Articles: School of Nursing

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    Undergraduates’ Lifestyle and Suboptimal Health Status (SHS): A cross-sectional Study in the Ha’il region of Saudi Arabia
    (UoEm, 2025-02-20) AlsaifID, Bandar; Otieno Asweto, Collins; Sehar-un-Nisa, Hassan; Ali Alzain, Mohamed; Elshiekh Saeed, Mohammed; Kassar, Ahmed; Elbssir Mohammed Ali, Kamal; Ghorbel, Mouna; Zrieq, Rafat; WangI, Wei
    University students in Saudi Arabia are embracing some of the negative traits of the fastpaced modern lifestyle, typified by unhealthy eating, low physical activity, and poor sleep habits that may increase their risk for poor health. Health and holistic well-being at the population level are among the priorities of the 2030 vision of a vibrant society in the Kingdom of Saudi Arabia. The current study thus aims at determining the prevalence and predictive factors of Suboptimal Health Status (SHS) among university students
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    Foetal Position: Can It Be Used to Predict the Sex of Unborn Baby?
    (Scientific research publishing, 2020-10) Limungi, Mbaabu G.; Kirigia, Consolata
    Sex is used to define the biological categorization of a human being as either a male or female. Globally, most of the pregnant women have expressed desire to know the sex of their babies prenatally. To determine sex of the baby before birth, both traditional and modern sex prediction methods have been used. The study aimed at answering the question; can foetal position and sex be related? If so, can it be used to predict the sex of the baby? Analytical perspective utilizing quantitative approach was conducted in a Referral County Hospital to collect data from a sample size of 340 women who were admitted in labour. Selection was done through convenience sampling method. Data were cross tabulated to determine variable frequencies and establish the association, while chi-square was used to test the study hypothesis. Overall results revealed statistically significant relationship between foetal position and sex of the baby (P = 0.001). Majority of female neonates (74.4%) had adopted right occipital anterior, while most of male neonates (57.4%) had adopted left occipital anterior. It follows then, that sex of the baby may be related to the foetal position. This knowledge may be used by the midwives to predict the foetal sex for the women who may not afford ultrasound scan. Further research may be necessary in a different setting.
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    Foetal Position: Can It Be Used to Predict the Sex of Unborn Baby?
    (Scientific research publication, 2020-10) Limungi, Mbaabu G.; Kirigia, Consolata
    Sex is used to define the biological categorization of a human being as either a male or female. Globally, most of the pregnant women have expressed desire to know the sex of their babies prenatally. To determine sex of the baby before birth, both traditional and modern sex prediction methods have been used. The study aimed at answering the question; can foetal position and sex be related? If so, can it be used to predict the sex of the baby? Analytical perspective utilizing quantitative approach was conducted in a Referral County Hospital to collect data from a sample size of 340 women who were admitted in labour. Selection was done through convenience sampling method. Data were cross tabulated to determine variable frequencies and establish the association, while chi-square was used to test the study hypothesis. Overall results revealed statistically significant relationship between foetal position and sex of the baby (P = 0.001). Majority of female neonates (74.4%) had adopted right occipital anterior, while most of male neonates (57.4%) had adopted left occipital anterior. It follows then, that sex of the baby may be related to the foetal position. This knowledge may be used by the midwives to predict the foetal sex for the women who may not afford ultrasound scan. Further research may be necessary in a different setting.
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    Perceived Social Support Among Clients Using Alcohol and Illicit Drugs at the Comprehensive Care Centre at the Coast General Hospital Kenya A Descriptive Cross Sectional Study.
    (International Journal Of Advanced Research (IJAR), 2017-11) Maina, Elizabeth; Wagoro, Miriam; Kirui, Angeline; Khasakhala, Lincoln
    Poor social support coupled with poor coping mechanisms among people with HIV infection may drive them to alcohol and illicit drug use to cope with the significant psychological challenges that HIV infection presents. In return, this affects adherence to Highly Active Antiretroviral Therapy and progression to Acquired Immune Deficiency Syndrome contributing to high mortality. The aim of the study was to explore perceived social support among clients using alcohol and illicit drugs at the Comprehensive Care Centre of the Coast General Hospital – Mombasa. The CAGE – AID (acronym for cut down, annoyed, guilty, eye opener – adapted to include drug use) tool was used to screen for alcohol and illicit drugs use and clients who scored ≥2 were included in the study. Convenience sampling method was used whereby 235 respondents were consecutively enrolled. Patients with a CAGE-AID score of ≥2 who consented were subjected to a socio-demographic questionnaire and the multidimensional scale of perceived social support (MSPSS). Data analysis was done using Statistical Package for Social Sciences version 21.0. Descriptive statistics were used to examine demographic characteristics. An analysis of variance was done to determine the significance of associations between the population characteristics and the various dimensions of social support. The confidence interval was set at 95%, p value at <0.05.The findings of the study demonstrated inadequate social support among HIV/AIDS infected alcohol and illicit drugs users. Providing social support may decrease the risk of alcohol and illicit drugs use hence better health outcomes. Social support should be strengthened in comprehensive care.
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    Early growth in preterm infants after hospital discharge in rural Kenya: longitudinal study
    (Pan African Medical Journal, 2016-06-22) Mawia, Diana S.; Chege, Margaret N.; Oyieke, Jennifer
    Prematurity is the single most important cause of mortality during the neonatal period. The early growth of these infants has been shown to be a predictor of their later growth and neurodevelopmental outcomes. The objective of this study was to establish the determinants of early growth in preterm infants after hospital discharge at the Kitui District Hospital, Kenya. Methods: A short longitudinal study design was adopted to execute the study. During the period of April and June 2014, all the preterm infants who were discharged from the Kitui District Hospital Newborn Unit were enrolled in the study by obtaining written informed consent from their guardians. The anthropometric measurements of these infants were taken at discharge and repeated two weeks later at the Pediatric Outpatient Clinic and the Maternal Child health Clinic. A questionnaire guided interview was held with the guardians to establish infant and maternal characteristics which influenced the infants' early growth. Results: A total of 112 participants were enrolled for the study with 106 (94.4%) of them being available for reassessment after two weeks. Majority (72.6%) had deficit in growth by failing to attain the recommended WHO average weight gain of 15g/kg/day. Most of the mothers (63.4%) were between the ages of 20-29 years with half of them being first time mothers. Many of them (66.1%) had only attained primary education and were married (66.1%) to self-employed husbands (56%). Conclusion: Most of the preterm infants at discharge were females who were born between 33 and 36 weeks gestation. Growth deficit was present in the majority and gestational age at birth was a major determinant of the early growth in these preterm infants.
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    Influence of Patient Related Factors on Health Seeking Behaviours among Men with Lower Urinary Tract Symptoms attending Surgical Out Patient Clinic at Meru Level Five Hospital, Kenya
    (2020-10) Muriuki, Festus M.; Oluchina, Sherry; Mbithi, Bernard W.; Kirigia, Consolata
    ackground: Currently there are increased cases of men presenting with Lower Urinary Tract Symptoms (LUTS) especially in low resource countries. These symptoms may or may not be related to prostate cancer and health seeking behaviours are not clear. Purpose: To establish the influence of patient related factors on health seeking behaviours for Lower Urinary Tract Symptoms (LUTS) among men attending surgical outpatient clinic at Meru hospital, Kenya. Methods: Descriptive cross-sectional study design was used. The study population involved 120 men suffering from LUTS, 2 physicians and 2 nurses. Questionnaires and interview guides were used for data collection. Study period was from August 2018 to March 2020. Results: Majority (67.0%) of the patients with LUTS were aged between 61-70 years. Also, the majority (68.8%) of the respondents had primary level of education. The findings also pointed out majority (72.0%) of the patients were farmers with income level of below Ksh. 20,000. Logistic regression was used whereby P-values determine the statistical significance of results with cut off set at (p ≤0.05). The inferential statistics pointed out that patient related factors test items had a statistical significant influence since the p-values were found to be less than 0.05 at 95% confidence interval. Conclusion: There was a significant negative influence of patient related factors such as lack of knowledge, low income levels and distance to health care facilities on health seeking practices. Therefore patients seek medical attention when quality of their lives has been threatened. The study recommends adopting measures of rising awareness on need for seeking early medical attention and initiate outreach health services in underserved areas or through telehealth.
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    Vascular inflammation, atherosclerosis, and lipid metabolism and the occurrence of non high albuminuria diabetic kidney disease: A cross-sectional study
    (Sage, 2021-02-09) Yang, Yuwei; Yan Liu, Peng Xu; Chen, Xiaohong; Feng, Jiafu
    Aim: Atherosclerosis involves vascular endothelial damage and lipid metabolism disorder, which is closely related to the occurrence and development of diabetic kidney disease (DKD). However, studies on non-high albuminuria DKD (NHADKD) with an albumin to creatinine ratio (ACR) <30mg/g are rare. This study is to investigate the relationship between atherogenic factors and the occurrence of NHADKD. Methods: Serum lipid indicators, lipoprotein-associated phospholipase A2 (Lip-PLA2) and homocysteine levels were measured in 1116 subjects to analyze their relationship with NHADKD. Results: Among all subjects, Lip-PLA2 had the closest but relatively weak correlation with ACR (r=0.297, p<0.001) and only homocysteine was moderately correlated with eGFR (r=−0.465, p<0.001). However, in patients with NHADKD, these atherosclerotic factors were weakly correlated or uncorrelated with eGFR (max. |r|=0.247). Stratified risk analysis showed that when ACR was <10mg/g, homocysteine [OR=6.97(4.07–11.95)], total cholesterol (total-Chol) [OR=6.04(3.03–12.04)], and high-density lipoprotein cholesterol (HDL-Chol) [OR=5.09(2.99–8.64)] were risk factors for NHADKD. There was no significant difference of OR between these three factors (Z=0.430–1.044, all p>0.05). When ACR was ⩾10mg/g, homocysteine [OR=17.26(9.67–30.82)] and total-Chol [OR=5.63(2.95–10.76)] were risk factors for NHADKD, and ORhomocysteine was significantly higher than ORtotal-Chol (Z=3.023, p<0.05). Conclusions: The occurrence of NHADKD may be related to the levels of homocysteine, total-Chol, HDL-Chol, and Lip-PLA2 in blood. Among them, homocysteine may be most closely related to NHADKD.
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    Factors affecting health seeking behaviour in hypertensive patients of Imenti North sub county, Kenya
    (2021-01-14) Kirigia, Consolata; Kamweru, Paul Kuria; Mwenda, Annarita Kajuju,
    Background: Prevalence of non-communicable diseases like hypertension is raising hence a burden to low resource countries like Kenya. Purpose of the study was to determine factors affecting health seeking behaviour in hypertensive patients in Imenti North sub county, Kenya. Methods: A cross-sectional study design and cluster random sampling method was used to select five health facilities for study. Purposive sampling was used to select total of 212 patients from selected health facility proportionally. Spearman’s Rho correlation and bivariate logistic regression was used to check for strength of associations. Results: Patients interviewed had an average of 51 years and higher proportions were above 40 years of age. Married and female patients were (66.5%), and 60% respectively. An average of (42%) had a secondary level of education. Knowledge on lifestyle modification strategies was above average (68%). Conclusions: Health education given during hypertensive clinics had positive influence. Slow service delivery, long queues and the long waiting times for laboratory investigation results influenced patients’ health seeking behavior negatively. The study recommends the government of Kenya to develop policies on implementation of support groups among hypertensive patients in all hospitals and intensify campaigns on importance of seeking medical attention early. This will empower the patients on knowledge of hypertension management. The study also recommends health care providers to ensure reduced waiting time for the patients.
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    Foetal Position: Can It Be Used to Predict the Sex of Unborn Baby?
    (Scientific Research, 2021-01-14) Limungi, Mbaabu G.; Kirigia, Consolata
    Sex is used to define the biological categorization of a human being as either a male or female. Globally, most of the pregnant women have expressed desire to know the sex of their babies prenatally. To determine sex of the baby before birth, both traditional and modern sex prediction methods have been used. The study aimed at answering the question; can foetal position and sex be related? If so, can it be used to predict the sex of the baby? Analytical perspective utilizing quantitative approach was conducted in a Referral County Hospital to collect data from a sample size of 340 women who were admitted in labour. Selection was done through convenience sampling method. Data were cross tabulated to determine variable frequencies and establish the association, while chi-square was used to test the study hypothesis. Overall results revealed statistically significant relationship between foetal position and sex of the baby (P = 0.001). Majority of female neonates (74.4%) had adopted right occipital anterior, while most of male neonates (57.4%) had adopted left occipital anterior. It follows then, that sex of the baby may be related to the foetal position. This knowledge may be used by the midwives to predict the foetal sex for the women who may not afford ultrasound scan. Further research may be necessary in a different setting.
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    Effects of increased residential mobility and reduced public spaces Effects of increased residential mobility and reduced public spaces mobility in containing COVID-19 in Africa
    (Global Reports, 2020-09) Asweto, Collins O.; Onyango, Patrick O.; Alzain, Mohamed A; Wang, Wei
    Background Background The rising COVID-19 crisis threatens to disproportionately hit African countries. As a result, most African governments have temporarily closed schools and non-essential businesses or banned social gatherings to contain the disease. It is therefore important to estimate the level of transmission reduction as a result of these measures. This study aimed at predicting COVID-19 cases in Africa based on COVID-19 community mobility report. Methods Methods Our study focused on 26 African countries whose community mobility data were available online. The number of daily confirmed cases for the period of February 15th, 2020 to May 29th, 2020 for each country was obtained from European Center for Disease Prevention and Control (ECDC) COVID-19 cases geographic distribution data. Multiple linear regression was performed to investigate the relationship between COVID-19 community mobility and confirmed cases. Results Results The maximum public place mobility change was -38.15% with an average of -18.85% (±3.47); residential mobility was at 23.17% with an average of 11. 268% (±1.448). The number of confirmed cases had a significant negative correlation with residential mobility change (r = -0.878, P<0.01) and positive correlation with public place mobility change (r = 0.881, P<0.05). Both mobility changes in public spaces and residential are significant predictors of COVID-19 cases. More specifically, about 1% change in a public place and residential mobility would result in 167 less COVID-19 daily cases, while total lockdown would result in 581 fewer daily cases. Conclusions Conclusions Our analysis shows that a COVID-19 containment strategy that focuses on increasing residential mobility and reducing public spaces mobility is effective. Therefore, the finding supports containment measures that aim to limit the movement of people.
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    Effects of increased residential mobility and reduced public spaces mobility in containing COVID-19 in Africa.
    (UoEm, 2020-09-28) Asweto, Collins O; Onyango, Patrick O; Alzain, Mohamed A; Wang, Wei
    The rising COVID-19 crisis threatens to disproportionately hit African countries. As a result, most African governments have temporarily closed schools and non-essential businesses or banned social gatherings to contain the disease. It is therefore important to estimate the level of transmission reduction as a result of these measures. This study aimed at predicting COVID-19 cases in Africa based on COVID-19 community mobility report.
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    Effects of female genital mutilation on physical, social and psychological health of the victims
    (EuroSciCon, 2018-06) Kirigia, Consolata
    Female circumcision also known as female genital mutilation (FGM), involves none medical cutting or removal of some parts or the entire external female genitalia. FGM is known to cause physical health problems such as scaring or formation of keloids, infertility, infections and menstrual difficulties. FGM also causes complications during labor and delivery, which include prolonged labor, post-partum hemorrhage and perineal tears. Psychological problems are major effects such as depression, low self-esteem and post-traumatic stress syndrome. Social health problems to victims and indirectly to significant others may include lack of intimacy related to sexual dysfunction like arousal, orgasm, lubrication and satisfaction. The practice is very rampant in most African countries and the effects have global impacts. Much is being done to try and alleviate the suffering of the victims as well as trying to eradicate the practice by educating communities through their leaders, men involvement and coming up with policies that protect the rights of women against such gender based violence. Studies have been done on FGM but still there is literature gap on the global physical, social and psychological effects of FGM. These effects need to be studied specifically on the victims as the study group and the survivors as the control group. Such studies will provide evidence to healthcare providers to effectively initiate high quality medical care to both the victims and the survivors of FGM.
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    Cervical cancer screening during the COVID-19 Crisis: Africa view point
    (eCancer, 2020-05) Kirigia, Consolata
    There are approximately 570,000 cases of cervical cancer and 311,000 deaths from cervical cancer globally (1). Approximately 70% of cancer deaths occur in low and middle income countries and cervical cancer is the most common cancer in Africa (2). Therefore cervical cancer screening saves lives by early detection of cases for early management.
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    Facilitators to Immediate Post Partum Intra Uterine Contraceptive Device Uptake among Mothers Delivering in Meru Hospital
    (Scientific Research Publishing, 2019-04) Kirigia, Consolata; Gitonga, Lucy; Muraya, Moses Mahugu
    Family planning allows people to attain their desired number of children and determine the spacing of pregnancies. It is important to promote uptake of family planning services because it is one of the four pillars of the Safe Motherhood Initiative to reduce maternal death in developing countries. It is also enshrined in health related Sustainable Development Goals. Post Partum Intra Uterine Contraceptive Device (PPIUCD) is the oldest methods of family planning. During the ancient times, foreign bodies like stones were introduced into the woman’s uterus for prevention of pregnancy. Post partum method of contraception is highly recommended because it is long acting, convenient, safe and highly effective with minimal side effects compared to the hormonal methods. Despite these advantages, the method is the lowest in use globally, regionally and locally. According to the Meru Hospital records for the year 2017, the immediate PPIUCD uptake was very low at 3.4%. The broad objective of this study was to assess the factors that facilitate uptake of PPIUCD at Meru Hospital. The study site was post natal ward maternity department of Meru Hospital for a period of two months that is September and October in the year 2018. A descriptive research design was used and the study population was the mothers who were admitted in the ward during the study period. A sample size of 74 respondents was used as the representative to the target population of 289 mothers. Simple random sampling was used to get the sample for the facilitators. Data were collected using structured questionnaires and interview schedules. The data collection instruments were pretested at Embu Level five Hospital and split half reliability test technique used. Validity was ensured through review of literature from similar studies and by consulting supervisors in the department. Permission to conduct the study was sought from National Commission for Science, Technology and Innovation through Chuka University Ethics and Research Committee. De-scriptive analysis was done to get percentages using Statistical Package for Social Science (SPSS) for windows version 23.0. Qualitative data were analyzed by grouping data into themes according to the study objectives. The analyzed data were presented in tables, charts and narratives. The findings of the study revealed that; the main client related facilitators to PPIUCD uptake were older age above 30 years, employment, tertiary level of education and knowledge on the method as a result of the providers’ effort to share information. That is 70% of older aged mothers, 60% of the employed and 40% with tertiary education had the insertion. The main provider facilitator to PPIUCD uptake was timely counseling and insertion services. 20% of those who had the insertion said that timely counseling was done during antenatal period. The main method related facilitator to PPIUCD uptake was past experience and preference to alternative methods of contraception. 50% of those who accepted the insertion had previous bad experience and side effects of other alternative methods. Some 30% of users perceived that the method was effective and convenient because once inserted no need for frequent visits to the clinic. The study concluded that clients, providers and method factors facilitated uptake of immediate PPIUCD. The study recommends putting in place strategies to improve the uptake of the method by considering the client, provider and method related facilitators.
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    Barriers to Immediate Post-Partum Intra-Uterine Contraceptive Device Uptake among Mothers Delivering at Meru Hospital
    (Scientific Research Publishing, 2019-03) Kirigia, Consolata; Gitonga, Lucy; Muraya, Moses Mahugu
    Global contraceptive use is at 64%, Africa lagging behind at 33.4%. Kenya has an unmet need for family planning at 23%. Hormonal injections are the most used in Africa at 9.8% and Intra-Uterine Contraceptive Devices at 3.8%. Low uptake of 3.4% was reported in Meru Hospital and lack of literature on immediate Post Partum Intra Uterine Contraceptive Device (PPIUCD) uptake. Immediate Post Partum Intra Uterine Contraceptive Device is a long acting reversible contraceptive device inserted into the uterus immediately within 48 hours after delivery. The objective was to assess Barriers to Immediate Post-Partum Intra-Uterine Contraceptive Device uptake among Mothers delivering in Meru Hospital. Descriptive research design was used and a population of 289 mothers was targeted. Sample size of 74 respondents was selected using simple random sampling. Questionnaires and interview schedules were used to collect data. The collected data were entered and analyzed using Statistical Package for Social Science windows version 23.0. Descriptive analysis was used to obtain frequencies and percentages. Chi-square was used to test the relationship of study variables and presented in tables. The qualita-tive data were analyzed thematically. The findings revealed that provider related barriers such as none provision of the services and untimely counseling for the insertion had the highest impact to low uptake (57%). Clients lacked information where 68% reported that they were not counseled. Demographic and reproductive characteristics also played a role in low uptake. Using the chi square test, there was a significant relationship, P = 0.001 between young age of the mothers, unemployment (53%), low parity (56%) and low uptake. Preference for other alternative contraceptives (25.8%) such as hormonal methods was a barrier to the uptake. Therefore, barriers to PPIUCD uptake are provider related, alternative methods of contraception and client related such as lack of information, unemployment, young age and low parity. The findings will inform Meru hospital management on barriers to immediate PPIUCD uptake. The study recommends an investigation on why providers hinder PPIUCD uptake and create awareness on PPIUCD services to the community.
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    Impact of Advanced Practice Nurses and Midwives on Patients’ Outcomes: A Systematic Review
    (2020-06) Kirigia, Consolata
    Background: Advanced practice nursing and midwifery education was introduced globally and in Kenya with an objective of introducing high quality nursing and midwifery care services that would result to improved patients outcomes. Currently there are hundreds of advanced practice nurses and midwives who are underutilized and more precisely in Kenya due to little available evidence of the impact of advanced practice nurses and midwives on patients’ outcomes. Objective: To review available evidence on the impact of advanced practice nurses and midwives on patients’ outcomes. Methods: A wide search method was used to site literature from variety of databases. Review process involved inclusion of qualitative, quantitative and mixed method research studies that were recent and relevant to this study’s objective. Data were abstracted, organized into themes and sub-themes, summarized and results were reported by means of narrative synthesis. Quality of the research study was evaluated by using Mixed Method Appraisal Tool (MMAT) version 2018. Measures of advanced practice nurses’ and midwives’ impact were matched against a set framework including clinical significance for evaluating patient’s outcomes. Results: Out of the 10 studies that were included, the results suggested that there was a great impact of advanced practice nurses and midwives on positive patients’ outcomes. The outcomes were; early detection of disease complications, efficient and effective continuity of care, diagnostic accuracy and reduced polypharmacy, reduced length of hospital stay, reduced mortality rates, innovative service delivery, patient safety and satisfaction. Conclusion: There is need for more involvement of advanced practice nurses and midwives in healthcare delivery systems and specifically in Kenya in order to achieve positive patients’ outcomes.
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    Corona Virus Disease among Pregnant Women: A Systematic Scoping Review
    (Scientific Research Publishing, 2020-05) Kirigia, Consolata
    Corona Virus Disease 2019 (COVID-19) is a deadly respiratory viral disease that started in China in the year 2019 before spreading to the world. It affects everybody regardless of race, religion, social economic status or age. However, literature indicates that people with compromised immune status are at a higher risk of contracting viral infections. During pregnancy, the immune status of the woman is suppressed because it acts to protect both the mother and her unborn baby. The purpose of this study was to provide an overview of available evidence on the risk of contracting COVID-19 and COVID-19 infection prevention among pregnant women. Relevant and recent articles were identified from various databases. Article selection was aligned to the study questions. Articles that were related to study objectives were included and those not related to study objectives were excluded. A narrative report was produced and results were described according to study objectives. Approximately 8 data sources were included and most of the reviewed articles indicated that pregnant women are at a higher risk of getting COVID-19. The reviews further indicated that pregnant women can be prevented from this deadly virus by providing community antenatal services instead of visiting the Journal of Obstetrics and Gynecology, 10, 671-677. https://doi.org/10.4236/ojog.2020.1050060 Received: April 16, 2020 Accepted: May 8, 2020 Published: May 11, 2020 Copyright © 2020 by author(s) and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ Open Access health facilities. If a pregnant woman develops symptoms of respiratory infection, it is advisable to seek immediate diagnosis to rule out COVID-19 and get appropriate management to avoid complications. The selected studies’ quality was appraised through Mixed Methods Appraisal Tool (MMAT) version 2018. Knowledge on the risk of COVID-19 infection among pregnant women will help health workers especially midwives who take care of pregnant women to design confidently and put into action preventive programs to address health needs of pregnant women who are at a higher risk of contracting COVID-19 as compared to other people in the general population. This also will assist health workers to provide appropriate care to pregnant women on the basis of their COVID-19 infection risk status at health facility and community levels. This study review is also creating more awareness on the risk of COVID-19 to pregnant women even in communities. It serves as evidence to guide health policymakers to put emphasis on addressing the preventive measure of this greatly vulnerable group of population. To prevent COVID-19 infection during pregnancy, pregnant women should strictly follow the laid down measures of prevention by World Health Organisation (WHO) and their local health authorities
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    Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017
    (Elsevier, 2018-11) Ngunjiri, Josephine W.
    Background Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the healthrelated SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030.