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Kumar Kolay, Swapan, and Siddharth Chowdhary. "Obstacles to Acquire Modern Medical Institutional Facility with Special Reference to Maternal Health Care among Tribals of South Bastar in Chhattisgarh." Indian Journal of Research in Anthropology 8, no. 1 (June 15, 2022): 9–17. http://dx.doi.org/10.21088/ijra.2454.9118.8122.1.
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Introduction: The Maternal Mortality Ratio of Chhattisgarh is 269 (SRS 2010-11) which are higher than the National average (178). If we analyze the state wise data of MMR we found that Chhattisgarh is fourth in position amongst all states of India. Maternal and child health care is an important aspect of health seeking behaviour which is largely neglected among the tribal groups (Basu et al., 1990). It has been seen that inspite of a lot of government incentive programmes for women health care and development, some obstacles create obstruction to acquire modern medical institutional facilities. It is a burning concern for the development because the problems of tribal women differ from a particular area to another area owing to their geographical location, historical background and the processes of social change (Chauhan, A., 1990). Objectives: The study concerned with the objective of understanding the gap between government modern health facilities and tribal women with special reference to maternal health care. Study Area: For the study purpose tribal dominating villages of south Bastar, Chhattisgarh was selected. Chhattisgarh is known as 10th largest state of India where Bastar is known as its rich and uniqueness of bio-cultural diversity in the whole world. Methodology: Random sampling technique was the key instrument for selecting sample as well as Snowball sampling is also used to identify a few households where maternal and infant related problems occurred through some key informants in the village and ask each of them to identify households where maternal problems have occurred. Questionnaire on different variables of knowledge, attitudes, belief and opinion about government health institution were organised by direct interview. Along with above semi participatory observation was strength for the data collection. Result: The findings stated that the acceptance of modern institutional health facilities is poor amongst tribal people. In addition, a lot of females suffered from ill health due to pregnancy and childbirth in the absence of a well defined concept of health consciousness. Conclusion: The health problems of mothers arise as a result of synergistic effects of malnutrition, poverty, illiteracy, unhygienic living conditions, infections and unregulated fertility. Apart from that superstitious beliefs play an essential obstruction to acquire modern medical facilities. At the same time, poor infrastructure and ineffective public health services is also responsible for low inadequate obstetric care. Keywords: Maternal mortality; Seeking behavior; Modern medical institutional; Tribal women; Superstitious beliefs.
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Beglyakova, Yuliya M., and Aleksander S. Shchirskii. "RURAL MEDICINE. CONDITION AND ISSUES." RSUH/RGGU Bulletin. Series Philosophy. Social Studies. Art Studies, no. 2 (2020): 103–10. http://dx.doi.org/10.28995/2073-6401-2020-2-103-110.
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The article analyses the accessibility of medical facilities in rural areas of modern Russia and the specifics of their organization and development. The authors reveal causes why rural residents have much less opportunities to seek quality medical care than urban ones, what leads to a disparity between the inhabitants of the city and the village. The thesis is substantiated that state programmes that should make health services accessible to the rural population to a greater extent do not cope with the task at hand. An attempt is made to highlight the public’s response to the existing disparity in the health services of the villagers compared to urban dwellers. Such a reaction can be considered an outflow of people from rural areas, and an increase in self-medication among rural people as a result of the difficulty in obtaining health services. The decrease in the number of treatment facilities in rural areas leads to a deterioration in the medicine situation in rural areas. That, according to the authors of the article, justifies the need to study the issues associated with the provision of medical care to the rural population.
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Egbunu Abiodun Abosede, Makolo Daniel, and Alkali Daniels Emmanuel. "A spatial analysis of health care accessibility and utilization among rural households in Kogi State, Nigeria." International Journal of Life Science Research Archive 3, no. 1 (September 30, 2022): 101–9. http://dx.doi.org/10.53771/ijlsra.2022.3.1.0085.
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This study was aimed at a Spatial Analysis of Health Care Accessibility and Utilization among Rural Households in Kogi State, Nigeria. Primary data employed in this study were obtained with the aid of well-structured questionnaires. A multi-stage sampling technique was employed in the selection of respondents. The analytical techniques used in this study included descriptive statistics and Healthcare Accessibility Index. Descriptive statistics such as frequencies and percentages were used to describe the sources and uses of healthcare facilities in relation to socio-economic characteristics as well as the level of utilization of health care services. Results obtained in this study revealed that 58% of the respondents had access to health care services while only 42.50% utilized these services. Findings in this study also revealed that 71% of the household heads were males while the remaining 29% were females. However, 41% of the male headed households have access to healthcare services compared to 17% of the female headed households. Furthermore, 71% of the respondents were in their economic active age (≤ 50 years). About 75.55% of the respondents within this age bracket accesses and utilizes healthcare service more than the elderly ones. Exactly 43.50% had no formal education while 6, 23.5, 11.5, and 15.5% had adult, primary, secondary and tertiary education respectively. Thirteen percent (13.0%) of those with primary education had access to health care services while 78.57% out of these utilized the healthcare services. Furthermore, 24.5% of those with no formal education had access to healthcare service while 69.23% of the respondents utilized healthcare services. Majority (40.5%) of the rural households lived 5 to 9 km to a public health center with 21% having access to healthcare facilities and 85.7% utilizing the facilities. Eleven percent of respondents living 4 km from the healthcare service provider have access to healthcare facilities while 90.09% of the respondents utilized it. About 13% of the respondent who lives 10 to 14 km from healthcare service had access while 61.11% utilized the services. Forty-three percent (43.75%) of respondents living more than 14 km to their healthcare providers makes use of the available healthcare facilities. The result, therefore, indicates that utilization of available health facilities increases with proximity to the health centers. Seven percent (7%) of respondents have family size of 1-4 members per household, whereas only 60% of the respondents within this group with access to healthcare facilities utilized it. Furthermore, those with household size above 14 members have the highest health service utilization with 85.71%. This study has shown that there is unequal distribution of health facilities as well as low level of accessibility of household to medical facilities in the study area. To this end, governments at all tiers should ensure equitable accessibility to health care delivery across the rural areas by deploying more medical and Para-medical staffs to the rural areas. Rural development policies should promote the creation of enabling environment to enhance participation in modern health care delivery in rural areas. There is also a serious need for sensitization programme to create awareness about the importance of using modern healthcare facilities among the rural dwellers.
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Vuzhyns’ka, Halyna. "System of rehabilitation and recreation of children in Lviv region: modern status, spatial features and problems." Visnyk of the Lviv University. Series Geography, no. 49 (December 30, 2015): 47–57. http://dx.doi.org/10.30970/vgg.2015.49.8605.
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The state of child population health of Ukraine is deteriorating in the last years. This situation requires careful attitude to the health of children, perfecting health systems, in particular, enhance the functioning of health resorts and spas in the regions of Ukraine in order to ensure the health and recreation of children. Scientific researchesthe current state of health child population, preconditions and factors of its formation, the spatial features we must also intensify. The relevance of research of the modern system of rehabilitation and recreation the children of Lviv region was show in the article. Regulatory-legal acts associated with this issue at the national and regional levels was analysed. Established dynamics of the number of children’s health and recreation facilities in Ukraine. It was established dynamics of the number of children’s rehabilitation and the recreation facilities in Ukraine. The mоst important children’s rehabilitation facilities that operated in 2013 in Lviv region was characterized. The spatial characteristics and problems of rehabilitation and rest of the child population in region were analyzed. Found, that the situation with the rehabilitation of children in the region over the past decade generally worsened, despite the presence of some positive developments. Recreational potential of the region was characterized and elucidated the impact of natural resources on the placement of establishments of children’s rehabilitation and recreation in the region. Most improving institutions (non-urban and sanatorium) are concentrated in areas with the best natural resources, medicinal mineral waters, climate, forest and water resources. Establishments recreation with the day care focused primarily in areas of high level of urbanization. Based on statistical information, traced the increased number of children’s institutions of rehabilitation and recreation in Lviv region. But, found that the growth achieved mainly by the rapid increase in the number of daycare camps created on the basis of educational institutions. Thus, the number of children’s institutions of rehabilitation (non-urban and sanatorium) annually decreases. In 2013 on the territory of Lviv region functioned 18 children’s institutions of rehabilitation that on seven institutions (18 %) less than in 2005. The measures for the conservation and improvement of existing children's Institutions the health and recreation, and also rebuilding and providing financing the Programme for the development of Ukrainian children's health resort “Skhidnytsia” were offered, that will allow in the future to solve the problem of rest and improvement of children. Key words: child population, spatial features, children’s institutions rehabilitation and recreation, system health improvement, territorial organization.
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Skuse, David. "The benefits of digitisation of psychiatric care facilities." BJPsych International 20, no. 3 (July 27, 2023): 53. http://dx.doi.org/10.1192/bji.2023.16.
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The potential benefits of providing digital mental healthcare to isolated rural populations are emphasised in two articles from Pakistan. Novel programmes of support have been instituted by both private and publicly funded services.
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Auras, Silke, and Max Geraedts. "International comparison of nine accreditation programmes for ambulatory care facilities." Journal of Public Health 19, no. 5 (March 23, 2011): 425–32. http://dx.doi.org/10.1007/s10389-011-0408-4.
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Domin, Michael A. "Highly Virulent Pathogens - a Post Antibiotic Era?" British Journal of Theatre Nursing (United Kingdom) 8, no. 2 (May 1998): 14–18. http://dx.doi.org/10.1177/175045899800800201.
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The spectrum of infectious diseases is changing rapidly. Emerging infectious agents present an intriguing constellation of nosocomial challenges. Antimicrobial resistance results in increased morbidity, mortality and costs of health care. Resistance to antimicrobial agents has been recorded since 1940 with penicillin resistant Escherichia coli (E coli) (Abraham and Chain 1940). A similar pencillin resistance was reported in 1944 in Staphylococus aureus (S. aureus) (Kirby 1944) Even before the widespread global use of penicillin, resistance had already been detected in both grampositive and gram-negative organisms. The 1990s herald the era of multiple drug resistance. To grasp further the enormity and complexity of our modern antimicrobial resistance problem, one only needs to think about how many - how fast -and in how many settings (hospitals, clinics, outpatients nursing and long term facilities, etc), these pathogens have developed antimicrobial resistance: Multiple drug-resistant Mycobacterium tuberculosis, penicillin-resistant Streptococcus pneumonia, fluconzole-resistant Candida, methicillin-resistant S. aureus (MRSA), vancomycin-resistant Enterococci (VRE) and now S. aureus with reduced susceptibility to vancomycin. Given the dramatic increase in the incidence of multiple drug-resistant organisms - and now - the mounting evidence of resistance transfer from one organism to another, we will certainly witness a combined growth of nosocomial pathogens, for which there are no antibiotic solutions. Appropriate infection control measures for such resistant strains depend, in part, on the mechanisms of genetic information exchanged among micro-organisms. Clearly we need to strengthen the basic tenets of infection prevention and control; hygiene, engineering and microbial barriers, to prevent transinfection. We need to control horizontal nosocomial transmission of organisms. Contaminated environmental surfaces are a reservoir for resistant organisms such as MRSA (Boyce et al 1997) and VRE (Karanfil et al 1992). Stringent infection control policies need to be developed and implemented. A comprehensively applied infection control programme will reduce the dissemination of resistant strains. Each patient care setting must examine its current practices and review the outcome efficacy. A consensus development conference to develop centres for disease control (CDC) formal guidelines against vancomycin intermediate-level resistant staphylococcus aureus (VISA) and vancomycin-resistant staphylococcus aureus (VRSA) may take a year or more to convene. This paper will examine the basic considerations currently offered by the CDC which may be valuable starting points for the enhancement of current infection control practices. Perspectives of the Society for Healthcare Epidemiology of America (SHEA) will also be included.
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Khan, Zubeda, Ghulam Y. Soomro, and Samina Soomro. "Mother's Education and Utilisation of Health Care Services in Pakistan." Pakistan Development Review 33, no. 4II (December 1, 1994): 1155–66. http://dx.doi.org/10.30541/v33i4iipp.1155-1166.
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Education is one of the crucial social development variables especially for mothers which enriches their mind about their social and reproductive experiences and broadens their understanding to make better choices for themselves and rearing and bearing of their children. In many developing countries there is evidence that mother's education plays an important role in determining child mortality even in situations where the medical facilities are scanty [Berrera (1990); Caldwell (1979, 1981)]. Education, it is argued influences women's beliefs about the good health, causes and cures of diseases that increases the demand of the utilisation of modern health care facilities. Therefore, educated mothers are more likely to seek medical treatment for themselves and for their children resulting in higher intensity of the use of a better quality modern care that grows with the advancement of education. Evidence from the research done elsewhere suggests that mother's education has individual positive effect on the use of health care facilities Abbas and Walker (1986); Berrera (1990) and Caldwell (1979) have pointed out that educated mothers are more likely to take advantage of the modern health facilities than their uneducated counterparts in compliance to the recommended treatments primarily due to the different attitudes in regard to the knowledge and perceptions of the importance of the modern medicine in the care of their children. Berrera (1990) in a study of child nutrition in the Philippines found that the children of educated mothers took more advantage of the public health care facilities than the children of uneducated mothers.
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Ayonrinde, Folasade Oluwatomi. "Prices, Quality, and Demand for Modern Health Care Facilities in Oyo State, Nigeria." IBADAN JOURNAL OF THE SOCIAL SCIENCES 3, no. 1 (June 15, 2005): 29–40. http://dx.doi.org/10.36108/ijss/5002.30.0130.
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The study assessed the impact of user fees on demand for health care facilities, and examined the relationship between quality of service and utilization of modern health facilities in the country. The data were collected from 388 individuals ill 1999 from the five health zones ill Oyo State. To analyse the determinants of health facility utilization, information was elicited on individuals’ choice of health care Treatment. Using the Multinomial logit model and analysing with the revealed preference principle that permits the nature of consumers’ preferences to be deduced from observed choices, the results revealed user fees, gender, and distance as significant determinants of demand for health facilities and indicated the clear preference of respondents for private health care providers over public health providers. The policy implications emanating from the study suggest that the distance of public health facilities from patients and waiting Time need to be reduced to increase the rate of utilization. This call be done by government providing more health facilities in all local government areas and these should be within the reach of household members.
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O C, Odeyale, Abegunrin O O, Olayemi O O, Ogunsola J O, Adelusi F T, and Ajanaku A O. "Utilization of modern animal processing facilities among butchers in amosun abattoir, akinyele local government area of oyo state." Global Journal of Agricultural Sciences 21, no. 2 (December 19, 2022): 111–18. http://dx.doi.org/10.4314/gjass.v21i2.2.
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To ensure good public health standard, the quality of management of abattoirs in the aspect of compliance to standard practice of meat inspection, sanitation and utilisation of modern facilities is fundamental. This study therefore examined utilization of modern animal processing facilities among butchers at Amosun abattoir in Akinyele Local Government Area of Oyo State. Simple random sampling was used to select 53% of the butchers out of 212 who use modern processing facilities to give total number of 112 respondents. Data were analysed using descriptive and inferential statistics such as frequency, percentage and Pearson Product Moment Correlation (PPMC). The result showed that all the respondents were male (100%) and married (90.1%). Also, 81.98% were below 50 years, 45% of them had primary school education and practiced Islamic religion (75.70%). The result further revealed that majority (70.3%) had low utilisation of modern processing facilities as well as unfavourable attitude (55.0%). Majority (64.0%) of the respondents identified some of the constraints to utilisation of modern processing facilities to be high. PPMC showed that there is significant relationship between utilisation of modern processing facilities and attitude (r= 0.221, p = 0.02). Also, constraints and respondents attitude toward utilisation of modern processing facilities was significantly related (r = -0.257, p= 0.007). It is therefore recommended that government should organize seminar and programmes to create awareness on the importance of utilizing modern animal processing facilities.
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Ferre Navarete, F., and I. Palanca. "Mental health care in Madrid." European Psychiatry 20, S2 (October 2005): s279—s284. http://dx.doi.org/10.1016/s0924-9338(05)80174-9.
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AbstractAimTo describe principles and characteristics of mental health care in Madrid.MethodBased on existing data, service provision, number of professionals working in services, funding arrangements, pathways intocare, user/carer involvement and specific issues are reported.ResultsIn Madrid, mental health services are organized into 11 zones/areas, divided into 36 districts, where there is a mental healthoutpatient service with a multi-disciplinary team. Home treatment and psychosocial rehabilitation services have been developed. Specialist programmes exist for vulnerable client groups, including Children and Adolescents, Addiction/Alcohol and Older People. The Madrid Mental Health Plan (2003–2008) is regarded as the key driver in implementing service improvement and increased mental health and well-being in Madrid. It has a meant global budget increase of more than 10% for mental health services. Results of the first 2 years are: an increase in mental health staff employed (17%), four new hospitalization units, 50% increase in places for children and adolescents Day Hospitals, 62 new beds in long care residential units, development of specific programmes for the homeless and gender-based violence, a significant investment in information systems (450 new computers) and development of best practice and operational guidelines. Mental health system was put to the test with Madrid's March 11th terrorist attack. A Special Mental Health Plan for Affected people was developed.DiscussionUnlike some European countries, public mental health service is the main heath care provider. There are no voluntary agenciescollaborating with mental health care. Continuity of care and coordination between all mental health resources is essential in service delivery. Increased demand of care for minor psychiatric disorders, children and adolescent mental health care, and implementation of rehabilitation and residential facilities for chronic patients are outstanding challenges similar to those in other European capitals. Overall, the mental health system had successfully coped with last year's increased care demand after March 11th terrorist attack in Madrid.
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Garba, Saleh Ngaski, Abdullahi Haruna Ibrahim, Emmanuel Ejembi Anyebe, Umar Yunusa, Umar Bello Lawal, Idris Abdurashid, Hassan Hassan Murtala, and Muhammad Awwal Ladan. "Evaluation of Emergency Obstetric Care Services in Primary Health Care Facilities in Niger State: A Mixed Methods Study." Bayero Journal of Nursing and Health Care 3, no. 2 (September 11, 2022): 918–26. http://dx.doi.org/10.4314/bjnhc.v3i2.12.
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Background: Primary health care (PHC) is built on the principles of equity in the distribution of quality health care, active community participation in health care programmes and emphasis on prevention of illnesses rather than cure. The main objectives of maternal health services in the primary health care programme are to ensure that every expectant mother maintains good health throughout the maternity cycle. Aim: The main aim of this study is to evaluate the provision of emergency obstetrics care (EmOC) in Primary Health Care facilities. Materials and Methods: Utilizing the mixed research design, data were collected from 887 women, 69 male participants and 24 healthcare providers across 24 PHC facilities in Niger State selected through the multistage sampling technique using the questionnaire, focus group discussion, indepth interview and facility assessment. Ethical approval and all necessary permission were obtained from the Niger State Primary Health Care Agency, stakeholders and the participants. Data were analyzed using descriptive statistics and transcription. Results: Findings from the study revealed that prolonged/obstructed labour, hypertension in pregnancy, bleeding in pregnancy, anaemia, retained placenta and breech presentation of the baby during childbirth were among the maternal health problems occurring in the study locations. Also, there were no facilities for the provision of EmOC services in the PHC facilities. Conclusion: Although prolonged/obstructed labour, hypertension in pregnancy, bleeding in pregnancy, anaemia, postpartum haemorrhage and retained placenta were among the frequently occurring maternal health problems, EmOC services were not provided in almost all the PHC facilities visited. It is therefore recommended that efforts should be made to improve the state of the PHC facilities.
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Tostões, Ana. "Health at the core of Modern Movement Architecture." Cure and Care, no. 62 (2020): 2–3. http://dx.doi.org/10.52200/62.a.6qvksdmb.
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Investigation into healthcare facilities involves dealing with multiple spheres beyond the technological, physical and psychological. Nowadays, the growing emphasis on wellbeing goes beyond the seminal ideas that modern buildings were cleansing machines, or that modern architecture and urbanism were shaped by bacteria. Presenting some stimulating philosophically-orientated essays, this journal makes a link between the Modern Movement and what we have entitled the “Cure and Care” concept, connecting health and the environment, body and design. Considering healthcare buildings and their role in the welfare policy of societies, the discussion addresses future challenges, driven by developments in technology and medicine, envisaging a key role for healthcare facilities in ensuring a sustainable built environment.
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Al-turaiki, M. H. S., and L. A. Al-falahi. "Prosthetics and orthotics: A survey of centres in the Kingdom of Saudi Arabia." Prosthetics and Orthotics International 16, no. 1 (April 1992): 38–45. http://dx.doi.org/10.3109/03093649209164306.
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This paper reports the results of a survey carried out to evaluate existing prosthetic and orthotic facilities and programmes of education, training, and research and development in the Kingdom of Saudi Arabia. One hundred and twenty hospitals and medical rehabilitation centres were each circularised with a questionnaire requesting information that mainly concerned (i) types of prostheses/ orthoses, (ii) area of facility, (iii) personnel number and qualifications, and (iv) problems encountered and suggested solutions. The completed questionnaires revealed that in the final analysis of data there were only ten prosthetic/orthotic facilities. The survey provided useful data on the personnel, equipment, and facilities available in each hospital or medical rehabilitation centre, together with details of the services to prospective referring clinicians. Two centres were found to provide high quality services by qualified personnel. There were no formal prosthetic/orthotic training programmes and there was only one prosthetic/orthotic research and development centre. The respondents generally felt that there were three major problems: (i) lack of qualified personnel, (ii) lack of materials and components, and (iii) lack of continuing education and training programmes. It is hoped that presentation of these results will provide facts for both health-care providers and educators which may be used as a basis for development in this important area of healthcare.
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Bouzanis, Katrina, Siddharth Joshi, Cynthia Lokker, Sureka Pavalagantharajah, Yun Qiu, Hargun Sidhu, Lawrence Mbuagbaw, et al. "Health programmes and services addressing the prevention and management of infectious diseases in people who inject drugs in Canada: a systematic integrative review." BMJ Open 11, no. 9 (September 2021): e047511. http://dx.doi.org/10.1136/bmjopen-2020-047511.
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ObjectivesPeople who inject drugs (PWID) experience a high burden of injection drug use-related infectious disease and challenges in accessing adequate care. This study sought to identify programmes and services in Canada addressing the prevention and management of infectious disease in PWID.DesignThis study employed a systematic integrative review methodology. Electronic databases (PubMed, CINAHL and Web of Science Core Collection) and relevant websites were searched for literature published between 2008 and 2019 (last search date was 6 June 2019). Eligible articles and documents were required to address injection or intravenous drug use and health programmes or services relating to the prevention or management of infectious diseases in Canada.ResultsThis study identified 1607 unique articles and 97 were included in this study. The health programmes and services identified included testing and management of HIV and hepatitis C virus (n=27), supervised injection facilities (n=19), medication treatment for opioid use disorder (n=12), integrated infectious disease and addiction programmes (n=10), needle exchange programmes (n=9), harm reduction strategies broadly (n=6), mobile care initiatives (n=5), peer-delivered services (n=3), management of IDU-related bacterial infections (n=2) and others (n=4). Key implications for policy, practice and future research were identified based on the results of the included studies, which include addressing individual and systemic factors that impede care, furthering evaluation of programmes and the need to provide comprehensive care to PWID, involving medical care, social support and harm reduction.ConclusionsThese results demonstrate the need for expanded services across a variety of settings and populations. Our study emphasises the importance of addressing social and structural factors that impede infectious disease care for PWID. Further research is needed to improve evaluation of health programmes and services and contextual factors surrounding accessing services or returning to care.PROSPERO registration numberCRD42020142947.
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Pipe, Andrew L., William Evans, and Sophia Papadakis. "Smoking cessation: health system challenges and opportunities." Tobacco Control 31, no. 2 (March 2022): 340–47. http://dx.doi.org/10.1136/tobaccocontrol-2021-056575.
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The systematic integration of evidence-based tobacco treatment has yet to be broadly viewed as a standard-of-care. The Framework Convention on Tobacco Control recommends the provision of support for tobacco cessation. We argue that the provision of smoking cessation services in clinical settings is a fundamental clinical responsibility and permits the opportunity to more effectively assist with cessation. The role of clinicians in prioritising smoking cessation is essential in all settings. Clinical benefits of implementing cessation services in hospital settings have been recognised for three decades—but have not been consistently provided. The Ottawa Model for Smoking Cessation has used an ‘organisational change’ approach to its introduction and has served as the basis for the introduction of cessation programmes in hospital and primary care settings in Canada and elsewhere. The significance of smoking cessation dwarfs that of many preventive interventions in primary care. Compelling evidence attests to the importance of providing cessation services as part of cancer treatment, but implementation of such programmes has been slow. We recognise that the provision of such services must reflect the realities and resources of a particular health system. In low-income and middle-income countries, access to treatment facilities pose unique challenges. The integration of cessation programmes with tuberculosis control services may offer opportunities; and standardisation of peri-operative care to include smoking cessation may not require additional resources. Mobile phones afford unique opportunities for interactive cessation programming. Health system change is fundamental to improving the provision of cessation services; clinicians can be powerful advocates for such change.
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Tesfay, Fisaha Haile, Sara Javanparast, Hailay Gesesew, Lillian Mwanri, and Anna Ziersch. "Characteristics and impacts of nutritional programmes to address undernutrition of adults living with HIV in sub-Saharan Africa: a systematic review of evidence." BMJ Open 12, no. 1 (January 2022): e047205. http://dx.doi.org/10.1136/bmjopen-2020-047205.
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ObjectivesAlthough some studies have identified various challenges affecting nutritional programmes to effectively tackle undernutrition among people living with HIV, evidence about the characteristics and impacts of these programmes on weight-related nutritional outcomes varies based on country contexts, specific programme goals and the implementation processes. This systematic review sought to synthesise evidence on the characteristics and impact of nutritional programmes on weight-related nutritional outcomes of people living with HIV in sub-Saharan Africa.DesignSystematic review.Data sourcesWe searched for primary studies published in the following databases: Web of Science, Medline, Scopus, ScienceDirect, ProQuest and Google Scholar, supplemented by checking reference lists of included papers.Eligibility criteriaStudies published from 2005 to 10 July 2020 and reporting on the weight-related nutritional outcomes of undernourished people enrolled in nutritional programmes in HIV care in sub-Saharan Africa were included.Data extraction and synthesisData were extracted using a data extraction proforma. Weight-related nutritional outcomes of people living with HIV before and after enrolment in a nutritional programme were compared and narratively synthesised.ResultsSixteen studies assessing the impact of nutritional programmes in HIV care on weight-related nutritional outcomes were included. Of these, 13 examined nutritional programmes implemented in health facilities and the remaining three were delivered outside of health facilities. Nutritional recovery (defined differently in the studies) ranged from 13.1% to 67.9%. Overall programme failure rate, which included default after enrolment in a nutritional programme or non-response, ranged from 37.6% to 48.0%. More specifically, non-response to a nutritional programme ranged from 21.0% to 67.4% and default from the programme ranged from 19.0% to 70.6%. Key sociodemographic, clinical and nutritional characteristics that affect nutritional recovery, non-response and default were also identified.Conclusions and recommendationsNutritional programmes in HIV care have led to some improvements in weight-related nutritional outcomes among people living with HIV. However, the programmes were characterised by a high magnitude of default and non-response. To improve desired weight-related nutritional outcomes of people living with HIV, a holistic approach that addresses longer-term determinants of undernutrition is needed.PROSPERO registration numberCRD42020196827.
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Olaleye, A., E. Orji, A. Akintayo, A. Olaleye, and J. Imaralu. "Perception and uptake of contraception among health workers in Ile-Ife, South-western Nigeria." Babcock University Medical Journal (BUMJ) 1, no. 1 (March 31, 2015): 21–28. http://dx.doi.org/10.38029/bumj.v1i1.22.
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Objective: This study was carried out to assess the perception of health workers towards contraceptive methods, determine the proportion of health workers using modern contraceptive methods and identify factors influencing their contraceptive practice.
Methods: A cross sectional descriptive survey of 300 practicing nurses in the health facilities within Ile-Ife, Nigeria was done using pre-tested, self-administered semi-structured questionnaires.
Results: Most of the respondents were less than 30years, married, multiparous and had practised for more than 2years. Prevalence of modern contraceptive use was 75.2%. Knowledge of contraceptives was poorest for injectables and oral contraceptive pills (32% each). Twenty six percent of respondents believed that contraception should be limited to women who had completed their families, while 32.4% were either uncertain or disagreed with the safety of contraceptives. The commonest method used was the condom, though contraceptive choice varied with cadre of staff. Desire for another pregnancy was the main reason for discontinuing contraception (51.2%). Older age, religion and marriage positively influenced contraceptive use.
Conclusion: Knowledge and perception of contraception among nurses in Ile-Ife is relatively poor. Ensuring accurate information on contraception among this target group of health workers is an important step towards achieving success in the national family planning programme.
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Rashid, Ahmed, Deborah Gill, and Lamis Ragab. "The Best of Both Worlds: Experiences of Co-developing Innovative Undergraduate Health Care Programmes in Egypt." Journal of Medical Education and Curricular Development 6 (January 2019): 238212051988512. http://dx.doi.org/10.1177/2382120519885122.
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As medical education has become increasingly globalised, universities across the world have sought to raise standards by partnering with well-established institutions and a number of different partnership models have emerged. This article describes an academic collaboration between University College London (UCL), UK, and Newgiza University (NGU), Egypt, to establish modern and innovative undergraduate medicine, dentistry, and pharmacy programmes delivered in Egypt. Academics from UCL and NGU co-developed programmes using established materials, assessments, and processes from the equivalent programmes at UCL. Dedicated project managers, regular steering group meetings, strong working relationships between project teams, and iterative curriculum and assessment development processes were important features of the success of this work. A multidisciplinary first semester included students across all 3 health care programmes. This promoted collaboration between academics at both institutions. Although UCL resources were the basis of this project, the different sociocultural, ethical, professional, and regulatory frameworks in Egypt have meant that a number of adaptations have been necessary, in both curricula and teaching content. Perhaps the most important factor underpinning the success of this project has been the mutual respect and sensitivity of academics and clinicians from both institutions.
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Martyniuk, Olivia JM, Leigh M. Vanderloo, Jennifer D. Irwin, Shauna M. Burke, and Patricia Tucker. "Comparing the nutrition environment and practices of home- and centre-based child-care facilities." Public Health Nutrition 19, no. 4 (January 6, 2016): 575–84. http://dx.doi.org/10.1017/s1368980015003535.
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AbstractObjectiveTo assess and compare the nutrition environment and practices (as they relate to pre-schoolers) of centre- and home-based child-care facilities.DesignUsing a cross-sectional study design, nineteen child-care facilities (ten centre-based, nine home-based) were assessed for one full day using the Environment and Policy Assessment and Observation (EPAO) tool (consisting of a day-long observation/review of the nutrition environment, practices and related documents). Specifically, eight nutrition-related subscales were considered.SettingChild-care facilities in London, Ontario, Canada.SubjectsChild-care facilities were recruited through directors at centre-based programmes and the providers of home-based programmes.ResultsThe mean total nutrition environment EPAO scores for centre- and home-based facilities were 12·3 (sd 1·94) and 10·8 (sd 0·78) out of 20 (where a higher score indicates a more supportive environment with regard to nutrition), respectively. The difference between the total nutrition environment EPAO score for centre- and home-based facilities was approaching significance (P=0·055). For both types of facilities, the highest nutrition subscale score (out of 20) was achieved in the staff behaviours domain (centre mean=17·4; home mean=17·0) and the lowest was in the nutrition training and education domain (centre mean=3·6; home mean=2·0).ConclusionsAdditional research is needed to confirm these findings. In order to better support child-care staff and enhance the overall nutrition environment in child care, modifications to food practices could be adopted. Specifically, the nutritional quality of foods/beverages provided to pre-schoolers could be improved, nutrition-related training for child-care staff could be provided, and a nutrition curriculum could be created to educate pre-schoolers about healthy food choices.
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MWANGA, J. R., P. MAGNUSSEN, THE LATE C. L. MUGASHE, THE LATE R. M. GABONE, and J. AAGAARD-HANSEN. "SCHISTOSOMIASIS-RELATED PERCEPTIONS, ATTITUDES AND TREATMENT-SEEKING PRACTICES IN MAGU DISTRICT, TANZANIA: PUBLIC HEALTH IMPLICATIONS." Journal of Biosocial Science 36, no. 1 (January 2004): 63–81. http://dx.doi.org/10.1017/s0021932003006114.
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A study on perceptions, attitudes and treatment-seeking practices related to schistosomiasis was conducted among the Wasukuma in the rural Magu district of Tanzania at the shore of Lake Victoria where Schistosoma haematobium and mansoni infections are endemic. The study applied in-depth interviews, focus group discussions and a questionnaire survey among adults and primary school children. The perceived symptoms and causes were incongruous with the biomedical perspective and a number of respondents found schistosomiasis to be a shameful disease. Lack of diagnostic and curative services at the government health care facilities was common, but there was a willingness from the biomedical health care services to collaborate with the traditional healers. Recommendations to the District Health Management Team were: that collaboration between biomedical and traditional health care providers should be strengthened and that the government facilities’ diagnostic and curative capacity with regard to schistosomiasis should be upgraded. Culturally compatible health education programmes should be developed in collaboration with the local community.
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Nasir, Naima, Adeniyi Kolade Aderoba, and Proochista Ariana. "Scoping review of maternal and newborn health interventions and programmes in Nigeria." BMJ Open 12, no. 2 (February 2022): e054784. http://dx.doi.org/10.1136/bmjopen-2021-054784.
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ObjectiveTo systematically scope and map research regarding interventions, programmes or strategies to improve maternal and newborn health (MNH) in Nigeria.DesignScoping review.Data sources and eligibility criteriaSystematic searches were conducted from 1 June to 22 July 2020 in PubMed, Embase, Scopus, together with a search of the grey literature. Publications presenting interventions and programmes to improve maternal or newborn health or both in Nigeria were included.Data extraction and analysisThe data extracted included source and year of publication, geographical setting, study design, target population(s), type of intervention/programme, reported outcomes and any reported facilitators or barriers. Data analysis involved descriptive numerical summaries and qualitative content analysis. We summarised the evidence using a framework combining WHO recommendations for MNH, the continuum of care and the social determinants of health frameworks to identify gaps where further research and action may be needed.ResultsA total of 80 publications were included in this review. Most interventions (71%) were aligned with WHO recommendations, and half (n=40) targeted the pregnancy and childbirth stages of the continuum of care. Most of the programmes (n=74) examined the intermediate social determinants of maternal health related to health system factors within health facilities, with only a few interventions aimed at structural social determinants. An integrated approach to implementation and funding constraints were among factors reported as facilitators and barriers, respectively.ConclusionUsing an integrated framework, we found most MNH interventions in Nigeria were aligned with the WHO recommendations and focused on the intermediate social determinants of health within health facilities. We determined a paucity of research on interventions targeting the structural social determinants and community-based approaches, and limited attention to pre-pregnancy interventions. To accelerate progress towards the sustainable development goal MNH targets, greater focus on implementing interventions and measuring context-specific challenges beyond the health facility is required.
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Bebe, D. Ngo, T. Dumbi, P. Bulemvo, and I. Bakanseka. "The Paradox of Community Participation in Primary Health Care in Zaire." Promotion & Education 2, no. 4 (December 1995): 29–47. http://dx.doi.org/10.1177/175797599500200410.
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Dr. Ngo Bebe, author of the preceding article, considers that the difficulty in achieving true community participation remains one of the main impediments to success in primary health care programmes (PHC). The classic approach fails from the very beginning when District Medical Officers and other health professionals are chosen to manage primary health care programmes. Their attempts to convince the communities of the necessity of following their advice are often far too overbearing, and thus reinforce the «expert to ignorant» situation to a point where maintaining a true partnership becomes difficult, even impossible. It often happens as well that the community representatives in PHC programmes adopt aspects of the overbearing, «expert-like» behaviour. When this happens, they alienate themselves from the community or, in the least, lose any influence toward initiating action. As for the health professionals, they most likely direct any influence they may have towards clinically-oriented health measures. The preceding tendencies result in programmes which are quite far from the community's true concerns for achieving well-being and development. The PHC's problems such as lack of medicine and care facilities are generally overtaken by the more pressing priorities such as lack of good roads, energy, safe water, diminishing crops, etc. Dr. Ngo Bebe's article describes an initiative wherein the traditional primary health care approach is replaced by an integrated, community - centered programme. The health center remains the physical point for coordination, and its personnel participates in a variety of activities already taking place in the community. A health aspect is included, but does not overpower the activity which was formerly underway. A community development worker is integrated into the health center team. This provides the opportunity for growth and exchange, thus rendering the various activities truly interdisciplinary. Although this community mobilisation process has been underway in certain villages in Zaire for the past two years, and seems to have a positive impact on community development and the health status of the villagers, it is still early to proclaim the initiative an entire success. Only an assessment of the long term benefits will indicate the strengths and weaknesses of the project.
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Rana, Radhika, and Pankaj Bhardwaj. "Paradigm Shift in Peripheral Health Post." Journal of Comprehensive Health 10, no. 1 (June 30, 2022): 41–43. http://dx.doi.org/10.53553/jch.v10i01.008.
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Indian Public Health Standards (IPHS) provides standards and guidance quality health rendered by public health system components such as infrastructure, human resource, drugs, diagnostics, equipment, quality and governance requirements for delivering health services at health facilities at all levels. Setting up a protocol at all health care levels is a dynamic process and needs to update with the introduction of new and existing National Health Programmes as per the epidemiological shift of diseases in the country. The Indian Public Health Standards (IPHS) for Sub-centre and Health and Wellness-Sub centre provide a guidance on essential package of services that are to be delivered at Health and Wellness-SC level, the population norms for its establishment, infrastructure, human resource, drugs & diagnostics, equipment & supplies and quality care assurance.
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Oleksich, Zhanna, Jan Polcyn, and Oleg Shtogrin. "Adaptation of the best European practices in administering local health care institutions." Health Economics and Management Review 2, no. 2 (2021): 15–22. http://dx.doi.org/10.21272/hem.2021.2-02.
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This study aimed to justify the mechanisms for improving the administration system of local health care facilities based on the best European experience. This study determined the state of health care facilities in Ukraine based on assessing the quality of medical services, rational resources usage, personnel management, and technical and technological improvement. Systematization of scientific sources and approaches to solving investigated issues showed methodological underdevelopment and methodological lack of administration systems of Ukrainian health care facilities at the local level, considering the specifics of medical services. Thus, healthcare institutions need to adapt, develop, and implement the best international practices in administrative technologies. For gaining the research goal, the study was carried out in the following logical sequence: 1) analyzing the current models of health care development processes in the world; 2) determining the features of administration system od the health care institutions; 3) developing recommendations for improving the administration system of local health care facilities in Ukraine. The methodological tool of this research is the systematization of information based on the content analysis of official websites. The research object is the administration system of health care facilities in Ukraine. In the study, the authors present several approaches to organize state administration of health care at the national and regional levels. The authors determined the effective tools for administering health care institutions. The study substantiated the strategic format of developing health care facilities in modern conditions by providing high-quality services, rational resources usage, personnel management, and technical and technological improvement.
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Zaman, Mufaiz-Ul, and Rasiya-Ul Zaman. "Importance of Hospital Furniture in Modern Medical Facilities." International Journal of Health Technology and Innovation 1, no. 02 (August 17, 2022): 50–52. http://dx.doi.org/10.60142/ijhti.v1i02.44.
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Hospital furniture is an essential part of medical care for hospitals. It includes trolleys, side screens and beds to name just a few. Medical devices alongside modern furnishings have played an important role within health care ever since its inception. Hospital Furniture is one thing that every hospital must possess. The hospitals are committed to ensuring that patients feel comfortable and safe during their treatments, which is why they use advanced furniture technology in all their clinical settings. Medical examination of patients is a crucial part in diagnosing them, and ICU hospital furniture helps to ensure the safety for critical ill people. Clinical furnishings thus have immense variety applications which can be found at any medical facility. Hospital furniture is a necessary and important part of any healthcare system. It can make or break the quality care patients receive while hospitalized, so its design must be top notch. From beds to stretchers, even medical carts, there are numerous types that each has their own specific purpose in mind for hospital use which will help you provide comfort as well maintain safety on both sides with ease. Furniture is essential for creating a comfortable and welcoming environment. It’s also necessary to ensure that furniture can be easily maintained, as well as being durable enough so it lasts through years of use without showing too much wear or tear from normal usage by patients in your hospital facility. The right medical supplier will help to me et al. these needs with their wide variety products available on the market today including: office chairs (especially those designed specifically towards hospitals), tables made especially low height spaces like examining rooms where people may want extra space around them when sitting down but not folded up completely against wall.
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Croke, Kevin, Andualem Telaye Mengistu, Stephen D. O'Connell, and Kibrom Tafere. "The impact of a health facility construction campaign on health service utilisation and outcomes: analysis of spatially linked survey and facility location data in Ethiopia." BMJ Global Health 5, no. 8 (August 2020): e002430. http://dx.doi.org/10.1136/bmjgh-2020-002430.
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BackgroundAccess to health facilities in many low-income and middle-income countries remains low, with a strong association between individuals’ distance to facilities and health outcomes. Yet plausibly causal estimates of the effects of facility construction programmes are rare. Starting in 2004, more than 2800 government health facilities were built in Ethiopia. This study estimates the impact of this programme on maternal health service utilisation and birth outcomes.MethodsWe analyse the impact of Ethiopia’s health centre construction programme on health service utilisation and outcomes, using a difference-in-difference design. We match facility opening years to child birth years in four rounds of Demographic and Health Surveys (DHS) using georeferenced data. We also use event study models to test for pre-trends in the outcomes of interest.ResultsOpening of new health facilities within 5 km increases facility delivery by 7.2 percentage points (95% CI 5.2 to 9.1) and antenatal care by 0.38 visits (95% CI 0.24 to 0.52). It is not significantly associated with changes in caesarean section births or neonatal mortality. Opening of district hospitals increases facility delivery by 18.2 percentage points (95% CI 12.7 to 23.7), and caesarean section births by 6.8 percentage points (95% CI 2.5 to 11.2), but is not associated with reduction of neonatal mortality.ConclusionsEthiopia’s facility construction program improved access to antenatal and delivery care. However, there was no detectable association between facility construction and neonatal mortality. Increased access to care must be combined with health system quality improvements and broader social development initiatives to sustainably improve health outcomes.
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Malatji, Hlologelo, Frances Griffiths, and Jane Goudge. "Community-orientated primary health care: Exploring the interface between community health worker programmes, the health system and communities in South Africa." PLOS Global Public Health 3, no. 2 (February 14, 2023): e0000881. http://dx.doi.org/10.1371/journal.pgph.0000881.
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Due to insufficient number of health workers and the evidence of the benefits of community health workers (CHWs), CHWs are being deployed to provide health care services to under-served communities. In this article, we explore to what extent the South African CHW programmes introduced between 2009 and 2011 are attuned to community needs, integrated into the healthcare system and community structures, and also implemented in accordance with community-orientated primary health care principles. Using a case study approach, we studied CHW teams in seven primary healthcare facilities located in semi-urban and rural areas of Gauteng and Mpumalanga provinces, South Africa. We collected data using in-depth interviews involving facility managers, CHW supervisors, community representatives and key informants, and focus groups and observations of CHWs. The implementation of community-orientated health interventions remains complex. In the different sites, there were efforts to integrate the views of stakeholders (e.g., political leaders) into the implementation of the CHW programmes. However, many residents were more concerned about access to housing than health services. The CHWs services’ were found to be generally comprehensive, however inefficient training, supervision and mentorship limited their effectiveness. The multidisciplinary approach to care, as introduced by some sites, helped enhance the knowledge and skills of some of the CHWs on complex health topics. The roll out of community orientated primary health care services is crucial in a resource-constrained setting like South Africa. However, significant socio-economic issues disrupt community involvement and the effective provision of services. Governments need to provide sufficient funds for training, supervision, supplies and remuneration to help overcome these barriers.
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Lumbantoruan, Christina, Margaret Kelaher, Michelle Kermode, and Endang Budihastuti. "Pregnant women’s retention and associated health facility characteristics in the prevention of mother-to-child HIV transmission in Indonesia: cross-sectional study." BMJ Open 10, no. 9 (September 2020): e034418. http://dx.doi.org/10.1136/bmjopen-2019-034418.
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ObjectivesDespite the national effort to integrate the Prevention of Mother-to-Child Transmission (PMTCT) programme into antenatal care clinics in Indonesia, the rate of mother-to-child HIV transmission remains high. This national study was conducted to describe PMTCT programme performance and to identify health facility characteristics associated with this performance in order to inform programme planning and policy development.DesignA retrospective cross-sectional study in December 2017.SettingAll health facilities providing PMTCT programmes in Indonesia.ParticipantsAll health facilities registering at least one woman in antenatal care in 2017.InterventionPMTCT data extraction from the national reporting system on HIV/AIDS and government reports.OutcomesWomen retention in the PMTCT programme for at least 3 months and associated health facility characteristics.ResultsA total of 373 health facilities registering 6502 HIV-positive women in antenatal care were included in the analysis. One-third of women (2099) never started antiretroviral treatment. Of the 4403 women who started, 2610 (57%) were retained; 462 (10%) were not retained; and the retention status of 1252 (28%) women referred out of the health facilities was unknown. Compared with primary health centres, hospitals were more likely to retain women (OR=2.88, 95% CI 2.19 to 3.79). The odds of retention were higher in hospital types A and B (OR=3.89, 95% CI 3.19 to 4.76), located within concentrated HIV epidemic areas (OR=2.09, 95% CI 1.83 to 2.38) and a high-priority area for the HIV programme (OR=1.83, 95% CI 1.60 to 2.09). We observed no differential retention between women who initiated PMTCT under different options (B+/non-B+).ConclusionsWe observed low retention of HIV-positive pregnant women in the PMTCT programme in Indonesia in 2017. Additional efforts are needed to improve women’s retention in the PMTCT programme. Retention could be increased through the delivery of PMTCT programmes by replicating strategies implemented at hospital types A and B located in concentrated HIV epidemic areas where an HIV programme is a high priority.
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Wroe, Emily B., Basimenye Nhlema, Elizabeth L. Dunbar, Alexandra V. Kulinkina, Chiyembekezo Kachimanga, Moses Aron, Luckson Dullie, et al. "A household-based community health worker programme for non-communicable disease, malnutrition, tuberculosis, HIV and maternal health: a stepped-wedge cluster randomised controlled trial in Neno District, Malawi." BMJ Global Health 6, no. 9 (September 2021): e006535. http://dx.doi.org/10.1136/bmjgh-2021-006535.
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BackgroundCommunity health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expanding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).MethodsWe conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.FindingsThe intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.InterpretationCHW programmes can be successfully expanded to more comprehensively address health needs in a population, although programmes should be carefully tailored to CHW and health system capacity.
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Bambaren, C. "(A3) Health Care Facilities Affected by the Earthquake in Chile." Prehospital and Disaster Medicine 26, S1 (May 2011): s1—s2. http://dx.doi.org/10.1017/s1049023x11000203.
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IntroductionOn February 27, 2010, a 8,8 MW earthquake struck the central and southern coast of Chile, that was followed by a tsunami that destroyed some cities such as Constitution, Ilaco, Talcahuando and Dichato. The national authorities reported 512 dead and 81,444 homes were affected. It was the one of the five most powerful earthquakes in the human modern history. The most affected regions were Maule (VII) and Bio (VIII).ResultsThe impact of the quake in the health sector was enormous especially on the health care infrastructure. The preliminary evaluations showed that 18 hospitals were out of service due severe structural and no-structural damages, interruption of the provision of water or because they were at risk to landslides. Another 31 hospitals had moderate damage. The Ministry of Health lost 4249 beds including 297 (7%) in critical care units. Twenty-two percent of the total number of beds and thirty-nine surgical facilities available in the affected regions were lost in a few minutes due to quake. At least eight hospitals should be reconstructed and other hospitals will need complex repair.ConclusionThe effect of the earthquake was significant on hospital services. It included damages to the infrastructure and the loss of furniture and biomedical equipment. The interruption of the cold chain caused loss of vaccines. National and foreign field hospitals, temporary facilities and the strengthening of the primary health care facilities had been important to assure the continuation of health care services. *Based on information from PAHO – Chile.
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Assan, Joseph K., Samuel K. Assan, Nicola Assan, and Lauren Smith. "Health Inequality in Resource Poor Environments and the Pursuit of the MDGs." Journal of Health Management 11, no. 1 (January 2009): 93–108. http://dx.doi.org/10.1177/097206340901100107.
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The article examines health inequalities and the impact of changing healthcare provision in rural Indonesia. Traditional medicine is often the only source of medical care for a majority of the population in rural Indonesia. However, the pursuit of the Millennium Development Goals (MDGs) requires the provision and implementation of modern healthcare systems. Using case studies from four rural districts in Kaledupa, a remote island in southeast Sulawesi in Indonesia, the study shows that although modern healthcare facilities are present in the sampled island, they seem to be remote with limited access in comparison with the number of traditional practitioners. High costs, cultural beliefs, distrust and distance to modern healthcare facilities appear to be the most common reasons for people opting for traditional healthcare. However, social reconstruction in the perception and provision of care has also led to a gradual disappearance of the traditional healthcare provision. The study calls for policy intervention approaches that are geographically and culturally sensitive as the most pragmatic means towards the attainment of MDG targets for the health sector of Indonesia.
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Chien, Jaime MF, Ban Hock Tan, Kok Soong Yang, Thuan Tong Tan, Chian Yong Low, Asok Kurup, Hoe Nam Leong, et al. "Severe Infection with H1N1 Requiring Intensive Care – Lessons for Preparedness Programmes." Annals of the Academy of Medicine, Singapore 39, no. 4 (April 15, 2010): 328–32. http://dx.doi.org/10.47102/annals-acadmedsg.v39n4p328.
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Introduction: The influenza pandemic has generated much interest in the press and the medical world. We report our experience with 15 cases of severe novel influenza A H1N1 (2009) infections requiring intensive care. The aim of this review is to improve our preparedness for epidemics and pandemics by studying the most severely affected patients. Clinical Picture: During the epidemic, hospitals were required to provide data on all confirmed H1N1 cases admitted to an intensive care unit (ICU) to the Ministry of Health. We abstracted information from this dataset for this report. To highlight learning points, we reviewed the case notes of, and report, the five most instructive cases. Treatment: There were 15 cases admitted to an ICU from July 4, 2009 to August 30, 2009. Two patients died. Conclusions: The lessons we wish to share include the following: preparedness should include having intermediate-care facilities that also provide single room isolation and skilled nursing abilities, stringent visitor screening should be implemented and influenza may trigger an acute myocardial infarction in persons with risk factors. Key words: Influenza pandemic, Preparedness for epidemic, Visitor screening
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Gamage, C. K. W., W. S. Sudusinghe, and H. A. E. Abdulmohsen. "Simulation-Based Medical Learning: The Future of Sri Lankan Health Care." South-East Asian Journal of Medical Education 17, no. 1 (October 25, 2023): 31–34. http://dx.doi.org/10.4038/seajme.v17i1.530.
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Novel medical curricula stress the need for proficiency in clinical skills by medical and nursing undergraduates over the mere possession of knowledge. Simulation-based Medical Learning has gained the attention of modern clinical training by enhancing clinical performance and patient safety more than traditional clinical training at hospitals. The present modern medical context uses various types of simulators. However, Simulation-Based Medical Learning in Sri Lanka remains at a preliminary stage compared to the international context due to multiple challenges.This paper aims to identify the challenges faced in Simulation-Based Medical Learning in Sri Lanka and recommend the mechanisms to overcome those challenges. Lack of resources and infrastructure, lack of funding, poor literacy on handling simulators, lack of trained personnel, and cultural and mindset barriers were the identified potential challenges in Sri Lanka towards Simulation-Based Medical Learning. Nevertheless, these challenges can be mediated by finding international partnerships and funding sources, establishing foreign training with new collaborations, increasing awareness through faculty development programmes, combining Simulated Patients with low-fidelity simulators, and integrating Simulation-Based Medical Learning into the medical curriculum.
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Yavorskyy, Andriy. "Analysis of Indicators of in Patient Surgical Care at the Health Care Facilities in Ivano-Frankivsk Region for 2005-2015." Galician Medical Journal 23, no. 4 (November 1, 2016): 201646. http://dx.doi.org/10.21802/gmj.2016.4.6.
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Surgical inpatient care is one of the most capital-intensive types of care. Therefore, the health care system task is to ensure public access to this type of care, to guarantee the safety and quality of its provision on the background of resources rational use.The objective of the research was to analyze the basic parameters of inpatient surgical care quality provided at Ivano-Frankivsk region health care facilities. Materials and methods. The data of statistical reports (17 and 20) of health care facilities in Ivano-Frankivsk region for 2005-2015 were analyzed. Sociological survey of 530 patients treated at the surgical units of inpatient facilities was conducted. Results of the research. Resources for surgical inpatient care in terms of quantity in Ivano-Frankivsk region including beds and staff were determined to be higher than the average national level. However, the quality of staffing of the regional health care facilities (secondary employment coefficient is less than one point, one third of surgeons is with the second qualifying category or is not certified) does not meet modern requirements. Low-duty health care facilities were detected to be characterized by low operational activity (60.6%, 114.0 operations per surgeon per year on average), insufficient relevance of hospitalization (40% of operations may be performed on an outpatient basis), low attractiveness for a significant per cent of patients (46.2%).Conclusions. Regional program for optimization of surgical care provision should be developed.
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Bhardwaj, Samita, Sonal Raut, and Vidyadhar B. Bangal. "Training of maternal health care providers in newer modalities of management of post-partum haemorrhage." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 3 (February 26, 2019): 1062. http://dx.doi.org/10.18203/2320-1770.ijrcog20190880.
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Background: Postpartum haemorrhage (PPH) is a life-threatening complication, that occurs suddenly and unexpectedly. Institutional delivery by skilled birth attendant who are trained in active management of third stage of labour and those who can use of Uterine Balloon Tamponade and Non-pneumatic anti shock garment can reduce incidence and morbidity related to PPH. The objective of the paper was to share the experiences of the training programmes held for maternal health care workers in the newer modalities of PPH management.Methods: During one and a half year period, 32 Continuation of Medical Education (CME) programmes, with the theme of “Managing Obstetric Emergencies and Obstetric Trauma”, covering important topics related to high risk pregnancies like Hypertension, Eclampsia ,Anaemia and Haemorrhage at 32 health institutions, spread over 11 states and 2 union territories in India, were conducted .In addition,42 hands on workshops at various health facilities were conducted with training of more than 2575 maternal health care providers.Results: The pre and post test scores revealed that 95 percent of the maternal health care providers were unaware about the use of Uterine Balloon Tamponade (Bakri balloon) in PPH and Non-pneumatic anti shock garment (NASG). Seventy percent were unaware about the proper sequence of steps of active management of third stage of labour. Training programmes helped to improve the knowledge, whereas hands on workshop, helped in skill development of the health care providers. The participants expressed great satisfaction regarding the knowledge and skills they acquired through training programme on management of post-partum haemorrhage. They gave positive feedback about the quality, contents and conduct of training programme.Conclusions: There is need for refresher training of maternal health care providers in newer modalities like AMTSL, NASG and Bakri balloon, which have potential to save lives.
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Махнова, Наталья, and Natalya Makhnova. "Improvement of financial security of health system of the Russian Federation in modern conditions." Services in Russia and abroad 9, no. 2 (July 22, 2015): 0. http://dx.doi.org/10.12737/11898.
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The essence of the problems and ways of improving the single-channel system of financial support of health care system implemented in the Russian Federation today are described in the article. The basic advantages (payment of the final result, the principle of extraterritoriality, etc.) and disadvantages of this type of financing (the growth of corruption in health care facilities, the claiming by regional authorities in advance reduced volumes of work of medical institutions under the territorial program programs of compulsory health insurance etc.) are highlighted. The legal aspects of functioning of the single-channel financing system are represented. In our view the measures for optimize the work of the health system in the Russian Federation should include: transition to the new salary system of health workers and the development of basic and additional list of criteria for the effectiveness of both health professionals and managers of health facilities. The problem of satisfaction of staff requirements in the Russian health care system has a systemic, multifactorial character. Forming an interconnected list of criteria of efficiency of medical staff and their managers would allow, on the one side to attract qualified staff to the region, on the other - to improve control of financial and economic activity of the heads of medical institutions. Furthermore, these measures will allow slightly reduce social tension among health care workers, that will positively impact on the quality of medical care.
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Parker, Whadi-ah, Nelia P. Steyn, Naomi S. Levitt, and Carl J. Lombard. "They think they know but do they? Misalignment of perceptions of lifestyle modification knowledge among health professionals." Public Health Nutrition 14, no. 8 (January 28, 2010): 1429–38. http://dx.doi.org/10.1017/s1368980009993272.
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AbstractObjectiveThe present study aimed to evaluate the knowledge and practices of public-sector primary-care health professionals and final-year students regarding the role of nutrition, physical activity and smoking cessation (lifestyle modification) in the management of chronic diseases of lifestyle within the public health-care sector.DesignA comparative cross-sectional descriptive quantitative study was conducted in thirty primary health-care facilities and four tertiary institutions offering medical and/or nursing programmes in Cape Town in the Western Cape Metropole. Stratified random sampling, based on geographical location, was used to select the health facilities while convenience sampling was used to select students at the tertiary institutions. A validated self-administered knowledge test was used to obtain data from the health professionals.ResultsDifferential lifestyle modification knowledge exists among both health professionals and students, with less than 10 % achieving the desired scores of 80 % or higher. The majority of health professionals seem to be promoting the theoretical concepts of lifestyle modification but experience difficulty in providing practical advice to patients. Of the health professionals evaluated, doctors appeared to have the best knowledge of lifestyle modification. Lack of time, lack of patient adherence and language barriers were given as the main barriers to providing lifestyle counselling.ConclusionsThe undergraduate curricula of medical and nursing students should include sufficient training on lifestyle modification, particularly practical advice on diet, physical activity and smoking cessation. Health professionals working at primary health-care facilities should be updated by providing lifestyle modification education as part of continuing medical education.
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Murudi-Manganye, Nthuseni Sharon, Lufuno Makhado, and Leepile Alfred Sehularo. "Integrated Management of HIV and NCDs within the Primary Health Care in the South African Context: A Comprehensive Literature Review." Open Public Health Journal 13, no. 1 (September 22, 2020): 447–54. http://dx.doi.org/10.2174/1874944502013010447.
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Introduction Low and middle-income countries, including South Africa, are facing a challenge of the dual burden of chronic communicable and non-communicable diseases, which again pose a challenge to the improvement of patients’ clinical outcomes in the primary health care facilities. The introduction of innovative intervention to address the dual burden in South Africa created a challenge on nurses working at primary health care facilities to acquire a new set of skills to improve patients’ clinical outcomes. HIV programmes have shown great improvement in patients with HIV. However, there is still much to be done to improve NCD management. The aim of this review was to understand the status of integrated management of HIV and NCDs in South Africa and document the strengths and opportunities to sustain the implementation of integrated management of HIV and NCDs in PHC facilities in South Africa. Methodology: A comprehensive literature review of integrated management of HIV and NCDs in South Africa was conducted and complemented with a hand search literature in the form of policy documents and guidelines that were obtained from the National Department of Health. Results: A total of 17 out of 183 documents were analysed. Various strengths and opportunities, such as availability of approved guidelines and standardised training for nurses, are essential for the sustainability of integrated management of HIV and NCDs in Primary Health care facilities in South Africa. Conclusion: The CLR revealed that South Africa has strengths and opportunities which can be used to sustain integrated management of HIV and NCDs at PHC facilities and develop a model to strengthen the implementation of integrated management of HIV and NCDs in other provinces with minimal resources.
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Kolbe, Lloyd J., Gerald N. Tirozzi, Eva Marx, Mary Bobbitt-Cooke, Sara Riedel, Jack Jones, and Michael Schmoyer. "Health programmes for school employees: improving quality of life, health and productivity." Promotion & Education 12, no. 3-4 (September 2005): 157–61. http://dx.doi.org/10.1177/10253823050120030115.
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School health programmes in the 21 century could include eight components: 1) health services; 2) health education; 3) healthy physical and psychosocial environments; 4) psychological, counselling, and social services; 5) physical education and other physical activities; 6) healthy food services; and 7) integrated efforts of schools, families, and communities to improve the health of school students and employees. The eighth component of modern school health programmes, health programmes for school employees, is the focus of this article. Health programmes for school employees could be designed to increase the recruitment, retention, and productivity of school employees by partially focusing each of the preceding seven components of the school health programme on improving the health and quality of life of school employees as well as students. Thus, efforts to improve the quality of life, health, and productivity of school employees may be distinct from, but integrated with, efforts to improve the quality of life, health, and education of students. School employee health programmes can improve employee: 1) recruitment; 2) morale; 3) retention; and 4) productivity. They can reduce employee: 5) risk behaviours (e.g., physical inactivity); 6) risk factors (e.g., stress, obesity, high blood pressure); (7) illnesses; 8) work-related injuries; 9) absentee days; 10) worker compensation and disability claims; and 11) health care and health insurance costs. Further, if we hope to improve our schools' performance and raise student achievement levels, developing effective school employee health programmes can increase the likelihood that employees will: 12) serve as healthy role models for students; 13) implement effective school health programmes for students; and 14) present a positive image of the school to the community. If we are to improve the quality of life, health, and productivity of school employees in the 21st Century: school administrators, employees, and policymakers must be informed about the need and the means to do so; school employee health programmes must become part of the culture of education and the expectation of educators; and colleges that prepare school administrators and other school employees must provide the pre-service and in-service training, research, development, and leadership to make it happen. This article outlines ten actions that can be taken by school districts to build or improve school employee health programmes, and a list of websites that provides more detailed information about such programmes.
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Teoh, Soo Huat, Karen Christelle, Hui Zhu Thew, and Mastura Mohd Sopian. "Colorectal cancer screening in Malaysia: a critical situation that must be addressed." Bangladesh Journal of Medical Science 23, no. 1 (January 1, 2024): 278–80. http://dx.doi.org/10.3329/bjms.v23i1.70775.
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In Malaysia, colorectal cancer is the second most common cause of cancer. Early detection through screening programmes is one of the most important public health initiatives in reducing cancer-related death. For decades, Malaysia has a colorectal cancer screening program in government-funded primary care facilities. However, screening uptake is minimal and numerous theories have been postulated. The aim of this article is to explore the possible reasons for low colorectal screening uptake among primary care physicians.
Bangladesh Journal of Medical Science Vol. 23 No. 01 January’24 Page : 278-280
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Jayaraj, Joshua Chadwick, Karapet Davtyan, Hayk Davatyan, Anush Khachatryan, Armen Hayrepetyan, Lilit Khachatryan, Seda Abgaryan, et al. "A country-wide evaluation of infection control for tuberculosis in health-care facilities in Armenia." Journal of Infection in Developing Countries 13, no. 05.1 (May 16, 2019): 035S—041S. http://dx.doi.org/10.3855/jidc.11021.
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Introduction: Infection control at health facilities is an important part of TB control programmes. To assess the implementation of tuberculosis infection control (TB IC) measures and barriers hindering their implementation in TB health care facilities (HCFs) in Armenia; to report the feasibility of using the WHO recommended checklist.
Methodology: A cross-sectional survey using WHO TB-IC checklist and direct observations was conducted between January and May 2018.
Results: The survey included all 62 TB institutions in Armenia. TB HCFs in Armenia had implemented some recommended TB IC measures: offering IC training to staff (48%), shortening time to diagnosing TB to less than one day (29%) and ensuring good ventilation (60%). N95 respirators were available in all HCFs. However, barriers that hindered implementation of TB IC measures were: lack of training, a different incentive model for primary care doctors versus TB doctors and lack of space and poor conditions of the building.
Conclusion: The use of the standardized WHO checklist in this first evaluation of TB IC measures in Armenia was found to be useful and feasible in identifying areas of weak IC implementation and barriers to achieving good infection control. Other TB programs may benefit from the use of this model of assessment, based on the WHO checklist.
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Udo, Helen Ime, Nsikan-Abasi Monday Udofia, and Ini Nka Jona. "Knowledge, Attitude and Practice of Care of Elderly Among Health Workers in Tertiary Health Facilities in Uyo Metropolis." International Journal of Research and Innovation in Social Science 06, no. 08 (2022): 51–57. http://dx.doi.org/10.47772/ijriss.2022.6804.
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Elderly care emphasizes the social and personal requirements of senior citizens who need some assistance with daily activities and health care, but who desire to age with dignity. With increasing rate of elderly in the society, there have been insufficient healthcare services for the elderly. Most health workers have very poor knowledge of health conditions which are common with the elderly and this lack of adequate knowledge triggers negative attitude towards the care of the elderly likely to result in serious problems in our society in the near future. This study was conducted to examine the knowledge, attitude and practice of care of elderly among health workers in tertiary health facilities in Uyo Metropolis. Three specific objectives, three research questions and three null hypotheses guided the study. The study employed a cross-sectional descriptive research design. The population of study consisted of 394 health workers. The sample of 241 health workers comprising of 27 doctors, 190 nurses, 10dentists and 14 Physiotherapist was determined using Taro Yamane and selected for the study using stratified sampling technique. The instrument used for data collection was questionnaire titled “Knowledge, Attitude and Practice of Care of Elderly Questionnaire (KAPCEQ)”. The instrument yielded the reliability coefficient of 0.84. The data were collected by the researcher and four trained research assistants. Frequency and percentage were used for the answering of the research questions while chi-square was used for testing of null hypotheses at .05 level of significance. Findings of the study indicated that health workers had adequate knowledge of care of elderly, exhibit good attitude toward care of elderly and sometimes practice care of the elderly in tertiary health facilities in Uyo Metropolis. Based on the findings of the study, the researcher recommended among others that Hospital Management Board should develop a system of periodical health workers evaluation to determine strategies of upgrading health workers knowledge and enhancing practice of care of the elderly. Furthermore, Professional bodies in the health sectors should develop a follow up courses and in-service training programmes to maintain efficient performance of individuals previously trained in the care of the elderly.
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Song, F., T. Rathwell, A. Long, and C. Thunhurst. "An Analytical Framework of Physician Productivity and Variation in Utilization." Health Services Management Research 6, no. 3 (August 1993): 146–55. http://dx.doi.org/10.1177/095148489300600301.
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The utilization of medical services by patients is an important determinant of doctor productivity, but this factor does not appear to have been given much attention in previous studies. In order to answer the question of why is there a wide variation in doctor output at low level medical facilities in China, an analytical framework of doctor productivity and utilization is developed. The simulation model is used to produce data that can be analyzed by such a framework. Great uncertainty about patient flows is one reason for the average lower and varying doctor productivity in lower level health facilities. Until uncertainty can be reduced, more flexibility is needed at the lower level to cope with changing utilization patterns and patient characteristics. The management by doctors of non-patient care activities (preventive programmes, medical research, teaching, and administration) is crucial to any approach to using doctor resources more effectively and efficiently.
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Chinyama, Jonathan, and Anitha J. Menon. "Mental Health and Healthcare Provision in Zambian Correctional Facilities." Medical Journal of Zambia 47, no. 3 (September 30, 2020): 208–14. http://dx.doi.org/10.55320/mjz.47.3.88.
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Objective: The aim was to determine the prevalence of psychiatric disorders, mental health problems and mental health care service provisions in Zambian correctional facilitiesStudy sample: 240 inmates interviewed using the MINI, the WEMWBS and demographic questionnaireResearch Design: This was a cross-section point prevalenceResults: Prevalence rates: Current psychiatric disorders 46.2%. Current and past 63.3%. Major depressive episode 47(19.6%), Psychotic disorder current 38(15.8%), Psychotic disorder lifetime 18(7.5%), Major depressive episode past 17(7%), Substance dependence current and Posttraumatic disorder 14(5.8%) each, Manic episode current 5(2.1%) and the rest below 2%. Suicide risks had 49 inmates out of 240(20.4%). Out of 49, 20(40.8%) had high- risk, 8(16.3%) moderate and 21(42.9%) low risk- levels. Medium had the highest prevalenceof inmates at risk of suicide 31(63.3%). Out of 31, 17(54.8%) had low, 6(19.4%) moderate and 8(25.8%) high-risk levels. Second highest was maximum 18(20%): out of 18, 4(22.2%) had low, 2(11.1%) had moderate and 12(66.7%) high- risk levels. Inmates in maximum correctional facility were more likely to have suicidal ideations and attempts than their counterparts in medium. Substance dependence is higher in medium (11%) compared to maximum (3%) and current substance abuse at 2% in both and 1% current alcohol abuse in medium. Mental Well-being WEMWBS mean score (cut-off point) at 50.7, Minimum (50.7) showed good and stable mental Wellbeing compared to Medium and Maximum whose participants recorded poor mental Wellbeing 36.2 and 37.4.Conclusion: There is a high prevalence of psychiatric disorders and mental health problems with total absence of mental health care services among inmates in the three Zambian correctional facility categories. Majority of these inmates are not screened and treated. Greater mental health awareness and provision of mental health services focusing on staff training programmes to detect mental illnesses are needed and further research is recommended throughout Zambia.
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O., Afolabi, Kio J., Afolabi A., Ajala C., and Ajayi O. "Acceptance of Partner’s Presence during Labour by Midwives, Clients and Partners in selected Health Facilities in Osogbo, Nigeria." African Journal of Health, Nursing and Midwifery 5, no. 1 (January 6, 2022): 15–23. http://dx.doi.org/10.52589/ajhnm-dv77ko9m.
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This study examined the acceptance of partners’ presence during labour by midwives, clients and partners in selected health facilities in Osogbo, Nigeria. Well-structured questionnaire was used to collect data from a total of 120 respondents consisting of midwives, clients and partners from the health facilities. Data collected and analyzed using descriptive and inferential statistics. The Statistics Package for Social Sciences (SPSS version 20) was employed for data analysis. All analyses were done at p≤0.05. The study reveals that there is no significant difference in the acceptance of partners’ presence during labour by the three categories of respondents. The study concludes that partners’ presence be embraced as an intentional policy in health care, Midwifery training and practices in labour management in Nigeria. The study recommends that Government should initiate policies to facilitate partners’ presence during labour and organize programmes on partners’ presence during labour which will be made a standardized practice in all hospitals and this should be communicated and taught to staff immediately they are employed into the health care institutions.
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Keller, Angela, B. T. Baune, A. Keller, and H. Zeeb. "P1.45: The influence of social factors on health status, utilization of health care facilities including screening programmes among migrants and Germans." Biometrical Journal 46, S1 (March 2004): 116. http://dx.doi.org/10.1002/bimj.200490020.
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Islam, Mohammad Zahidul, M. Mofizul Islam, Md Mostafizur Rahman, and Md Nuruzzaman Khan. "Prevalence and risk factors of short birth interval in Bangladesh: Evidence from the linked data of population and health facility survey." PLOS Global Public Health 2, no. 4 (April 22, 2022): e0000288. http://dx.doi.org/10.1371/journal.pgph.0000288.
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The Sustainable Development Goals 3 targets significant reductions in maternal and under-five deaths by 2030. The prevalence of these deaths is significantly associated with short birth intervals (SBI). Identification of factors associated with SBI is pivotal for intervening with appropriate programmes to reduce occurrence of SBI and associated adverse consequences. This study aimed to determine the factors associated with SBI in Bangladesh. A total of 5,941 women included in the 2017/18 Bangladesh Demographic and Health Survey 2017/18 and 1,524 healthcare facilities included in the 2017 Bangladesh Health Facility were linked and analysed. The sample was selected based on the availability of the birth interval data between the two most recent subsequent live birth. SBI was defined as an interval between consecutive births of 33 months or less, as recommended by the World Health Organization and was the outcome variable. Several individual-, households-, and community-level factors were considered as exposure variables. We used descriptive statistics to summarise respondents’ characteristics and multilevel Poisson regression to assess the association between the outcome variable with exposure variables. Around 26% of live births occurred in short intervals, with a further higher prevalence among younger, uneducated, or rural women. The likelihoods of SBI were lower among women aged 20–34 years (PR, 0.14; 95% CI, 0.11–0.17) and ≥35 years (PR, 0.03; 95% CI, 0.02–0.05) as compared to the women aged 19 years or less. Women from households with the richest wealth quintile experienced lower odds of SBI (PR, 0.61; 95% CI, 0.45–0.85) compared to those from the poorest wealth quintile. The prevalences of SBI were higher among women whose second most recent child died (PR, 5.23; 95% CI, 4.18–6.55), those who were living in Chattogram (PR, 1.52; 95% CI, 1.12–2.07) or Sylhet (PR, 2.83, 95% CI, 2.08–3.86) divisions. Availability of modern contraceptives at the nearest healthcare facilities was 66% protective to the occurrence of SBI (PR, 0.34; 95% CI, 0.22–0.78). Also, the prevalence of SBI increased around 85% (PR, 1.85; 95% CI, 1.33–2.18) for every kilometer increase in the distance of nearby health facilities from women’s homes. Targeted and tailored regional policies and programmes are needed to increase the awareness of SBI and associated adverse health outcomes and availability of modern contraception in the healthcare facilities.
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Dvoynikov, Sergey, and Svetlana Arhipova. "To the Problem of Increased Efficiency in Health Care Strategic Management." Medical Technologies. Assessment and Choice (Медицинские технологии. Оценка и выбор), no. 1 (35) (May 1, 2019): 50–55. http://dx.doi.org/10.31556/2219-0678.2019.35.1.050-055.
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Introduction. Modern health care is a leader in the social sector in terms of the number of public-private partnership projects. Monitoring of the implementation of strategic projects proves that the targets on the key indicators of the road map are reached. However, experts give a negative assessment of the availability and quality of medical care. Methods. The article describes the experience of using the balanced scorecard as an instrument for linking the key health care indicators and performance indicators of individual health facilities. Principles underlying cohesion and balance of the separate elements of the system are justified. Methods for identifying a statistically significant causal relationship between indicators are analyzed. A general model for the assessment of the attainment of the strategic goals by taking into account the three-level healthcare system is proposed. Results. The presented details on the structure of indicators could be used by managers of health facilities for the development of their own strategies. The article concluded that further specification on the methodology of obtaining objective information to assess the success in health care strategic management is necessary.
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L., J. F. "MOUNTING SENSE OF JOB MALAISE PROMPTS MORE HEALTH-CARE WORKERS TO JOIN UNIONS." Pediatrics 94, no. 3 (September 1, 1994): 396. http://dx.doi.org/10.1542/peds.94.3.396.
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In search of job security and a voice in health-care reform, a growing number of workers at hospitals, nursing homes, and rehabilitation facilities are joining labor unions. Hospital workers filed 158 petitions for union elections in 1993, up from only 19 in 1989, according to a study by Management Science Associates, Inc, a labor consulting firm. And unions won 58% of health-care elections in 1993—the highest win rate in the industry since 1984, according to Modern Health Care, an industry journal.