Asian Journal of Medicine and Health

Assessing Health Information System Data Quality Management in LifeNet-supported Facilities in South Kivu, Democratic Republic of Congo

Bwanondo Kachelewa Sylvain — 2025-11-20

Aims: To evaluate the quality of HIS data in LifeNet-supported facilities in South Kivu and correlate data completeness, accuracy, and timeliness with staff competency, training, and governance factors to validate current data management practices. This study is significant as it enhances understanding of data quality in LifeNet-supported health facilities, guiding improvements in information management and health service delivery in South Kivu.

Study Design: A retrospective quantitative cross-sectional analytical research design.

Place and Duration of Study: Study conducted in LifeNet International-supported health facilities across ten health districts in South Kivu Province, Democratic Republic of Congo, including Idjwi, Ibanda, Kabare, Kadutu, Miti-Murhesa, Nundu, Nyangezi, Nyatende, Uvira, and Walungu, between October 2023 and March 2024.

Methodology: This study included 155 healthcare workers from 74 LifeNet International-supported health facilities across ten districts in South Kivu Province, DRC. Data were collected through a retrospective review of Maternal and Child Health (MCH) records and a structured HIS Assessment Questionnaire administered to healthcare workers. Data completeness, accuracy, and timeliness were evaluated using the Verification Factor (VF). Descriptive and inferential statistical analyses were performed using SPSS version 28 to assess relationships between HIS data quality and influencing factors.

Results: MCH data quality was high: accuracy 89%, consistency 87%, completeness 93.3%, and timeliness 86.7%. Health worker competency showed high neutrality—data aggregation 62.6%, in-service training 65.2%, electronic skills 72.3%, HMIS usability 61.9%, pre-service training 75.5%—indicating limited confidence in HIS skills. Challenges in data collection were notable, with 46.5% neutral on cross-checking, 71.6% unsure about functional databases, and 62.6% unclear on monitoring roles. Regression analysis indicated systemic challenges strongly predicted health information use (β = 0.850, p < 0.001), while individual competency was not significant, highlighting the need for improved operational support.

Conclusion: Systemic challenges, more than individual competency, significantly affect health information use, highlighting the need for stronger operational support, clear roles, and targeted HIS capacity-building in facilities.

Patterns of Injury and Discharged Against Medical Advice among Road Traffic Accident Victims in a Tertiary Hospital, North Central Nigeria

Suega P. Inunduh — 2025-11-25

Aim: Discharged against Medical Advice with its attendant effects of increased cost and mortality is common globally. The aim of this study was to highlight the Patterns of injuries by Road Traffic Accident victims, the implications of Discharged against Medical Advice on certain critical injuries, and the importance of follow up.

Methods: A retrospective study was carried out at the Federal Medical Centre Makurdi, a tertiary health facility in North Central Nigeria, from January 2021 to March 2022. Data was extracted from medical records (case notes) of all patients who were involved in Road Traffic Accidents (RTAs), and were admitted either into the ward through the Accident and Emergency Unit, or at the Accident and Emergency Unit of the hospital. A total of 121 patients were admitted, 15 were discharged against Medical Advice, while others were either discharged home or referred to other health facilities. Descriptive Statistics was deployed using Microsoft Excel and Statistical Package for Social Sciences (SPSS) to analyze the data.

Results: Of a total of 121 patients admitted for various injuries due to RTAs, there were 15 (12.4%) of DAMA, with 8 females (6.6%) and 7 (5.7%) males. Head injury was the commonest injury 8 (53.3%) seen, while musculoskeletal injuries were 7 (46.7%). Majority of the victims, 6, were in the age group, 30-39 years, with an average age of 37.2. Farmers and House Wives were the dominant occupational groups involved. There was no tracking or follow up. Average hospital stay was 6 days. There was no any form of health insurance coverage, or follow up.

Conclusion: DAMA for critically injured patients is common in our environment, and there is no any known established follow up system. There is no health insurance coverage. Physicians must strive to track and follow up on these patients to improve outcomes.

Whether Vaginal Misoprostol has Better Outcome than Intra Cervical Catheterization for Cervical Ripening in Intra Uterine Fetal Death

Tashrifa Rahman — 2025-11-27

Background: Intrauterine fetal death (IUFD) is one of the most distressing obstetric complications, necessitating timely and safe induction of labor to prevent maternal morbidity. Effective cervical ripening is crucial to ensure successful induction and reduce complications. Both vaginal misoprostol and intracervical Foley’s catheterization are widely used for this purpose; however, their relative efficacy and safety in IUFD cases remain under evaluation.

Objective: To compare the efficacy and safety of vaginal misoprostol versus intracervical Foley’s catheterization for cervical ripening in cases of intrauterine fetal death (IUFD) between 28 weeks and full-term gestation.

Methodology: This randomized clinical trial was conducted at the Department of Obstetrics and Gynaecology, Sir Salimullah Medical College and Mitford Hospital, Dhaka, from May 2023 to January 2024. A total of 108 women diagnosed with IUFD were enrolled and randomly assigned into two groups: Group A received vaginal misoprostol (25 µg every 6 hours for 24 hours), and Group B underwent intracervical Foley’s catheterization for 24 hours. Primary outcomes included initiation-to-cervical ripening time and cervical ripening-to-delivery time, while secondary outcomes assessed oxytocin augmentation, duration of augmentation, and complications.

Results: The mean initiation-to-cervical ripening time was significantly shorter in the misoprostol group compared to the Foley’s catheter group (11.53 ± 6.59 hours vs. 16.0 ± 8.99 hours; p = 0.005). However, no significant difference was found in the cervical ripening-to-delivery interval (p = 0.120). The need for oxytocin augmentation was markedly lower in the misoprostol group (40.7%) than in the catheter group (83.3%) (p < 0.001), with a shorter augmentation duration (5.78 ± 2.30 vs. 8.30 ± 4.46 hours; p = 0.014). Both methods were well tolerated, with minimal hyperstimulation and no cases of uterine rupture. Postpartum hemorrhage occurred more frequently in the catheter group (18.5%) than in the misoprostol group (5.6%) (p = 0.038).

Conclusion: Vaginal misoprostol demonstrated greater efficacy in cervical ripening compared to intracervical Foley’s catheterization, achieving faster cervical readiness and requiring less oxytocin augmentation with comparable safety. Hence, vaginal misoprostol (25 µg every 6 hours) may be considered a superior and reliable method for cervical ripening in IUFD cases.

Neck Circumference as a Possible Indicator of Cardiometabolic Risk among Nigerian Adults with Type 2 Diabetes

Martins Ehizode Emuze — 2025-12-03

Background and Aim: Neck circumference (NC) has been associated with cardiovascular risk factors. Type 2 diabetes mellitus (T2DM) is a chronic disorder that is driven by insulin resistance. This study aimed to evaluate the relationship between NC and insulin resistance with cardiometabolic factors among persons with T2DM.

Methods: The study was a comparative cross-sectional study with a total sample size of 180, which included 120 patients with T2DM attending the medical outpatient clinic of a tertiary health facility in Nigeria and 60 healthy controls. Neck circumference of subjects with T2DM and controls was measured, and parameters such as waist circumference, waist-hip ratio and body mass index were estimated. Insulin resistance was determined using the homeostasis model assessment of insulin resistance (HOMA-IR). Data obtained was analyzed with Statistical Package for Social Sciences (SPSS), version 22.

Results: There was no statistical difference in the mean neck circumference of the subjects with T2DM and controls (34.30 ± 3.09 cm vs 34.81 ± 2.61 cm; P>0.05). Neck circumference of male subjects with T2DM was higher than their female counterparts and this was statistically significant (37.46±2.97 cm vs 33.05±2.09 cm; P=0.01). Significant correlation was observed between NC and HOMA-IR among controls (rho = 0.34; P = 0.01) but not among patients with T2DM (rho = 0.13; P=0.16). There was significant positive correlation between NC and body mass index (rho = 0.30; P = 0.001), waist circumference (rho = 0.48; P<0.001) and waist-hip ratio (rho = 0.26; P = 0.004) amongst patients with T2DM.

Conclusion: Neck circumference correlated positively with some cardiometabolic risk factors among subjects with T2DM in the study population. This may possibly indicate that simple measurement such as neck circumference could serve as a supplementary or surrogate marker of central obesity, which might have implications for development of cardiovascular diseases.

Sociocultural Factors Influencing Malaria Prevention and Treatment Pathways among Pregnant Women in the Foumban Health District, Cameroon

DJAM CHEFOR ALAIN — 2025-12-03

Background: Pregnant women are disproportionately affected by malaria, with 13.3 million exposed in Africa in 2021. In Cameroon, the prevalence reaches 29%, impacting their social and economic conditions.

Objective: This study analysed the Sociocultural Factors Influencing Malaria Prevention and Treatment Pathways Among Pregnant Women in the Foumban Health District.

Methods: This mixed-type study was conducted in Foumban in the Noun Division. Interviews were conducted using a questionnaire digitised on Kobocollect and administered face-to-face. The chi-square test of independence was used to assess the association between sociocultural characteristics and treatment pathway.

Results: In total, 458 (91.2%) have a good level of knowledge, 43 (8.6%) have an average level of knowledge, and 1 (0.2%) has a low level of knowledge. 263 (52.4%) had pharmacy as their first choice of therapeutic route, and 303 (60.4%) had consultation with a traditional healer as their second choice of therapeutic route. The Christian religion influences 95% of the pharmacy and health training routes, and the Bamoun ethnic group influences 95% of the pharmacy and traditional self-medication routes.

Conclusion: The study indicated that despite good knowledge of malaria, there is an average possession and use of control measures by the population; therefore, malaria transmission persists in the region. The study highlights the need to implement additional control measures to improve malaria control in the region.

System Drivers of Hypertension Control in Africa: A Beta Regression and Dynamic Factor Modeling Approach

Francis Ayiah-Mensah — 2025-12-04

Noncommunicable Disease (NCD) Risk Factor Collaboration supplied population-representative data detailing hypertension management in Africa for individuals aged 30 to 79 years from 1990-2019. Ten cascade indicators were analysed via both age-standardized and crude metrics. Beta regression with a logit link and a continuous function of year was used to assess the effects of sex on each outcome. A one-factor state‒space model integrated mixed temporal dynamics and enabled forecasts extending to 2030, adding policy scenario that enhances diagnosis and treatment by 10 percentage points. Compared with men, women were more likely to receive therapy and control on both metrics (odds ratios of approximately 2.2 and 2.1). Diagnosis indicated negligible benefits for females. Women presented a greater prevalence of untreated stage-2 disease, although they demonstrated superior control. A prevalent latent factor indicated significant persistence (ϕ approximately 0.98). By 2030, the scenario indicated a significant increase in control, particularly for women. Findings also indicate the need for increased capacity to prevent the onset of severe uncontrolled disease. The results reveal a dual approach of treatment and management while simultaneously emphasizing diagnosis and intervention. It is recommended to implement a cohesive data pipeline featuring monthly joint-factor dashboards and prompt remedial measures linked to control and untreated stage-2 indications.