Background: Poor utilization of maternal healthcare services remains a public health concern in most low and middle-income countries (LMICs), including Afghanistan. Late, inadequate, or no utilization of antenatal care (ANC) services pose a great concern. Objectives: This study assessed the predictors of ANC service utilization among Afghan pregnant women, using secondary data from the Afghanistan Health Survey 2018 (AHS2018). Methods: In this study, we used data from 10,855 ever-married women, aged 13–49 years, who gave birth in the two years prior to the survey or those women who were currently pregnant. The outcome variable was defined as a binary variable on ANC utilization (≥1 ANC visit equals 1, and zero otherwise). We fitted a binary logistic regression model and examined the associations between ANC utilization and explanatory variables, providing findings based on univariate and multivariate analysis. STATA version 17 was employed for the data analysis. Results: Overall, 63.2%, 22.0%, and 3.1% of women had at least one ANC visit, ≥4 ANC visits, and ≥8 ANC visits during their last pregnancy, respectively. Higher odds of ANC utilization were observed in women who could read and write (AOR = 1.55, 95%CI: 1.36–1.77), whose husbands could read and write (AOR = 1.42, 95%CI: 1.29–1.56), who knew 1 sign (AOR = 1.93, 95%CI: 1.74–2.14), 2 signs (AOR = 2.43, 95%CI: 2.17–2.71) and ≥ 3 signs (AOR = 1.55, 95%CI: 1.36–1.77) of complicated pregnancy, and those with almost daily access to radio (AOR = 1.19, 95%CI: 1.08–1.327) and TV (AOR = 1.92, 95%CI: 1.73–2.13). We also found that women with one (AOR = 0.64, 95%CI: 0.49–0.84) and more than one (AOR = 0.60, 95%CI: 0.47–0.76) parity status, those for whom in-laws and others decided for their birthplace [(AOR = 0.85, 95%CI: 0.74–0.97) and (AOR = 0.63, 95%CI: 0.55–0.72), respectively], and those that resided in rural areas (AOR = 0.89, 95%CI: 0.79–1.00) had reduced odds of ANC utilization. Conclusion: ANC service utilization is unacceptably low by pregnant women in Afghanistan. The predictors of ANC utilization identified by the study should be considered in the design of future interventions to enhance antenatal care utilization in Afghanistan.

Background: Village health volunteers (VHVs) engaging in community-based COVID-19 prevention and control measures played a key role in mitigating effects of the COVID-19 pandemic in Thailand. We conducted a cross-sectional questionnaire survey study to investigate factors affecting VHVs’ COVID-19 self-protective behaviors and social distancing in Songkhla Province during the first COVID-19 outbreak. Such information may help to understand how to support VHVs in future pandemics. Methods: A total of 152 VHVs from 13 sub-districts participated in the study, completing a 54-item questionnaire based on the Health Belief Model (HBM). The questionnaire included items assessing susceptibility, severity, benefits, barriers, self-efficacy, social distancing, and self-protective behavior. Stepwise multiple regression analysis determined which aspects of the HBM could explain VHVs’ self-protective behavior. Results: The VHV population sampled broadly reflected the main demographic characteristics of the local population, although VHVs were predominantly female. Self-protective behavior was significantly associated with VHVs’ role (higher perceived compliance for village leaders than non-leaders) but not with other demographic characteristics. Most VHVs reported high levels of self-efficacy (80.5%), adherence to social distancing measures (70.9%), and engagement in self-protective behavior (72.8%) against COVID-19. However, compliance with hand hygiene appeared to be suboptimal, suggesting room for improvement. Self-efficacy and perceived social distancing showed strong and moderate correlations with self-protective behavior against COVID-19 (r = 0.917, β = 0.819; and r = 0.561, β = 0.173 respectively; p < 0.001). The final HBM-based regression model accounted for 87.2% of the variance in VHVs’ self-protective behavior. Conclusions: This study highlights the importance of VHVs’ self-efficacy for achieving self-protective behavior during a COVID-19 outbreak, and suggests that self-efficacy may help to overcome barriers that might otherwise hinder behaviors to mitigate against COVID-19. Policies that support self-efficacy should be implemented in any future pandemic, and steps to support VHVs with hand hygiene compliance and empower non-leaders to increase their self-protective behavior may also be helpful. Whilst the HBM provided a useful framework for interpretation, the final model was driven mainly by self-efficacy.

BACKGROUND: Type 2 diabetes, especially in the elderly, continues to plague the world. Thailand a developing country is not immune to these ravage effects and their distressing upsurge in health and economic societal burdens. Self-care management is an essential strategy to prevent complications and reduce type 2 diabetes complications. AIM: This study aimed to examine the treatment outcome and factors predicting diabetes self-care behaviors among elderly in Thailand. METHODS: A cross-sectional correlative predictive design using multiple linear regression models to evaluate data in elderly type 2 diabetics in Thailand (August through December 2017) to assess perceived behavioral control on diabetic self-care management. One hundred thirty-four participants data were collected via questionnaire along with individual health records becoming the foundation of this study. RESULTS: Most patients controlled glycemic outcome (77.9 %) through self-care behaviors at moderate rates (majority 55.9%). Subjective norms and perceived control strongly correlated with behavioral intention and self-care behaviors. Perceived behavioral control was the most important factor predicting intentions ( 4.025, p .01) and self-care management behavior (15.258, p .001). Patients responding to items regarding self-care behavior for diet, exercise and medication adherence showed favorable outcomes. CONCLUSION: More than half of the patients had moderate levels in self-care management and the majority had good glycemic outcomes. From the analysis, we find that perceived behavioral control is critical to predicting behavioral intention and diabetic self-care behavior among the elderly.

Comparison of Self-Management between Glycemic Controlled and Uncontrolled Type 2 Diabetic Elderly in Thailand: A Qualitative Study

BACKGROUND/OBJECTIVES: Diabetes risk screening tools are essential for identifying individuals with prediabetes and preventing the progression to diabetes. However, systematic reviews focusing on such tools, particularly for prediabetes screening, are scarce. This scoping review examines the characteristics, development methods, and effectiveness of diabetes risk assessment tools in identifying prediabetes and predicting its progression to diabetes. MATERIALS AND METHODS : A scoping review was conducted following the Joanna Briggs Institute methodology. Searches were performed in PubMed, ScienceDirect, and Google Scholar, complemented by citation tracking. Eligible studies included asymptomatic adults with prediabetes. Studies were excluded if they lacked relevant data, were not in English, or had no validation measures. Data were extracted independently by two reviewers and synthesized narratively, focusing on study design, risk model features, performance statistics, and quality assessments. RESULTS: Fourteen studies met the inclusion criteria, covering 26 risk models. Sensitivity and specificity were used in 9 risk screening tools, with Hazard Ratios and C-Statistics assessing diabetes progression in six. Common risk factors included age, BMI, family history of diabetes, and hypertension. Non-invasive tools and predictive models showed promise, with most studies assessed as having a low risk of bias using QUADAS-2. High-sensitivity tools utilizing FBG, HbA1c, and OGTT cutoffs demonstrated effectiveness but require balancing cost and feasibility for broader implementation. CONCLUSION: A range of different screening tools has been tested that could identify people with prediabetes or a high risk of developing type 2 diabetes. However, where sufficient evidence was available to compare tools across studies the performance of these tools was inconsistent. Several tools have only been investigated in single studies, with uncertainty around their wider generalisability. Clinicians or researchers wishing to screen people for prediabetes or a high risk of developing type 2 diabetes using any of these tools should be aware of their potential limitations. The full text of the article is available in the electronic version of the journal on the website www.dia-endojournals.ru