Indonesian Journal of Health Research and Development

Addressing Counterfeit Medicines and Community Risk: Insights from South African Spaza Shops

Michael Mncedisi Willie, Athandile Hadebe — Sat, 28 Feb 2026 00:00:00 +0700

Background: Governance and regulatory enforcement in South Africa reveal complex interactions among formal legal frameworks, operational capacity, and informal market practices. While deliberative processes, such as public consultations on the draft Traditional Courts Regulations, demonstrate transparency and inclusivity, interventions in the healthcare sector are often reactive, triggered by crises such as food contamination fatalities and the sale of illegal medicines. This contrast underscores disparities in institutional capacity and sectoral prioritisation.
Objectives: This paper investigated regulatory gaps and enforcement challenges in informal medicine markets, with a focus on spaza shops. The focus was on structural, operational, and social factors influencing the circulation of counterfeit, expired, and improperly stored medicines, and explores how governance, public service delivery, and community dynamics interact to affect public health outcomes.
Methods: A qualitative case-study approach guided this research, focusing on the analysis of secondary data sources and qualitative literature. Purposive selection of documents and reports included government communications, regulatory guidelines, parliamentary hearing transcripts, media coverage, and peer-reviewed studies, ensuring that the sources provided rich insights into governance, regulatory enforcement, and informal pharmaceutical practices.
Findings: Systemic gaps exist between regulatory intent and operational reality. Although legal frameworks restrict the dispensing of scheduled medicines to licensed pharmacies and authorised health professionals, widespread non-compliance persists in township spaza shops.
Conclusion: Effective mitigation of counterfeit and illegally sold medicines requires an integrated, multi-dimensional approach that strengthens regulatory oversight, secures supply chains, mobilises community engagement, and leverages technological monitoring. The proposed Integrated Regulatory-Community Framework for Counterfeit Medicines in Spaza Shops (IRCF-CMSS) aligns formal legislation with practical enforcement and social realities, promoting sustained compliance, enhanced public safety, and institutional trust.

Health Beliefs, Illness Perceptions, and Self-Management Behaviors in Hypertension Clients

Muhamad Jauhar, Ririn Widyasari, Heny Siswanti, Novi Tiara — Sat, 28 Feb 2026 00:00:00 +0700

Background: Hypertension is a health problem that impacts all age groups and social backgrounds, with the risk of serious complications, reduced quality of life, and a huge burden for clients, families, and the country. The increasing number of hypertension cases requires serious attention to reduce its impact.
Aims: This study analyzes the relationship between health beliefs disease perceptions and self-management behavior in hypertensive clients at the Juwana Community Health Center.
Methods: This research used a cross-sectional design and involved 95 clients selected using purposive sampling. Data was collected through a valid and reliable questionnaire and then analyzed using the Spearman-Rho correlation test
Result: The results showed a significant relationship between health beliefs and self-management behavior (r = 0.327; p = 0.001), while the relationship between illness perception and self-management was insignificant (r = 0.178; p = 0.083). The majority of clients had sufficient categories for health beliefs (74%), disease perceptions (81.3%), and self-management behavior (71.9%).
Conclusion: In conclusion, health beliefs influence self-management behavior, while illness perceptions do not have a significant relationship. Interactive media-based educational programs are needed to increase health confidence and support self-management of hypertension patients.

Stem Cell Research Awareness and Perception in Nigeria: Inferences from Sickle Cell Advocacy Centers in Kano and Lagos

Akon Ekpenyong Usoh, Jamiu Adeniyi Yusuf — Sat, 28 Feb 2026 00:00:00 +0700

Abstract

Background: Sickle cell disease (SCD) remains a critical public health challenge in Nigeria, particularly in Lagos and Kano, where prevalence is high. Although hematopoietic stem cell transplantation (HSCT) is an advancing global cure, awareness and acceptance of stem cell therapies in Nigeria are alarmingly low.
Aims: This study examines public knowledge and attitudes toward stem cell research and treatments in Lagos and Kano. It also explores barriers to acceptance and evaluates the role of advocacy and institutional programs in promoting awareness.
Methods: A mixed-method approach was adopted. Quantitative data were collected from 400 respondents using structured questionnaires, while qualitative insights came from key informant interviews with healthcare professionals and advocacy staff. Four SCD centers were also assessed for their stem cell awareness programs.
Result: Findings show that only 32.5% of Lagos respondents and 18.7% of Kano respondents had prior awareness of stem cell research, with far fewer demonstrating accurate knowledge of its applications and safety. Major barriers to acceptance include cultural beliefs, ethical concerns, financial constraints, and misinformation. Of the four centers evaluated, only one had a structured awareness program, while advocacy efforts were hindered by inadequate funding, limited technical training, and weak engagement with healthcare institutions.
Conclusion: Public awareness of stem cell therapies in Nigeria is critically low. Strengthening advocacy capacity, implementing targeted education campaigns, and expanding government support through policy and financing are essential to improve access, acceptance, and utilization of novel stem cell treatments for SCD.

Acute Ischemic Stroke Following A Single Wasp Sting: The Impact of Early Intensive Multidisciplinary Rehabilitation (A Case Study)

Sasirekha K, Priya J, Ganesan B, Arun B — Thu, 26 Feb 2026 00:00:00 +0700

Background: Cerebrovascular accidents following Hymenoptera stings are exceptionally rare, with most reported cases involving multiple stings. This case study presents an unique case of acute ischemic stroke triggered by a single wasp sting and highlights the critical role of early intensive physiotherapy in achieving excellent functional recovery.
Case Presentation: A 55-year-old previously healthy electricity lineman sustained a single wasp sting over the neck. After initial symptomatic treatment at a primary health center, he returned to work but collapsed within two hours, presenting with right side weakness, mild aphasia, and apraxia. Brain imaging showed subtle small-vessel ischemic changes without large-vessel occlusion. Extensive thrombophilia and cardioembolic workups were normal. The stroke was attributed to venom-induced vasospasm and inflammatory/thrombogenic effects. The patient was managed with intravenous corticosteroids, dual antiplatelet therapy, and low-molecular-weight heparin. Structured inpatient physiotherapy commenced on the patient who stays in the wards, good progression was noted as the day passes.
Results: At the time of discharge the patient was walked with minimal assistance. At one-month follow-up, he achieved modified independence in activities of daily living, with ongoing gradual recovery of hand function. Functional Independence Measure (FIM) on admission it was 13, later it improved to 39 at the time of discharge, and the follow-up of the patient rose to 52. scores improved markedly since the admission to the follow-up.
Conclusion: This case demonstrates that even a single wasp sting can precipitate acute ischemic stroke via vasospasm and inflammation. Prompt medical stabilization combined with early, intensive, goal-directed physiotherapy can yield rapid and substantial functional recovery.

A Coverage of Maternal Health Checks Before Discharge in Cambodia: A Population-Based Analysis of the 2021-22 Demographic and Health Survey

Sokha YEM — Thu, 26 Feb 2026 00:00:00 +0700

Abstract

Background: The immediate postpartum period represents a critical window for preventing maternal morbidity and mortality. In Cambodia, facility delivery rates reached 93.9% by 2021-22, yet whether essential quality-of-care processes such as maternal health assessment before discharge are consistently implemented remains uncertain. This study aimed to estimate national coverage of maternal health checks before discharge and quantify missed opportunities among facility deliveries.

Methods: We conducted a cross-sectional secondary analysis of the 2021-22 Cambodia Demographic and Health Survey (CDHS), including women aged 15-49 with a most recent live birth in the preceding 24 months (n=3,348 unweighted). The primary outcome was whether maternal health was checked before discharge. Weighted prevalence estimates with 95% confidence intervals (CI) were calculated overall and stratified by sociodemographic and delivery characteristics. Multivariable logistic regression identified factors associated with missed checks among facility deliveries.

Results: Nationally, 91.0% of women (95% CI: 89.6-92.2) reported a maternal health check before discharge. Among the 93.9% who delivered in facilities, 91.0% received a check, leaving 9.0% as missed opportunities. Substantial geographic disparities were observed, with coverage ranging from 82.4% in some regions to 96.8% in others. Women with no education (adjusted OR=2.89, 95% CI: 1.45-5.76), rural residence (aOR=1.67, 95% CI: 1.12-2.49), and those in the poorest wealth quintile (aOR=2.34, 95% CI: 1.34-4.09) had significantly higher odds of missed checks. Primiparous women and those with delivery complications also experienced lower coverage.

Conclusions: Despite near-universal facility delivery, nearly one in eleven women were discharged without documented maternal health assessment, with pronounced inequities by socioeconomic status, education, and geography. These findings reveal critical gaps in postpartum quality of care that disproportionately affect vulnerable populations. Strengthening standardized discharge protocols, enhancing staff accountability through integrated checklists and supervision, and prioritizing equity in service delivery are essential to ensure consistent, high-quality postpartum care for all women.

Keywords: Cambodia; Demographic and Health Survey; postpartum care; quality of care; health equity; maternal health; discharge assessment

Implementation of SBAR Communication among Nurses during Handover between Shifts before and after a Mini Seminar in the Mawar Inpatient Ward, West Kalimantan

Ignasius Yogi, Lidya Maryani — Sat, 28 Feb 2026 00:00:00 +0700

Delayed care processes, lack of attention, and limited knowledge in receiving patient information often lead to poor communication among nurses. The World Health Organization recommends SBAR (Situation, Background, Assessment, Recommendation) as a structured communication tool to convey critical information requiring immediate action. This study aimed to determine the implementation of SBAR communication among nurses during handovers between shifts before and after a mini seminar in the Mawar Inpatient Ward, West Kalimantan. A pre-experimental design with a one-group pretest–posttest approach was applied and described descriptively. The results showed that before the mini seminar, 50% of respondents applied SBAR communication incorrectly, while 50% applied it correctly. After the mini seminar, there was a significant improvement, with 100% of respondents applying SBAR communication appropriately. These findings indicate that the mini seminar successfully improved the implementation of SBAR communication among nurses during shift handovers. In conclusion, the mini seminar was proven to enhance the professionalism of nursing services by optimizing communication, reducing the risk of medical errors, and supporting better quality of care in the inpatient ward.

Phytochemical Screening and Antimicrobial Activity of Phyllanthus Amarus Leaves (Stone Breaker) Against Some Selected Microorganisms

Imrana Lawan, Suwaiba Abba Ismail, Aminu Baita, Zeenatu Ali Baba — Sat, 28 Feb 2026 00:00:00 +0700

BACKGROUND: Phyllanthus amarus is among the most significant medicinal plants found in tropical and subtropical regions, commonly used in the treatment of diseases affecting the stomach, liver, kidneys, and spleen. This study aimed to identify the phytochemical constituents and evaluate the antimicrobial activities of the leaves of Phyllanthus amarus

METHOD: The powdered leaf sample was extracted using ethanol at a sample-solvent ratio of 1:3. The resulting crude extract was then fractionated using four different solvents: petroleum ether, chloroform, acetone, and methanol. Each of the four fractions was subsequently subjected to phytochemical screening and antimicrobial activity evaluation.

RESULTS: The results indicated that the plant leaves contained all the phytochemicals tested. The petroleum ether fraction showed the presence of all the phytochemical constituents. The chloroform fraction contained alkaloids, saponins, polyphenols, and glycosides only. The acetone fraction exhibited all the phytochemicals except saponins, polyphenols, and terpenoids, while the methanol fraction contained alkaloids, steroids, polyphenols, and glycosides. Antimicrobial analysis revealed zones of inhibition against the tested organisms, with the chloroform fraction demonstrating the highest activity. These findings suggest that the plant possesses both physiological and medicinal significance for humans, consistent with previous research reports

CONCLUTION: The antimicrobial evaluation of four fractions showed zones of inhibition on the tested organisms, which verified their uses in the treatment of various ailments may be attributable to some of its phytochemical constituents with high drug properties.