ABSTRACT
Background: Breast cancer is the leading cancer among women in Kenya, with late-stage presentation contributing significantly to high morbidity and mortality. Self-breast examination (SBE) is a cost-effective screening method for early detection, yet its uptake remains low, particularly in rural and sub-county healthcare settings. This study investigated the determinants of SBE practice among women attending the family planning clinic at Chuka Level 5 Hospital, Tharaka Nithi County, Kenya. Methods: An analytical cross-sectional design utilizing a mixed-methods approach was conducted. A total of 129 women were selected through systematic random sampling, while six healthcare providers (nurses, clinical officers, and gynecologists) were purposively sampled for key informant interviews. Data were gathered using researcher-administered questionnaires and structured interview schedules. Quantitative data were analyzed using SPSS v29 using descriptive statistics, Chi-square tests, and logistic regression analysis. Qualitative data underwent thematic analysis. Results: The mean age of participants was 26.03 ± 7.46 years (range 18–54), with 54.3% residing in rural areas and 55.9% having attained tertiary education. The prevalence of SBE practice was 66.1%; however, only 52.4% performed it on a monthly basis, and 47.6% performed it at the recommended time after menstruation. Primary reasons for non-performance included lack of awareness of correct steps (30.0%) and forgetfulness (27.9%). Women with primary education were significantly more likely to perform SBE compared to those with tertiary education (AOR = 0.247, 95% CI: 0.101–0.608, p = 0.002). Farmers were 4.48 times more likely to perform SBE than women in formal employment (AOR = 4.48, 95% CI: 1.31–15.29, p = 0.017). Overall knowledge of SBE was moderate (mean 69.88%), with 38.6% demonstrating good overall knowledge. Family encouragement significantly promoted SBE uptake (AOR = 0.345, 95% CI: 0.148–0.806, p = 0.014).

ABSTRACT
Background: A referral system is an essential component in healthcare. The unpredictable nature of any pregnancy and the potential for life-threatening complications necessitate timely and effective referral mechanisms to ensure access to appropriate emergency obstetric care. An optimal obstetric referral system reduces delays and ensures timely access to appropriate care, leading to a reduction in pregnancy and childbirth complications. However, weaknesses in transport and communication systems, including health infrastructure often compromise the provision of quality obstetric care. The study aimed to assess the referral process for emergency obstetric care in primary level facilities as well as the availability of essential supplies for EmOC. Methods: The study used a cross-sectional design. The study was conducted between August and December 2022, targeting all healthcare workers working in obstetric units in Level 3 and 4 hospitals. Cochran’s formula was used to estimate the sample size (n =151). Stratified random sampling was used to select study participants. An interviewer-administered structured questionnaire and an observation checklist were used to collect data. The data was entered into SPSS v25 for analysis and analysed using descriptive and inferential statistics as applicable. Findings: Most of the respondents were aged between 30-39 years (54.0%), held a diploma education (88.2%), were nurses/midwives (81.4%) and were from Level 3 facilities (55.7%). Over 98% of the respondents agreed that EMoC referral is a common occurrence in their facilities and 96.3% were aware of obstetric signal functions. Effective communication and transport (linear regression coefficient, T=3.24, p=0.001), healthcare workers' perceived competence on the use of signal functions (linear regression coefficient, T=7.15, p=0.003), and the availability of supplies and equipment were strongly associated with the provision of quality EmOC services during the referral process (Chi-s

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Background: Growing up without parental care can significantly affect a child's psychological well-being. Challenges within family relationships may further contribute to emotional difficulties among orphaned children. Objective: To assess the mental health status of orphaned children and examine its association with selected socio-demographic and orphanage-related characteristics in Bangladesh. Methods: A descriptive cross-sectional study was conducted among 102 orphaned children aged 10–18 years. The participants were residing at Sir Salimullah Muslim Orphanage, Azimpur, Dhaka, Bangladesh. Convenience sampling was used to select the participants. Data were collected through face-to-face interviews. A socio-demographic questionnaire was used to collect background information. Status of Mental health was assessed using the 38-item Mental Health Inventory (MHI-38). Frequencies, percentages, means, and standard deviations were used to summarize the data. Independent-samples t-tests, one-way analysis of variance (ANOVA), and Pearson’s correlation were used for data analysis. A p-value of less than .05 was set as statistically significant. Results: The mean mental health score was 85.67 ± 32.97. Mental health status was significantly associated with age (r = .297, p = .002), sex (p = .009), educational level (p = .035), academic performance (p = .003), frequency of relatives’ visits (p = .004), relationship with caregivers (p = .004), and living arrangements (p < .001). Older children, girls, and those with higher education and better academic performance had higher mental health scores. Children receiving relatives’ visits, having better caregiver relationships, and living in well-organized arrangements also had higher scores. Ages at parental loss, duration of stay, age at placement, and reason for admission were not significantly associated with mental health status. Conclusion: The mental health status of orphaned children was associated with several factors. These

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Background: Low back pain (LBP) is a major public health problem and one of the leading causes of disability worldwide. It adversely affects physical functioning, psychological well-being, and overall quality of life, particularly among women living in rural communities. Objective: To examine the relationship between level of low back pain and quality of life among women in a rural area of Bangladesh. Methods: A descriptive correlational study was conducted among 101 women with low back pain from four villages in Gopalpur Upazila, Tangail, Bangladesh. Participants were recruited using a multistage sampling technique. Data were collected through face-to-face interviews using a socio-demographic questionnaire, the Numeric Pain Rating Scale (NPRS), and the 36-Item Short Form Health Survey (SF-36). Descriptive and inferential statistics (Pearson correlation, independent-samples t-test, and one-way ANOVA) were performed, with statistical significance set at p < 0.05. Results: The mean age of the participants was 41.90 ± 7.03 years. Most participants (66.3%) reported moderate low back pain, while 18.8% and 14.9% experienced mild and severe pain, respectively. The mean total quality-of-life score was 38.45%. Educational qualification (F = 4.518, p = 0.013), monthly family income (r = 0.395, p < 0.001), and number of children (F = 4.779, p = 0.010) were significantly associated with quality of life. A significant negative correlation was observed between low back pain intensity and quality of life (r = −0.672, p < 0.001), indicating that higher pain intensity was associated with poorer quality of life. Conclusion: Low back pain was significantly associated with poorer quality of life among rural women in Bangladesh. Early identification and appropriate interventions are needed to reduce pain and improve quality of life in this population.

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Background: Hypertension is a major global public health problem and a leading risk factor for cardiovascular diseases. Improving awareness is essential for promoting preventive practices and reducing hypertension-related morbidity and mortality. Objectives: To assess awareness and preventive practices regarding hypertension and to examine the relationship between awareness, socio-demographic characteristics, and preventive practice among rural adults in Bangladesh. Methods: A descriptive correlational study was conducted among 101 rural adults selected using a multistage sampling technique. Data were collected through face-to-face interviews using a structured questionnaire from February to March 2023. Descriptive statistics, independent-samples t-test, one-way analysis of variance (ANOVA), and Pearson's correlation coefficient were used to analyze the data. Results: The mean awareness score was 3.58 ± 0.46, and the mean preventive practice score was 2.55 ± 0.35, indicating moderate levels of awareness and preventive practice. Participants demonstrated higher awareness regarding stroke as a complication of hypertension, regular blood pressure measurement, and excess salt intake, whereas awareness of overweight, physical inactivity, and family history as risk factors was comparatively lower. Preventive practice was positively correlated with awareness (r = .464, p < .001). Age (r = .286, p = .004), marital status (t = 2.69, p = .010), and family history of hypertension (t = 4.44, p < .001) were significantly associated with preventive practice, while gender, religion, educational level, occupation, and monthly family income showed no significant associations. Conclusion: Rural adults demonstrated moderate awareness and preventive practices regarding hypertension. Higher awareness was associated with better preventive practices. Community-based health education and lifestyle promotion programs are recommended to improve hypertension prevention among rural populations

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Background: Fast-food consumption among children and adolescents is a growing global health concern due to changing dietary habits and lifestyles. The study aimed to examine the relationship among attitude, subjective norms, perceived behavioral control and intention to fast-food consumption among high school students in Bangladesh. Methods: A correlational design using the Theory of Planned Behavior assessed attitudes, subjective norms, and perceived behavioral control in relation to fast-food consumption intention. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, and Pearson's correlation coefficient. Results: Using the Theory of Planned Behavior, the study found that Attitude (r=.487, p<.001), subjective norm (r=.177, p<.05), and perceived behavioral control (r=.594, p<.001) were significantly positively correlated with students' intention toward fast-food consumption. Conclusion: Improved nursing practices and policymaker strategies can support effective health education to change adolescents’ and families’ attitudes toward fast food consumption. The study’s findings may guide government and private sectors in appointing child health nurses in schools and colleges.

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Background: Maternal mortality remains a major public health concern in developing countries, including Bangladesh, where preventable pregnancy-related complications continue to contribute significantly to maternal deaths. Objective: This study aimed to assess the level of knowledge and involvement in pregnancy-related care and to examine the relationship between knowledge and involvement among married male partners in a rural community in Bangladesh. Methods: A correlational cross-sectional study was conducted among 105 married men in Madhabpur, Bangladesh (July 2023–June 2024). Data were collected via face-to-face interviews using structured questionnaires on socio-demographics, knowledge, and involvement. Descriptive and inferential statistics (t-test, ANOVA, Pearson’s correlation) were used with p < .05. Results: The mean age of participants was 32.24 years (SD = 5.53). Nearly half (46.7%) had poor knowledge, 33.3% had moderate knowledge, and 20.0% had high knowledge. More than half (55.2%) showed poor involvement in pregnancy-related care. The mean knowledge score was 7.78 (SD = 3.67), and the mean involvement score was 38.04 (SD = 15.19). Education, occupation, monthly income, duration of marriage, and number of children were significantly associated with knowledge and involvement (p < .05). A strong positive correlation was found between knowledge and involvement (r = .797, p < .001). Conclusion: Male partners demonstrated inadequate knowledge and low involvement in pregnancy-related care. Strengthening targeted health education and male-friendly maternal health interventions is essential to improve male participation and maternal health outcomes in rural Bangladesh.