementias
Speaker
Biography:

Alejandra Martínez has her expertise in molecular processes of tau protein in dementias. She stars her scientist formation since she was studying chemistry at UNAM in Mexico. After that, she continues her formation in one of the most prestigious investigation center in México, CINVESTAV, obtaining a PhD in cellular and molecular neurobiology. She is currently a professor at a prestigious university and collaborates with the National Brain Bank at CINVESTAV. The goal of her research is to find therapeutic targets for Alzheimer’s disease and other dementias. She also currently interested in studying the molecular mechanisms involved in mental disorders such as autism, attention deficit disorder, depression and stress. 

Abstract:

Dementia is a complex disorder of multifactorial etiology that results in alterations in health status changes in lifestyle. It is important to identify the risk factors at an early age, to prevent disease. Diabetes mellitus type 2 is the most common type of diabetes in which autoimmune antibodies appear to be the cause. In this type of diabetes, insulin resistance is observed, which limits the ability to respond to hormones, both endogenous and exogenous. In some cases, insulin resistance is a result of a lower number or a mutation of insulin receptors. These receptors are expressed in the central nervous system. When there is insulin resistance as in the case of diabetes mellitus type 2 or there is no insulin production as in the case of diabetes mellitus type 1, the pathways involved in the neuronal function are not activated. Therefore, some proteins involved in neuronal death such as tau, amyloid-ß, and å-synuclein are activated. These proteins will form intracellular and extracellular deposits, which are histopathological features of dementias such as Alzheimer’s Disease and Parkinson Disease. Neuronal death caused by the lack of insulin is one of the reasons why diabetes mellitus is a risk factor for dementia.

  • Public Health and Healthcare Management
Biography:

Abstract:

Objectives: Passive smoking describes the unintended exposure of non-smokers to tobacco smoke and is an important public health problem. In all over the world, 40% of children and 34% of non-smoker adults are exposed to cigarette smoke.  It has long been known that tobacco smoke has a detrimental effect on people who doesn’t smoke. We aimed to evaluate the knowledge of the patients and their relatives about the health problems occurred by passive smoking.

Materials and methods: Our study was applied with the volunteers from patients and their relatives in the outpatient clinics of Smoking Cessation and Chest Diseases. A questionnaire was used to evaluate the demographic characteristics and the knowledge of the patients and relatives about results of passive smoking . The questionnaire included 17 statements that included the definition and results of passive smoking. For participants some options were presented "I agree", ”I disagree“ or "I don’t know".

Results: 520 participants were included in the study. The mean age of the participants was 42,73 ± 15,40, 328 (63,10%) were male and 192 (36,90%) were female. 41,70% of the participants were smokers, 42,50% had never smoked, 15,80% had stopped smoking. Most participants (89,10%) knew the definition of passive smoking. Knowledge was high in some statements like passive smoking relation with heart disease, asthma, lung cancer, bronchitis, pneumonia, cardiovascular diseases and COPD. However, relationship between passive smoking and diabetes mellitus, dementia and sudden infant death were not known well. To the statements of “In infants of smokers, sudden infant death in sleep is more common” (p: 0.037) and “in children of smokers cough, sputum and wheezing are more common” (p: 0.005), agreement of smokers was less than who never smoked and than those who quit smoking. The majority of those who did not agree in the statement “Cough, sputum and wheezing are more common in the children of smokers” were male (p: 0.033).

Conclusion: In our study, the participants had known some of the harmless effects of passive smoking on health. Although the smoke-free airspace policy, which has been implemented for ten years in our country, has increased the public's awareness of the hazards of cigarette smoke; this is not enough. Therefore, people can be protected from the damages of passive smoking with the application of laws and increasing public awareness. Especially parents can take some protective measures for their children by the awareness of all passive smoking hazards.

Biography:

Abstract:

Purpose:

It has been observed an increased of participation of women in the medical profession over several countries worldwide over the past decades. This study aimed at addressing the of health workforce feminization among doctors in Oman and exploring the health system readiness in dealing with this phenomenon.

Methods:

Literature review was conducted to study the global trend of female’s participation in the medical profession. Furthermore, reports and records were reviewed regarding the human resources and gender of the health care workers, specifically the doctors in Oman.

Results:

Findings regarding the medical students showed higher number of females compared to males (64% females in 2015 compared to 54% in 2009). A similar trend was observed in the postgraduate students (61.5% of the graduated residents were females).

As for active workforce, the Ministry of Health statistics revealed that female doctors represent 42% of the total doctors compared to 27% in 1990. It increased 4% from 1990 to 2000, doubled to 8% from 2000 to 2010. The proportion of specialized female doctors reached 31% in 2015 compared to 21% in 1990. There also was gender variation among specialities. The proportion of female General Practitioners reached 50% in 2015 compared to 30% in 1990 (4% increase every five years).

Conclusions:

The feminization phenomenon in Oman requires more attention in order to assess the health system readiness of meeting the needs and accommodating the females' as the main care providers. The trend can have important consequences on future planning, given that women doctors differ from men in how they participate in the workforce. It may also potentially contribute to a shortage in supply due to difference in preferences and consequently affect the skill-mix and productivity. The cultural, social context and dimensions need to be explored; and feasible options to be provided for better planning.

Halil Demir

Istanbul Rumeli University, Turkey

Title: Toxic Leadership in a Public University Hospital
Speaker
Biography:

Halil Demir is a lecturer of Istanbul Rumeli University, Department of Medical Documentation and Secretarial.He has been conducting lessons about Medical Documentation, Administration of Healthcare Facilities, Writing Techniques in Healthcare and Ethics of Healthcare for 2 years. He participated in "Green Growth and Sustainable Development Forum" as a Turkish Delegate in France(Paris) OECD Centre(20-22 November 2017).He took place in several symposiums, conferences and forum about Health Science and Healthcare Management with his papers and oral presentations such as "Global Social Responsibility Levels of The Medical School Students, Attitudes of Health Care Vocational School Students on Patient Privacy, The Effects of Different Attitudes of Health Administrators on Institution Employees”in France, Bulgaria, Kosovo, Bosnia and Herzagovina). Currently, his paper which is entitled  "Social Gender Perceptions of Women Working  in the Healthcare Sector" was accepted by West East Institute for oral presentation at Harvard Faculty Club(Boston, U.S.A.) between 29 June and 02 August 2019.

Abstract:

Some  leadership  styles  have  negative  and  toxic features  such  as  destructive  leadership, authoritarian  leadership,  narcissistic  leadership  and  brute-bullying  leadership.  Toxic leadership  is  defined  as  the  sum  of  the  negative  aspects  of  leadership  which  might  include charisma,  personalized  use  of  power,  narcissism,  negative  life  themes,  and  an  ideology  of hate. This  study  aims  at  contributing  to  the  theoretical  gap  in  Turkish literature  about  destructive leadership.  In this regard, first of  all, the definitions of destructive leadership made by several authors are presented in the literature.  Later, the levels of perception by 200 health workers in a university hospital are investigated using the "Toxic Leadership Scale" and the results of the research  are  analyzed.  Finally,  the  findings  are  discussed  and  evaluations  are  made  for research and application. In  this  study,  the  relationship  between  gender,  age,  marital  status, education  status,  duty  in hospital,  income,  occupational  status,  unit  variables  of  health  workers,  and  toxic  leadership levels  were  examined  in  terms  of  both  the  general  average  of  toxic  leadership  scale  and subscales  of  scale.  The  Cronbach-Alpha  coefficient  in  the  study  was  found  to  be  0.98.  The general average of the health workers obtained from the Toxic  Leadership  Scale (2.91 ± 1.03) was  moderate;  there  were  statistically  significant  differences  due  to  age  and  income  situation; the  toxic  leadership  perceptions  of  administrative  staff  (3.40  ±  0.98)  were  higher  than  the average of other health workers.

Vasfiye Bayram Deger

Artuklu University, Turkey

Title: Transcultural Nursing
Speaker
Biography:

Abstract:

Individuals' health behaviors and health perceptions are regarded inseperable from each other. Communities having endeavored to maintain their cultural characteristics for centuries have passed down this on their health behaviors and strived for finding cures to their health problems in their cultural lives. The individuals’ beliefs about health, attitudes and behaviors, past experiences, treatment practices, in short their culture, play a vital role in improving health, preventing and treating diseases. Culture is influential at many levels in health, ranging from the formation of new diagnostic groups, to the diagnosis of disease to the determination of what is called a disease or not symptoms and disease cues. However, in almost all regions of the world,  wars, ethnic conflicts, repressive regimes, environmental and economic crises along with globalization have forced many people to abandon their country and migrate in their country or to immigrate other countries as refugees. As a result, multicultural populations comprised of individuals, families and groups from different cultures and subcultures are rapidly emerging all around the world. In order to improve the health behaviors of the community, cultural factors affecting health behavior and health care services need to be clearly recognised. Unless health care initiatives are based on cultural values,  it will be impossible to achieve the goal and the care provided will be incomplete and fail. Cultural differences and health beliefs have been recognized for many years as prior knowledge in practice. Despite that, cultural health care is unfortunately not part of a routine or common health practice. Knowing cultural beliefs related to health can enable us to build a framework for data collection in health care. In order for the societies to regulate health care that will meet the needs of different groups in terms of culture, all health team members must be equipped with the necessary knowledge and skills. The nursing profession, which plays an important role in the health team, is a cultural phenomenon. The patient's cultural values, beliefs and practices are an integral part of holistic nursing care. Transcultural nursing provides effective nursing care to meet the cultural needs of individuals, families and groups. The concept of "Transcultural Nursing" derived from the need to care for individuals in different cultures in nursing was first used by Madeleine Leininger in 1979. Transcultural nursing is sensitive to the needs of families, groups and individuals who are representatives of groups with different cultures in a community or socieity. This sensitive approach provides support for the individual in achieving the well-being and happiness. The aims of transcultural nursing are to provide sensitive and effective nursing care to meet the cultural needs of individuals, families and groups, to integrate transcultural concepts, theories and practices into nursing education, research and clinical applications, to improve transcultural nursing knowledge, and to incorporate this knowledge into nursing practice. The International Nurses Association (ICN) invited the nurses from the World Health Organization (WHO)  member countries to work on adaptable models to their communities at the 1989 Seoul Conference. Some of these models include ;

  1. Leininger’s Sunrise Model
  2. Narayanasamy’s ACCESS Model:
  3. Giger and Davidhizars’s Transcultural Assessment Model
  4. Purnell’s Model For Cultural Competence

Faaiz Alhamdani

Ibn Sina University of Medical and Pharmaceutical Sciences, Iraq

Title: Medical Research from Realism to Abstractism
Speaker
Biography:

Faaiz Alhamdani finished his PhD in Newcastle University, UK in 2012. Part of his PhD project was qualitative study on patients’ experiences with blow-out fractures of the orbit. Since then he became interested in qualitative research methodologies. Beside his interest in qualitative research he is also interested in educational research and quality of life research, particularly in Oral and Maxillofacial Surgery. He works now as Vice Dean for Scientific Affairs, College of Dentistry, Ibn Sina University for Medical and Pharmaceutical Sciences, Baghdad-Iraq. He joined IADR 2010. From 2010-2016 he worked as Iraqi Division Secretary. On August 2016 he was elected as President of Iraqi Division. From 2012 he co-organized most of Iraqi Division (IAOR) events and in August, 2017 he was the main organizer and President of the 4th IAOR Scientific Conference in Antalya Turkey. He is also member of The American Association for Advancement of Sciences.He is a writer, poet and fine art critic. He published 3 collections of poetry book and 4 books on fine art.

 

Abstract:

During the last 2 decades, the medical research underwent a gradual transition from purely quantitative research (post-positivist) to endorse qualitative research (interpretivist) paradigm. This article tries to shed a light on this transition and use fine art examples as analogy. For the sake of clarification it is important to explain some of the terms used in this article for readers whom their interest might be out of the scope of qualitative research or fine art. 

  • Women's Health, Gynaecology & Obstetrics
Speaker
Biography:

Abstract:

Manuela Cristina Russu

Carol Davila University of Medicine and Pharmacy, Romania

Title: Neuroprotection in perimenopausal women. New insights for hormone therapy
Biography:

Consultant of  obstetrics and gynecology (1991), PhD (2002); Habilitated Professor of obstetrics and Gynecology, and Head of “Dr I Cantacuzino” Discipline of obstetrics and gynecology , at “Carol Davila” University of Medicine and Pharmacy, Bucharest (2016), President of   The Romanian  Menopause Medical Association (June 2019) with active involvement in women’s health research and care, from the entrance in the speciality., with focus on hormonal contraceptive methods, non-oral routes for menopausal hormone therapy, gynecological conservative surgery, besides maternal-fetal medicine.

Abstract:

Endocrine and neural senescence overlap in time, by  intertwined complex feedback loops. Women’s brain  is more prone to suffer  during life,  perimenopause is a ”critical period”, offering to the scientific and medical communities a  “critical window of opportunity” to delay the onset of brain aging and neurodegenerative diseases, Alzheimer’s disease(AD) being actually the most analyzed. Women’s brain exposure to estrogens from puberty during reproductive years is crucial for the  brain health in elder ages, different from populations. Depression associated to memory, learning, cognition disorders are present from earlier ages when hysterectomy with/without adnexectomy vs general population. The multifactorial  nature of women’s brain aging opens many hypotheses and tests in health research and practice.  AD is  characterized not only by Aβ oligomers, plus fibrils accumulation, but also by metabolic and inflammatory changes, with onset in transition, and early years of menopause. Animals models are helpful to sustain the still controversial results of human clinical  observational/randomized controlled trials. Deep analysis of endocrine, neural, metabolic pathways are giving new insights to the sequential view of Aβ-centric in AD pathogenesis, prevention and treatment from  perimenopause, for maintaining women’s neurological health, to maintain brain volume, proved to diminish. Estrogens, progesterone and androgens, with nuclear and membrane receptors, genes, and epigenetics, their connections to cholinergic, GABAergic, serotoninergic, and glutamatergic systems are involved in women’s brain normality or pathology through direct/indirect mechanisms of modulating/protecting plasticity, vessels net-work, fuel metabolism- glucose, ketones, ATP, insulin resistance, aging brain’s inflammation through  blood-brain-barrier disruption, and microglial aberrant activation, neural cell survival/loss, în myelination, and influences on congnitive processes. Estradiol protects the neurons from excytotoxic damage and increases neuronal survival. Progesterone with it’s 5α-reduced metabolite, allopregnanolone stimulates neurological and functional recovery, different from progestagens.  Androgens also exhibit a wide array of neuroprotective effects in motoneurons, including supporting cell survival, axonal regeneration, and dendritic maintenance.

Speaker
Biography:

Taniya Thapa, graduated as Masters in Nursing (Women’s health and Development) and Masters in Sociology with two and half years experience in clinical as Nursing In charge and two years experienced as Nursing Lecturer  and recently working as Lecturer in Chitwan Medical College approved by Tribhuwan University in Nepal. With the work experiences and skills attained so far has inspired for further career development with readiness to face with new challenges

 

Abstract:

Objectives: Pelvic organ prolapse is the descent of one or more of the pelvic structures from the normal anatomic location toward or through the vaginal opening influencing the quality of life of women particularly among adults and old women in developing countries. We aim to assess the awareness regarding pelvic organ prolapsed among women attending in a teaching hospital, Chitwan so that necessary awareness program could be recommended if found unsatisfactory.

Methods: A descriptive cross-sectional study was done among 110 women attending Gynae Gynaecology Outpatient Department of Chitwan Medical College Teaching Hospital, Chitwan who participated voluntarily in face to face interview that used structured questionnaire from 1st July to 5th August, 2018 selected using consecutive sampling technique. Data was analyzed using descriptive and inferential statistics like frequency, percentage, mean, standard deviation, chi-square and fisher exact test.

 

Results: Among 110 respondents the median age was 37.0 years, 31.8% were from the ages between 31-40 years. Majority of the respondents were literate, 47.3% were housewife, 51.8% had first child between the ages of 20-24 years, 46.4% had two children, 33.6% had abortion, 49.1% had heard about pelvic organ prolapsed from friends and relatives and 6.4% were diagnosed with pelvic organ prolapse and among the diagnosed 28.6% had received treatment, 65.5% were aware regarding pelvic organ prolapse and age of having first child was significantly associated with the level of awareness (p=0.002).

Conclusion: In conclusion more than half of the women were aware regarding pelvic organ prolapse. Further awareness program can be conducted at rural settings by Female Community Health Volunteers and health workers to enhance the awareness level regarding pelvic organ prolapse among women.

  • Nursing in Healthcare
Speaker
Biography:

ANOUA Adou Serge Judicaël is a Doctor in socio-anthropology and Assistant Professor in the Department of Anthropology and Sociology at the Alassane Ouattara University. He is a coordinator of the Laboratory of Studies and Research in Reproductive Health care Transition. He intervenes at the Basic School of the National Institute for Training of Health Agents of Bouaké, at the graduate cycle of the National Institute for Training of Health Agents of Abidjan and in Master of Health Community at the Continuing Training Center at Alassane Ouattara University. He has published several papers in journals and is an editorial board member. My domain of speciality is the socio-anthropology of health. The general problem that occupies my scientific reflection is the issue of Reproductive Health in rural Africa, particularly in Côte d'Ivoire. I also conduct research activities in the domain of community health and environmental health and nursing care.

 

 

Abstract:

Statement of the Problem: The epidemiological transition remains a major challenge for public health in Côte d'Ivoire. It stems from the medicalized vision of the health system. In fact, the action plans of the various national programs are in no way officially supported by any sociological support study. The reference structure for prevention remains the service of epidemiological surveillance. The implication of such an attitude is the fact of sociological resistance in the acculturative process. In this context, the human component is a dimension of importance. From this we deduce that this epidemiological monopoly underlying the public health approach in Côte d'Ivoire seems to us to be wrong. How to reduce this complex health situation? And how to get people to take charge of their own health individually and collectively? Intervention: Faced with these questions, we propose the establishment of a training system in health promotion anchored in lifestyle. It is a matter of guiding the different social strata of the population towards the adoption of the behaviors in favor of a general well-being, in addition to the control of their own health. It is in this context that the opening in 2014 of the community health training program at Alassane Ouattara University in Bouaké, meets a healthy wait. This stream recruits nurses, midwives and doctors. They are trained in theory and practice from a multidisciplinary perspective in order to establish the mechanism of behavioral change in the population. Results: The first promotion has just been released in 2018, with the Master's degree in Community Health. Conclusion: It is envisaged for these new graduates, the creation of a national network to maintain relations, strengthen the spirit of professional belonging and develop a framework for collaboration and exchange of experiences for improving skills.

Biography:

Abstract:

Background: management of critically ill patient in emergency department is a critical health status which requires standardized care policies and qualified skilled health providers to obtain good outcome of management. Objectives: To study nurse’s competences regarding management of critically  ill patients. Methods: A descriptive hospital-based study conducted at Emergency Department in Omdurman Military Hospital / Sudan during the period of September 2018 to December 2018. Sixty nurses working in emergency department were assessed for their knowledge, practices and attitude towards management of critically ill patients. The assessment was performed by using a questionnaire for knowledge and check list for practical skills. Results: Females represented (60%) of the total sample and most participants had experience of 1-5 years. The overall participant's knowledge for all the variables analyzed in this study revealed that 18 participants (30%) had poor knowledge in the emergency department which was considered alarming in caring for critically ill patients. Twenty eight   participants scored below (50%) for applying critically ill patient care. Also the participants showed positive attitude regarding management of critical ill patient in emergency department.

There was a highly significant association between level of knowledge and Educational level P.V ≤ 0.05, also Significant associated with Training course and Knowledge stated P.V ≤   0.05.

Conclusion: The study showed good knowledge, but generally nurses’ performance in the current study found low. Practical skills wasn't  compatible with participants’ knowledge.

Positive attitude was attined regarding management of critical ill patient in emergency department. 

  • Diabetic Healthcare
Speaker
Biography:

Bin Ghouth has experience in primary health care and research methodology and epidemiology. Bakramn has expierence in clinical practice especially in diabetic care, the other co-aithors are medical students participating in proposal development , data and specimens collection and data analysis. All of author and co-authors participating in writing and reviewing the final report and approve it. Hadramout University is an academic institution where the research conducted in its laboratories.

 

Abstract:

Statement of the problem: Patients with diabetes mellitus are at high risk of cardiovascular events because of abnormal lipid levels status. Dyslipidemia is common in patients with type 2 diabetes mellitus. However; in Yemen this issue was not yet addressed. The purpose  of this study is to determine the prevalence and patterns of dyslipidemia in patients with T2DM in Mukalla city, Yemen, in 2017. 

Methodology & Theoretical Orientation: A Cross-sectional study was conducted in a randomly selected eligible patients from the diabetic registry of the AL Noor Charity Center (ACC), Mukalla city in eastern Yemen during the period from May-July 2017. A well structured questionnaire and blood investigation for lipid profile and blood sugar were the tools of data collection from 120 randomly selected T2DM patients registered in the ACC.

Findings:  The prevalence of dyslipidemia in type 2 diabetic patients was 85%, prevalence of dyslipidemia in males was 86% while in females was 84% but the difference was not significant (P-value 0.4).  Regarding age group, BMI and duration of DM, there is no significant association exist with dyslipidemia. About half of the studied T2DM patients have high serum cholesterol level (52.5%), while 22.5% had low serum HDL- C levels and 39.2% had high serum triglyceride level, most of patients had serum LDL-C levels above normal range (67.5%), so the common patterns of dyslipidemia in this study were LDL-C followed by cholesterol.

Conclusion& Significance: High prevalence of dyslipidemia among type 2 diabetes mellitus in Mukalla city were observed and so the common patterns of dyslipidemia is LDL-C followed by cholesterol. This study recommended  screening of lipid profile among DM patients as these abnormalities may lead to development of cardiovascular diseases.

Biography:

Omotosho Tobiloba Oyejide Alex graduated from the Department of Nursing and Reproductive Health of the University of The Gambia in 2016 and is currently pursuing a masters degree in Community health nursing at the same institution. Presently working as a registered nurse at the only teaching hospital in The Gambia and as a graduate assistant with the University of the Gambia, he has developed interest in the areas of chronic disease management, health promotion and reproductive health.

 

Abstract:

Staterment of the Problem: Nurses are often the first point of contact for people seeking information on diabetes care and therefore have a major role in insulin administration. Inadequate knowledge of nurses on insulin treatment can cause errors and several adverse outcomes. It is therefore expected that nurses should have information about how insulin works, when and why insulin is needed. The purpose of this study was to determine the level of knowledge of insulin therapy among nurses in Edward Francis Small Teaching Hospital, The Gambia. Methodology: A hospital-based descriptive cross-sectional study was conducted among 127 randomly selected trained nurses using the EFSTH staff list as the sampling frame. Data were collected using a self-administered questionnaire. Data were analysed using IBM SPSS version 20. Findings: A total of 127 nurses participated in this study but 118 completely filled and returned the questionnaires making a total response rate of 93%. The mean years of experience of nurses was 3.86±4.051 years with a minimum of 1year (20.3%) and maximum of 23years (0.8%). Most of the nurses were females (n=66, 55.6%), had a diploma in nursing (n=75, 63.6%) and working at the surgical department (n = 47, 39.8%) respectively. The majority (n = 93, 78.8%) of them had never attended an in-service training on diabetes management. The majority of nurses rated their knowledge of diabetes as good (n = 72, 61%). General level of knowledge score on insulin therapy was low (n=88, 74.6%). There was a significant mean difference of the nurses’ years of experience in relation to their knowledge of sign and symptoms of hypoglycaemia (p < 0.05). Eighty-six (72.9%) nurses reported administering insulin injection in the arm while 4.2% (n=5) of them reported checking for expiry date prior to giving insulin injection. Conclusion: The nurses with more than four years of practice were more knowledgeable on the requirements of effective insulin administration than those with two years or less practical experience. Recommendations are made for the urgent need for an educational intervention on diabetes and insulin therapy for the nurses in EFSTH.

 

  • Primary Care Dentistry
Speaker
Biography:

Ignateva Lilya is a graduate student of the last year of study in KSMU. The doctor also runs a private practice as an orthodontist. Her research interests are focused on myofunctional disorders of the maxillofacial region in children. In addition to the scope of his scientific interests, the doctor constantly attends conferences and seminars in his profession and is also the speaker of these events.

 

Abstract:

Annotation. Many studies speak about the dependence of myofunctional disorders and the formation of occlusion pathology. Our study shows changes in the bioelectric activity of muscles during orthodontic treatment, and also shows the effect of orthodontic treatment on the change in electromyography.

Introduction. Recent studies allow us to rationally explain the complex pathogenetic mechanisms of dental anomalies and deformities, which have a multifactorial nature. It was found that myofunctional disorders are the most significant among postnatal factors affecting the formation of occlusion. It should also be noted that many researchers.

The aim of our study is the effect of orthodontic treatment on the bioelectric activity of muscles in the presence of combined pathology of dentoalveolar anomaly in children aged 9-12 years.

Experimental methods. Electromyographic study was performed using four-channel computer neuromyopathies analyzer "Synapsis" in dental equipment connected to the computer with the given software for the analysis of the obtained results.

Research result. Previously, three groups of children were recruited. The first group included 53 patients treated with the use of the device of functional action, the second-50 patients in whom the hardware treatment was supplemented by the use of a myofunctional simulator, the third – 34 patients using only the simulator.

Summary.Thus, according to the results of the evaluation of the values of the average amplitude of EMG potentials achieved after correction, it was found that the greatest decrease was observed in patients receiving combined treatment-using both the apparatus and the simulator.

 Thus, the greatest decrease in EMG potentials was expressed in the correction of VHF by a combination of hardware treatment and a simulator. The use of the simulator was accompanied by a moderate negative dynamics of EMG potentials, and with the isolated use of hardware correction, changes in indicators were practically absent.

Day 2 :

  • Healthcare and Pharmaceuticals
Speaker
Biography:

Dawit Kumilachew has his expertise in pharmaceutical supply chain management and passion in improving health and wellbeing through improved pharmaceuticals availability and utilization. He has conducted this research after years of experience in research, evaluation, teaching and community service both in hospital and educational institution. The study was conducted after thorough assessment of the problem and based on a series of scientific procedures and methodologies. He is currently working as a lecturer at department of Pharmaceutics and social Pharmacy, School of Pharmacy, college of medicine and health sciences, university of Gondar. He has a bachelor’s degree in pharmacy and MSc in pharmaceutical supply chain management. 

Abstract:

Statement of the Problem: Besides their substantial lifesaving importance, medications can also be disastrous when inappropriately taken and managed. Medications waste management is of a great importance because of the potential environmental hazards and public health risks. A significant amount of potentially effective and lifesaving medications were wasted at the health facilities due to lack of a system for checking their effectiveness and returning them to the system. Medication wastage at the health facilities is a huge concern due to wastage of potentially useful medications as well as the costs associated with disposal of those medications. The purpose of this study was to assess the prevalence of unused medications and related consequences in selected health facilities of Awi zone, Amhara regional state, Ethiopia. Methodology & Theoretical Orientation: A facility-based cross-sectional study design supplemented by a qualitative approach was employed. Descriptive data were collected using checklists while interviews were conducted with respective personnel at the health facilities. Findings: A total of 4 health facilities were included in the study. During the 1 month of study period, 56 types of medications were found unused at the health facilities. Anti-infective medications were the most commonly unused medications 36.4%. At the in-patient departments of the 4 hospitals, a total of 173 medications were found unused. Similarly, 605 medications were found wasted at the pharmacy stores of those hospitals in the 2009 fiscal year. Conclusion & Significance: A significant amount of unused medications were present at the health facilities. Health facilities need to monitor health professionals strictly follow national and international treatment guidelines and monitor the rational use of medications. There should also be a reverse logistics system in the pharmaceuticals supply system of the country for the proper management of unused medications at the health facilities.

Biography:

Abstract:

The significant mean CD4 count fall had been observed both in HIV positive patients as well as even with the patients of severe tuberculosis without  HIV infections.. But  it has been observed  that  generally, the patients with tuberculosis does not seem to suffer that much  from any secondary or opportunistic microbial infections, while in contrast, the HIV patients with same mean CD4 count suffer  from plenty of opportunistic or secondary  infections.  Aim: Emphasizing the pivotal role of CD4 count in TB/HIV patients in maintaining their immune system effective (by maintaining CD4 count) and thus decreasing MDR/XDR, morbidity and mortality among  these patients. Calculating average mean CD4 count  for  Indian scenario  in cART era. Discussing and suggesting new scope of treating HIV patients for prevention of secondary infections.  Material and methods: All the 961 HIV infected patients early morning sputa  were screened for AFB and few of the samples were even cultured on LJ medium.  All patients’ CD4 count were also evaluated by flow cytomerty method within one week of sputa collection. Seven other published work of HIV/TB patients were analyzed  in relation to CD4 count. Moreover other five published research  on  CD4 in TB+ve/HIV-ve  patients  were also discussed in this article. Results: Out of  961 patients with  HIV/RTI ,  308(32.06%) found positive for tuberculosis with  mean CD4 count  found to be 198.5 and 105.9 cells/μl  for pulmonary  TB  and for extra-pulmonary TB respectively in present study. The average mean CD4 count  from seven research studies from India  were found to be 169.75  and 145.3 cells/μl  for pulmonary and extra-pulmonary TB respectively, in TB/HIV co-infected patients on  cART.  Brenda et al.(1997)  and other four  found that  in advanced/sever  TB but HIV-negative  patients mean CD4 count found to be 341+116. It means in severe tuberculosis patients CD4 count may reduce up to 198 cells/μl but in TB patients, But the difference between HIV and TB patients found by researchers was the   CD4:CD8 ratio which always almost maintained in TB patients only but not in HIV patients. Even some researchers like MA Hauman, Fiske CT et al,(2015) could not find increased intracellular bacterial infections (ICBIs)  in  only TB patients(HIV-ve). Conclusion: HAART  and ATT both are equally important in maintaining immune system(maintaining CD4 count)  of TB/HIV co-infected patients. In India, clinician should  more suspect  for TB at around   mean CD4 count of  169.75  even if found negative by AFB staining for, but should be confirmed  by culture on LJ medium, PCR or by any other Latest technique   in HIV-positive patients. It is not only reduced CD4 count responsible for secondary infections seen in HIV patients but it might be  spoiled CD4:CD8 ratio, or in other world increased CD8 cells in comparison with CD4 cells might be responsible for secondary infections seen in HIV patients, to confirm this further research should be done. If we can maintain CD4:CD8 ratio in HIV patients, by giving anti-antibodies to CD8 appropriately, it should have theoretically reduce/stop secondary  or opportunistic infections  in HIV patients.   

cART= combined Antiretroviral Treatment

ATT= anti Tubercle Treatment

 

  • Nutrition and Obesity
Speaker
Biography:

Hala Demerdash is currently Consultant Clinical Pathology-Alexandria University Hospitals, Former Associate Professor, Pharos University in Alexandria, Egypt. She graduated from faculty of Medicine Alexandria University 1990. She received her master degree in 1997, Medical Research Institute as she was a resident in the Chemical Pathology department1992-1995. Then she received her M.D in Clinical Pathology, faculty of Medicine Tanta University 2007. Diploma in Health Care Quality Management, Arab Academy for Science & technology 2009. She is a member of Editorial Board of Obesity Research Open Journal and has published more than 23 papers in reputed journals. Attended several International Conferences in Clinical Chemistry and laboratory Medicine. She received Eposter Award; poster title “Chitotriosidase Enzyme Activity and MiRNA-146a Expression and Their Value as Potential Biomarkers of Subclinical Atherosclerosis in Type 2 Diabetes Mellitus”. At Labquality Days Congress Helsinki, Finland 2019.

Abstract:

Obesity is a major public health problem all over the world. The objective of this work was to evaluate effectiveness of various weight management strategies through an interview-based study. study was accomplished in various nutrition clinics in Alexandria city and pursued the following data: demographic data, body mass index (BMI), lipid profile, comorbidities, with emphasize on the authenticity of the effectiveness of weight management strategies. Results; The study comprised 2,240 participants following weight management strategies at nutrition clinics; 59.8% were obese (group I) and 40.2% were overweight (group II). BMI was highest among age group 30-40 years in group I and 18-20 years in group II. Weight management strategy by dietary control merely in 55.8% of group I and 59.5% of group II. 33.5% of group I implemented exercise training plan and 41.5% of group II respectively. 14.7% of group I responded to adjuvant anti-obesity prescriptions versus 1.5% of group II. The most commonly adopted anti-obesity prescription was Orlistat. Conclusion Participants who received anti-obesity prescriptions combined with dietary control and exercise obtained the best results when compared to other strategies, therefore anti-obesity prescriptions may be beneficial in conditions that are resistant to other weight management strategies. Comorbidities, particularly dyslipidemia; may partially impede effective obesity management protocols.

  • Public Health and Healthcare Management

Session Introduction

Johra khan

Majmaah University, Saudi Arabia

Title: Dyslipidemia relationship with socioeconomic status in Motihari district population
Biography:

Abstract:

Background: The study was designed to investigate variabilities in lipid profile in Motihari adults by age, gender, smoking, BMI, exercise and income.

Methods: Blood sample of 100 subjects various Private clinics of Motihari District, Bihar India of mean age 27±7 were analyzed for Total Cholesterol, HDL-Triglyceride, LDL-C.

Results: Mean ± SD conc. of total cholesterol, HDL-cholesterol, LDL-cholesterol, total lipid and triglycerides were found to be 173 ± 43 mg/dl, 42 ± 9 mg/dl, 97 ± 39 mg/dl, 495 ± 255 mg/dl and 176 ± 84 mg/dl respectively. HDL -cholesterol were significantly high in younger age group (<30 yrs) than older (>30 yrs) group (45±10 mg/dl vs 41±9 mg/dl; p=0.03). Mean conc. of HDL-cholesterol were found significantly high in upper income group (>25,000 Rs pm) than lower income (<10,000Rs pm) group (48±11mg/dl vs 40±8 mg/dl; p=0.001). Mean levels of triglycerides were also significantly high in males than females (191±88mg/dl vs 154±74 mg/dl; p=0.02). Similarly mean value of triglycerides were significantly low in individuals performing exercise than individuals who do not perform exercise (130±42 mg/dl vs 186±87 mg/dl;p=0.01), mean triglyceride levels also significantly higher in hypertensive individuals (207±100 mg/dl vs 166±76 mg/dl ;p=0.03).

Conclusions: Mean levels of total lipid were found to be significantly higher in older people than younger also significantly higher in males than in females. Similarly mean triglycerides levels were significantly high in lower income group than upper income level group.

Biography:

Tathio Sylvain is an expert in public health, particularly in Medical Parasitology. He is a protagonist for universal health promotion. he is the promoter of a book which is being published entitled '' My Trainer '' for learners in paramedical and medicalhealth training.He is deeply involved in epidemiological investigations leading to eradicate microbe borne diseases in communities. His experiences take source from several researches and teaching dispensed in Health Institutions. Starting from the fact that, epidemiological data collected are able to help control all diseases and improve population healthcare.

Abstract:

Statement of problem: Njombe-Penja population living in rural area with unhealthy watercourses is at high risk of being threatened by water-related diseases such as schistosomiasis. This population who experienced this infection undergoes at the individual level others related crises such as haematuria, hepatitis and abdominal pains while in socio-economic level, loss of incomes. Researchers have reported that, such area is more difficult to be spared from the disease due to numerous rivers and unhealthy behaviors. However, in this population, disease distribution has not been previously studied. The study aimed to evaluate population morbidity status base on prevalence and intensity infections as well as socio-demographic influences.

Methodology: Between September 2014 and May 2015, according to a cross sectional study, 369 participants (172 males and 197 females) were randomly sampled while Kato-Katz and centrifugation techniques were utilized respectively to analyze feces and urine samples.

Results: Two species of schistosomes Schistosoma mansoni (19.8%) and Schistosoma haematobium (0.3%) with an overall prevalence of 20.1% were recorded. On the other hand, persons aged from 23 years (5.7%; P ≥ 0.05) and females (10.3%; P ≥ 0.05) were more infected. Furthermore, students (14.7%; P ≥ 0.05) and persons with primary school level of education were more infected as quarters crossed by streams such as Mbouale (5.4%; P ≥0.05) and Mouantaba (4.3%; P ≥ 0.05). However, mean parasitic load of intestinal schistosomiasis was 39.8 eggs/g of feces and 01egg/ 10ml of urine for urinary schistosomiasis.

Conclusion: This study reveals that, infection prevalence of schistosomiasis as well as parasitic load within Njombe-communities remain relatively high. While in socio-demographic influences, subjects with 23 and above, females, primary level of education, Mbouale and Mouantabaquarters had highest prevalence. Therefore, there is a huge need for integrated control program by treating the whole population.

  • Primary Care Oncology
Speaker
Biography:

Aura Rhea Lanaban is a Family and Community Medicine Physician as well as a Hospice and Palliative Care Specialist.   Aside from her clinical practice both in public and private hospitals, she is also  active in academic institutions.  One of her passion and commitment is to make Hospice and Palliative  Care accessible to all.  Hence, she has actively participated in the orientation and basic training of medical practitioners and primary health care workers.

Abstract:

Statement of the problem: Postmastectomy pain syndrome (PMPS) is the chronic neuropathic pain in the anterior aspect of the thorax, axilla, and/or upper half of the arm that persists beyond three months after mastectomy. Although psychosocial factors have been known to affect the perception of pain, the relationship of PMPS and the psychosocial characteristics of the patient’s family has not been explored. If psychosocial factors indeed play a role in pain perception in PMPS, psychosocial management can be added to the present pharmacologic interventions in order to improve the overall biopsychosocial care of patients with breast cancer. Objective: To determine the proportion of patients with PMPS among those who underwent mastectomy for breast cancer and identify factors associated with the syndrome. Design: Cross-sectional study. Setting: Outpatient Unit in Southern Philippines Medical Center. Participants: 45 women who had mastectomy for breast cancer. Main outcome measures: Proportion of patients with PMPS; prevalence odds ratios (POR) of having PMPS for selected factors. Main results: The patients had a mean age of 53.18 ± 8.09 years, mean BMI of 23.57 ± 2.65, and--on average--were 27.09 ± 35.76 months postmastectomy upon entry into the study. Of the 45 patients, 22 (48.89%) had PMPS. Univariate POR of having PMPS were significantly high for patients who: had distant metastasis (POR=5.56; 95% CI 1.27 to 24.29; p=0.0227), experienced premastectomy breast pain (POR=35.70; 95% CI 6.14 to 207.52; p<0.0001), were in late-stage family life cycle (POR=9.18; 95% CI 1.02 to 82.22; p=0.0476), and were in late-stage family illness trajectory (POR=4.96; 95% CI 1.39 to 17.70; p=0.0137). Conclusion: In this study, 48.89% of patients had PMPS. Factors associated with PMPS include: having distant metastases, having premastectomy breast pain, being in late-stage family life cycle, and being in late-stage family illness trajectory.

  • Pediatric & Neonatal Healthcare
Biography:

Jane Koech has her expertise in monitoring and evaluation and passion in improving maternal newborn and child outcome. . She has built this after years of experience in research, evaluation, and program based implementation. She has also strong background in community dynamics and engagement using ecological model

 

Abstract:

Introduction

Nairobi City County, with its major, informal urban settlements, is home to a large and growing proportion of people living with HIV. Alike in other cities, urban dynamics – such as high mobility, high population density and high concentrations of marginalized, fragile and stigmatized communities – create and exacerbate vulnerability to HIV infection (The Nairobi City County HIV Fast Track Report 2015).he youth. Nairobi City County Health Management team, is working to eliminate mother-to-child transmission (MTCT) in Nairobi’s informal settlements.  In 2016, the Kariobangi Health Center (HC), located in Kasarani Sub-county, recorded a high early infant diagnosis (EID) positivity rate of 6.1% (NASCOP EID 2015 .hence comprehensive strategy to reduce MTCT was necessary. The objective of the study was to establish the most effective interventions in eliminating mother to child transmission (MTCT) in Kariobangi H/C through comprehensive Provision of comprehensive eMTCT services.

Methodology

From October 2016 to March 2017, a strategy to improve delivery of prevention of MTCT (PMTCT) services was implemented. HTS counselors performed HIV testing at first antenatal care (ANC), labor and delivery, and six-week postpartum visits to ensure timely initiation of ART and follow-up.  Mentor Mothers conducted aggressive follow-up with clients who declined ART, Continuous medical education and on-the-job training were done to capacitate nurses to provide PMTCT care, Monthly Work Improvement Team (WIT) meetings were held to review the PMTCT continuum of care and   Peer education and psychosocial support

Results

Timely ART initiation for PMTCT clients has led to high ART uptake in Kariobangi HC. Rates of ART provision were sustained with 100% (110) of HIV-infected pregnant women provided with ART in 2016 and 100% (93) in 2017.and the interventions have also led to a reduction in HIV positivity for infants under the age of 12 months from 6.1% in 2016 to 2.4% in 2018 %.

Conclusion

Provision of comprehensive PMTCT services, timely ART initiation, and continuous follow up of the mother-baby pair are key in reducing pediatric HIV infections and ultimately preventing child deaths.