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    ABSTRACT: Postpartum family planning (FP) in Kenya is low due to inadequate sensitization and awareness among women, particularly in rural areas. This paper identifies most widely used types of FP, intent and unmet needs among women, FP counseling and barriers to FP uptake. Focus group discussions with providers, traditional birth attendants (TBAs) and mothers, as well as in-depth interviews identify key themes including preferred postpartum FP, limits to existing FP counseling and barriers to FP uptake. Postpartum FP is common including injectable contraceptives, oral contraceptives, coils, condoms, and calendar methods. FP counseling is provided by peers, friends, TBAs and formal health providers. FP practices are associated with family support, literacy, access to FP information, side effects, costs and religion. In conclusion, changes in service provision and education could encourage increase in postpartum FP use in Kenya.
    African Journal of Reproductive Health 09/2013; 17(3):44-53.
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    ABSTRACT: Hepatitis C virus (HCV) is a viral pandemic and a leading cause of chronic liver disease. This review highlights the epidemiology and management of Hepatitis C in Africa. We searched for articles on medline using the terms, "Hepatitis C", "Prevalence", "Epidemiology", "Africa" and "Treatment". The bibliographies of the articles found were used to find other references. We included articles published after 1995 only. The data was summarized and presented in tables and figures. Africa has the highest WHO estimated regional HCV prevalence (5.3%). Egypt has the highest prevalence (17.5%) of HCV in the world. Genotypes commonly found in Africa are 1, 4 and 5. Genotype 3 is found in Egypt and parts of Central Africa. Blood transfusion is a major means of acquisition of HCV infection. While treatment with peginterferon and ribavirin is recommended for patients with chronic HCV, no data were found on their use in Africa. Neither were there any data on definitive management (liver transplantation) for those with end stage disease. Data on HCV infection in Africa are scarce. This suggests that hepatitis C is still a neglected disease in many countries. Limited data exist in literature on HCV in Africa.
    The Pan African medical journal. 01/2013; 14:44.
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    ABSTRACT: Ensuring good data quality within telemedicine and e-health systems in developing countries is resource intensive. We set out to evaluate an approach where in-built functionality within an electronic record system could identify data quality and integrity problems with little human input. We developed a robust data integrity module to identify, enumerate, and facilitate correction of errors within an e-health system that is in wide use in sub-Saharan Africa. The data integrity module was successfully implemented within an electronic medical record system in Western Kenya. Queries were set to fail if one of more records did not meet defined criteria for data integrity. Only one of 14 data integrity checks implemented uncovered no errors. The other queries had errors or questionable results ranging from 51 records to 30,301 records. However, as a proportion of all patients and all observation, the identified records with likely data integrity problems only constituted a small percentage of all records (mean 0.96%, range 0-4.1%). Twelve of the 14 queries (86%) were executed in<15 s, with the longest query lasting 2 min and 18 s. A tool that allows for automatic data integrity and quality checks was successfully implemented within an e-health system in sub-Saharan Africa. The tool potentially reduces the burden of maintaining data quality by limiting the scale of manual reviews needed to identify electronic records with errors.
    Telemedicine and e-Health 12/2011; 18(1):5-10.

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