Articles de revues : « Populations (access to essential service for) »

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Russell, Grant, Susannah Westbury, Sharon Clifford, Elizabeth Sturgiss, Anna Fragkoudi, Rob Macindoe, Deborah Stuart, Marina Kunin, Jill Walsh et Cathie Scott. « Improving access for the vulnerable : a mixed-methods feasibility study of a pop-up model of care in south-eastern Melbourne, Australia ». Australian Journal of Primary Health 28, n^o 2 (25 février 2022) : 143–50. http://dx.doi.org/10.1071/py21188.

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Access to appropriate health and social care is challenging for vulnerable populations. We used a ‘pop-up’ delivery model to bring community-based services in contact with communities with poor access to health and social care. Our aim was to examine whether pop-up events improve access to essential health and social support services for selected vulnerable communities and increase collaboration between community-based health and social services. Set in south-eastern Melbourne, two pop-up events were held, one with people at risk of homelessness attending a community lunch and the other with South Sudanese women helping at-risk youth. Providers represented 20 dental, housing, justice, employment and mental health services. We made structured observations of each event and held semi-structured interviews with consumers and providers. Pre-post surveys of managers assessed acceptability and perceived impact. We reached 100 community participants who had multiple needs, particularly for dentistry. Following the events, participants reported increased knowledge of services and access pathways, community members spoke of increased trust and partnerships between service providers were fostered. The pop-up model can increase provider collaboration and provide new options for vulnerable populations to access needed services. ‘Bringing the service to the person’ is a compelling alternative to asking consumers to negotiate complex access pathways.

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Mark, Ochala, EyaChukwunonso Patrick, Okoronkwo, Patience Nnenna, Okoliko Emmanuel Ojonugwa et Musa Zakari. « NATIONAL HEALTH INSURANCE POLICY AND PROGRAMME AND ACCESS TO HEALTH CARE SERVICE AMONG FEDERAL GOVERNMENT WORKERS IN NIGERIA ». International Journal of Economics Finance & ; Management Science 09, n^o 04 (7 avril 2024) : 01–14. http://dx.doi.org/10.55640/ijefms-9151.

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The study examined the effect of National Health Insurance on health care service delivery Among Federal Workers in Nigeria. This mixed research design study investigates the relationships between primary and secondary health care service providers and the provision of essential healthcare services to enrollees in Nigeria. The population of the study encompasses federal governamnt workers with primary and secondary health care facilities across various regions in Nigeria. A sample size of 400 enrollees and 50 health care providers was selected using stratified random sampling techniques. Data were collected through structured interviews and surveys, focusing on the perceptions and experiences of both health care providers and enrollees regarding the provision of affordable health care, testing and diagnostic services, and referral services. The collected data were analyzed usingboth qualitative and quantitative methods, including thematic analysis and correlation analysis. The findings reveal significant relationships between primary health care service providers and the provision of affordable health care and testing and diagnostic services to enrollees in Nigeria. Moreover, the study identifies a significant relationship between secondary health care service providers and the provision of referral services to enrollees, highlighting the importance of collaboration between primary and secondary healthcare sectors to ensure comprehensive healthcare delivery in Nigeria. These results underscore the need for policy interventions and resource allocation strategies aimed at strengthening primary and secondary healthcare systems to improve access to essential healthcare services for all enrollees in Nigeria. The study recommends that Federal Government through the NHIA shouldimplement policies that aim to increase the affordability of healthcare services for all citizens, especially those in lower socioeconomic strata. This may involve subsidizing healthcare costs, expanding insurance coverage, or introducing targeted assistance programs for vulnerable populations. Additionally, encourage healthcare providers to offer transparent pricing structures and explore innovative payment models, such as sliding-scale fees or income-based discounts, to improve access for individuals with varying financial capacities.

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Cuadrado, Cristóbal, Francisca Vidal, Jorge Pacheco et Sandra Flores-Alvarado. « Cancer Care Access in Chile’s Vulnerable Populations During the COVID-19 Pandemic ». American Journal of Public Health 112, S6 (août 2022) : S591—S601. http://dx.doi.org/10.2105/ajph.2021.306587.

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Objectives. To examine the COVID-19 pandemic’s impact on cancer care access in Chile, analyzing differential effects by insurance type, gender, and age. Methods. We conducted a quasi-experimental study using interrupted time series analysis. We used multiple data sources for a broad evaluation of cancer-related health care utilization from January 2017 to December 2020. We fit negative binomial models by population groups for a range of services and diagnoses. Results. A sharp drop in oncology health care utilization in March was followed by a slow, incomplete recovery over 2020. Cumulative cancer-related services, diagnostic confirmations, and sick leaves were reduced by one third in 2020; the decrease was more pronounced among women and the publicly insured. Early diagnosis was missed in 5132 persons with 4 common cancers. Conclusions. The pandemic stressed the Chilean health system, decreasing access to essential services, with a profound impact on cancer care. Oncology service reductions preceded large-scale lockdowns and supply-side disruptions. Importantly, not all population groups were equally affected, with patterns suggesting that gender and socioeconomic inequalities were exacerbated. (Am J Public Health. 2022;112(S6):S591–S601. https://doi.org/10.2105/AJPH.2021.306587 )

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Shafiq, Mudassar, Hudyeron Rocha, António Couto et Sara Ferreira. « A Clustering Approach for Analyzing Access to Public Transportation and Destinations ». Sustainability 16, n^o 16 (13 août 2024) : 6944. http://dx.doi.org/10.3390/su16166944.

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Promoting sustainable and equitable public transportation services is essential for addressing disparities and preventing social exclusion among diverse population groups for daily activities. This paper proposes a comprehensive approach to assess transport disadvantages and identify areas with limited access to public transport and services. By combining statistical and geographic techniques, we analyze demographic, socioeconomic, and travel data to spatially contextualize areas based on the social structure and understand the characteristics of population groups facing transportation challenges in the Porto Metropolitan Area. Cluster analysis results revealed four distinct clusters with homogeneous characteristics. In contrast, service area analysis assessed the public transport coverage to identify served zones, the population within these zones, and activities reached in the region. Our findings indicate that suburban and rural areas often lack access to public transport stops, aggravated by lower service frequencies, leading to high reliance on private cars for essential activities, such as work and education. Despite the good geographical coverage of rail and bus stops, urban and central–urban areas also suffer from inadequate service frequencies, impacting public transport usage. Improving service quality in high-demand areas could encourage greater public transport utilization and enhance accessibility. Identifying areas facing inequities facilitates targeted policy interventions and prioritized investments to improve accessibility and address mobility needs to access services effectively.

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Koporc, Kimberly M., David R. Hotchkiss, Charles F. Stoecker, Deborah A. McFarland et Thomas Carton. « Assessing the effects of disease-specific programs on health systems : An analysis of the Bangladesh Lymphatic Filariasis Elimination Program’s impacts on health service coverage and catastrophic health expenditure ». PLOS Neglected Tropical Diseases 15, n^o 11 (23 novembre 2021) : e0009894. http://dx.doi.org/10.1371/journal.pntd.0009894.

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This study presents a methodology for using tracer indicators to measure the effects of disease-specific programs on national health systems. The methodology is then used to analyze the effects of Bangladesh’s Lymphatic Filariasis Elimination Program, a disease-specific program, on the health system. Using difference-in-differences models and secondary data from population-based household surveys, this study compares changes over time in the utilization rates of eight essential health services and incidences of catastrophic health expenditures between individuals and households, respectively, of lymphatic filariasis hyper-endemic districts (treatment districts) and of hypo- and non-endemic districts (control districts). Utilization of all health services increased from year 2000 to year 2014 for the entire population but more so for the population living in treatment districts. However, when the services were analyzed individually, the difference-in-differences between the two populations was insignificant. Disadvantaged populations (i.e., populations that lived in rural areas, belonged to lower wealth quintiles, or did not attend school) were less likely to access essential health services. After five years of program interventions, households in control districts had a lower incidence of catastrophic health expenditures at several thresholds measured using total household expenditures and total non-food expenditures as denominators. Using essential health service coverage rates as outcome measures, the Lymphatic Filariasis Elimination Program cannot be said to have strengthened or weakened the health system. We can also say that there is a positive association between the Lymphatic Filariasis Elimination Program’s interventions and lowered incidence of catastrophic health expenditures.

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Shobichah, Shobichah, et Aurelia Widya Astuti. « Analysis of Social Factors In Improving Access and Utilization of Healthcare Services In the Community ». International Journal of Social Health 2, n^o 11 (27 novembre 2023) : 367–73. http://dx.doi.org/10.58860/ijsh.v2i11.82.

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Healthcare is an essential aspect of societal well-being, and ensuring equitable access to healthcare services is crucial for achieving better health outcomes and improving the overall quality of life in communities. This study aims to analyze the social factors contributing to improving access and utilization of healthcare services in the community. The study adopts a mixed-methods approach, combining quantitative and qualitative methods. Quantitative data collection is conducted through surveys using structured questionnaires distributed to random samples from relevant community populations. Meanwhile, qualitative data is gathered through in-depth interviews with key informants with experience and knowledge regarding healthcare service access and utilization. The analysis reveals several social factors influencing the enhancement of access and utilization of healthcare services in the community. Social factors such as education level, income level, socioeconomic status, and awareness of the importance of healthcare services play pivotal roles in determining the extent to which individuals and families can access and benefit from available healthcare services. Furthermore, social factors such as stigma towards specific diseases, culture, and traditions, and communication and information patterns within the community also impact healthcare service access and utilization. A comprehensive understanding of these factors will assist in designing appropriate interventions to improve access and utilization of healthcare services in the community. In conclusion, this research identifies critical social factors that contribute to improving access and utilization of healthcare services in the community.

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Yokobori, Yuta, Hiroyuki Kiyohara, Nadila Mulati, Kaung Suu Lwin, Truong Quy Quoc Bao, Myo Nyein Aung, Motoyuki Yuasa et Masami Fujita. « Roles of Social Protection to Promote Health Service Coverage among Vulnerable People toward Achieving Universal Health Coverage : A Literature Review of International Organizations ». International Journal of Environmental Research and Public Health 20, n^o 9 (8 mai 2023) : 5754. http://dx.doi.org/10.3390/ijerph20095754.

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A wider range of social protection services, including social insurance and social assistance, are gaining global attention as a key driver of improved health service coverage and financial protection among vulnerable populations. However, only a few studies have investigated the associations between social protection and universal health coverage (UHC). Therefore, we conducted a literature review on relevant international organizations with respect to this topic. We found that many international organizations consider the wide range of social protection services, including social insurance and social assistance, essential for achieving UHC in 2030. In specific health programs, social protection is considered an important service to promote health service access and financial protection, especially among vulnerable populations. However, discussions about social protection for achieving UHC are not given high priority in the World Health Organization. Currently, the coverage of social protection services is low among vulnerable populations in low- and middle-income countries. To address this issue, we employed the metrics recommended by the migrant integration policy index (MIPEX). Based on our findings, a conceptual framework was developed. We expect this framework to lead synergy between social protection and health systems around the globe, resulting in healthy ageing.

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Kirkbride, J. B., et P. B. Jones. « Parity of esteem begins at home : translating empirical psychiatric research into effective public mental health ». Psychological Medicine 44, n^o 8 (9 août 2013) : 1569–76. http://dx.doi.org/10.1017/s0033291713001992.

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There is increasing recognition that parity of esteem between mental and physical health disorders is essential to improve the course, outcome and quality of life of individuals within different populations. Achieving this parity now underpins the objectives of several nations. Here, we argue that parity of esteem between mental and physical health can only be realized when parity of esteem also exists across mental health disorders, particularly in terms of service commissioning and planning. Using first-episode psychosis and early intervention in psychosis services as a motivating example, we demonstrate how carefully conducted psychiatric epidemiology can be translated to develop precise forecasts of the anticipated incidence of first-episode psychosis in different populations, based on an understanding of underlying local needs and inequalities. Open-access prediction tools such as PsyMaptic will allow commissioners of mental health services to more effectively allocate resources across services, based on empirical evidence and local need, thus reducing inequalities in access to mental health care.

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Malmstrom, P. E., T. Faherty et P. Wagner. « Essential Nonmedical Perinatal Services for Multiple Birth Families ». Acta geneticae medicae et gemellologiae : twin research 37, n^o 2 (avril 1988) : 193–98. http://dx.doi.org/10.1017/s0001566000004128.

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AbstractParents of multiples suffer unique stresses which can severely impair family health and welfare. Access to information, counseling, and community resources increase parents' abilities to cope, and reduce the risk of child and spousal abuse. Twinline, a social service agency in Califormia, provides a variety of free and low-cost nonmedical perinatal services to meet the needs of a heterogeneous population of over 1,000 multiple birth families and parents expecting multiples in the urban and rural counties of the San Francisco Bay Area.

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Contreras-Velásquez, Julio César, Omaira Suárez Bernal, José Alban Londoño Arias, Luis Eduardo Rodríguez Arenas, Jorge Isaac García-Navarro, Carlos Hernán González Parias et Jessica Manosalva Sandoval. « Access to Essential Utilities by The Bottom of The Pyramid (BoP) Population in Colombia ». Revista de Gestão Social e Ambiental 18, n^o 10 (6 septembre 2024) : e07149. http://dx.doi.org/10.24857/rgsa.v18n10-014.

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Objective: The article analyzes whether there is an association between the different levels of the BoP and the area of residence with the variables of access to essential utilities in a region of Colombia. Theoretical Framework: The literature review addresses the concepts of access to essential utilities and the BoP Population. Method: The data analyzed comes from 2,394 homes in the Norte de Santander region (Colombia), which were segmented by poverty conditions, resulting in 1,521 in the BoP. To establish the association between variables, the Mann Whitney U test was used; the magnitude of the association has been determined using Cramér's V coefficients. Results and Discussion: Results show that cooking fuel, excreta disposal, and urban waste management services have a high association with the socioeconomic levels at the BoP; while the drinking water service has a moderate association, yielding a Cramer V value of 0.47. Regarding the area of residence, the independence between the variables Access to essential utilities and Area of residence is rejected; that is, they are associated. Little interest was evident on the part of public and private organizations in the essential services sector in serving this market segment, by not including it in their marketing targeting strategies. The finding was also that people from the BoP in Norte de Santander, Colombia, who reside in urban areas, have better access to these services than those in rural areas, confirming the hypotheses raised based on similar studies carried out in regions from Asia. Research Implications: These results leads to recommending that companies in the essential services sector that have the BoP as their target market make a distinction in marketing strategies between the urban and rural markets of the BoP. Originality/Value: The study uses an innovative socioeconomic level classification method that facilitates comparison with other regions by not using income level as the only variable.

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Yeboah, Isaac, Duah Dwomoh, Rawlance Ndejjo, Steven Ndugwa Kabwama, Fidelia Ohemeng, Sylvia Akpene Takyi, Ibrahim Issah, Serwaa Akoto Bawuah, Rhoda Kitti Wanyenze et Julius Fobil. « Maintaining essential health services during COVID-19 in Ghana : a qualitative study ». BMJ Global Health 8, Suppl 6 (mars 2024) : e013284. http://dx.doi.org/10.1136/bmjgh-2023-013284.

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IntroductionEvidence suggests that non-pharmaceutical interventions such as lockdown policies, restriction of movement and physical distancing to control the novel COVID-19 contributed to the decline in utilisation of essential health services. We explored healthcare providers’ and policy-makers’ experiences of the barriers, interventions and response actions that contributed to ensuring the continuity of essential health services during the COVID-19 pandemic in Ghana to help inform future practice and policy.MethodsWe used a qualitative study approach. Data were analysed using thematic analysis. Thirty Four participants composed of 20 healthcare providers and 14 policy-makers who worked across regions with low and high recorded COVID-19 cases in Ghana during the COVID-19 pandemic were involved in this study.ResultsParticipants reported that essential health services including maternal, reproductive and child health services, communicable and non-communicable disease care, and elective surgeries were disrupted during the COVID-19 pandemic. Barriers to the utilisation of essential services were constructed into three subthemes: (1) fear, (2) poor quality of care at the facility and (3) financial limitation. These barriers were mitigated with population-based interventions underpinned by the socioecological model at the individual and interpersonal level (including psychosocial care for families and home visits), institutional and community levels (such as allocation of funds, training of health workers, public education, triage stations, provision of logistics, appointment scheduling, telemedicine and redeployment of health workers) and public policy level (tax relief packages, transportation arrangements and provision of incentives), which helped in maintaining essential health services during COVID-19.ConclusionDisruption of essential health services during COVID-19 in Ghana instigated population-based interventions which aided in expanding the populations’ continuous access to essential health services and strengthened health service delivery.

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Hennis, Anselm J. M., Anna Coates, Sandra del Pino, Massimo Ghidinelli, Rodolfo Gomez Ponce de Leon, Edwin Bolastig, Luis Castellanos, Renato Oliveira e Souza et Silvana Luciani. « COVID-19 and inequities in the Americas : lessons learned and implications for essential health services ». Revista Panamericana de Salud Pública 45 (28 décembre 2021) : 1. http://dx.doi.org/10.26633/rpsp.2021.130.

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The COVID-19 pandemic has exacerbated social, economic, and health-related disparities, which disproportionately affect persons living in conditions of vulnerability. Such populations include ethnic groups who face discrimination and experience barriers to accessing comprehensive health care. The COVID-19 pandemic has exposed these health disparities, and disruptions of essential health services have further widened the gaps in access to health care. Noncommunicable diseases are more prevalent among groups most impacted by poor social determinants of health and have been associated with an increased likelihood of severe COVID-19 disease and higher mortality. Disruptions in the provision of essential health services for noncommunicable diseases, mental health, communicable diseases such as HIV, tuberculosis, and malaria, and maternal and child health services (including sexual and reproductive health), are projected to also increase poor health outcomes. Other challenges have been an increased frequency of interpersonal violence and food insecurity. Countries in the Americas have responded to the disruptions caused by the pandemic by means of health service delivery through telemedicine and other digital solutions and stepping up social service support interventions. As vaccinations for COVID-19 create the opportunity to overcome the pandemic, countries must strengthen primary health care and essential health services with a view to ensuring equity, if the region is to achieve universal health coverage in fulfillment of the Sustainable Development Goals.

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VanBenschoten, Hannah, Hamsadvani Kuganantham, Elin C. Larsson, Margit Endler, Anna Thorson, Kristina Gemzell-Danielsson, Claudia Hanson, Bela Ganatra, Moazzam Ali et Amanda Cleeve. « Impact of the COVID-19 pandemic on access to and utilisation of services for sexual and reproductive health : a scoping review ». BMJ Global Health 7, n^o 10 (octobre 2022) : e009594. http://dx.doi.org/10.1136/bmjgh-2022-009594.

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IntroductionThe COVID-19 pandemic has negatively impacted health systems globally and widened preexisting disparities. We conducted a scoping review on the impact of the COVID-19 pandemic on women and girls’ access to and utilisation of sexual and reproductive health (SRH) services for contraception, abortion, gender-based and intimate partner violence (GBV/IPV) and sexually transmitted infections (STIs).MethodsWe systematically searched peer reviewed literature and quantitative reports, published between December 2019 and July 2021, focused on women and girls’ (15–49 years old) access to and utilisation of selected SRH services during the COVID-19 pandemic. Included studies were grouped based on setting, SRH service area, study design, population and reported impact. Qualitative data were coded, organised thematically and grouped by major findings.ResultsWe included 83 of 3067 identified studies and found that access to contraception, in-person safe abortion services, in-person services for GBV/IPV and STI/HIV testing, prevention and treatment decreased. The geographical distribution of this body of research was uneven and significantly less representative of countries where COVID-19 restrictions were very strict. Access was limited by demand and supply side barriers including transportation disruptions, financial hardships, limited resources and legal restrictions. Few studies focused on marginalised groups with distinct SRH needs.ConclusionReports indicated negative impacts on access to and utilisation of SRH services globally, especially for marginalised populations during the pandemic. Our findings call for strengthening of health systems preparedness and resilience to safeguard global access to essential SRH services in ongoing and future emergencies.

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Arenike Patricia Adekugbe et Chidera Victoria Ibeh. « INNOVATING SERVICE DELIVERY FOR UNDERSERVED COMMUNITIES : LEVERAGING DATA ANALYTICS AND PROGRAM MANAGEMENT IN THE U.S. CONTEXT ». International Journal of Applied Research in Social Sciences 6, n^o 4 (7 avril 2024) : 472–87. http://dx.doi.org/10.51594/ijarss.v6i4.986.

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Innovating service delivery for underserved communities in the United States is imperative to address systemic inequalities and ensure equitable access to essential services. This paper explores the integration of data analytics and program management to develop tailored solutions within the U.S. context. Underserved communities, characterized by socioeconomic disparities and limited access to resources, present unique challenges that necessitate innovative approaches. Leveraging data analytics enables organizations to gain insights into community needs, predict trends, and allocate resources effectively. Furthermore, program management methodologies, such as agile practices and stakeholder collaboration, facilitate the design and implementation of responsive and impactful initiatives. Through case studies in healthcare, education, and housing assistance, we demonstrate the practical application of these strategies in addressing diverse community needs. However, several challenges, including accessibility barriers, equity concerns, and financial constraints, must be navigated to ensure the success and sustainability of innovative programs. Looking ahead, advancements in technology and policy support offer opportunities to further enhance service delivery for underserved populations. By prioritizing collaboration, innovation, and equity, stakeholders can work towards creating inclusive systems that uplift and empower all communities. This paper underscores the importance of continuous adaptation and investment in innovative solutions to address the complex needs of underserved populations in the United States. Keywords: Innovation, Service Delivery, Underserved Communities, Data Analytics, Program Management, U.S. Context.

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Mondésir, Guinsly, et Lisl Schoner-Saunders. « Learning from a Distance ». Bulletin - Association of Canadian Map Libraries and Archives (ACMLA), n^o 171 (24 février 2023) : 9–18. http://dx.doi.org/10.15353/acmla.n171.5292.

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With the onslaught of the global COVID19 pandemic, universities were forced to quickly pivot to exclusively remote and virtual service options. To further complicate the situation, many international student populations at these institutions were forced to study remotely in their home countries due to the pandemic and visa restrictions. In Canada and Ontario, International students make up a major revenue source for post-secondary institutions, making the need to find viable solutions to continue to serve these populations essential to their financial stability.The Ontario Council of University Libraries (OCUL) runs a shared virtual reference service called Ask a Librarian (Ask). This paper assessed the global pandemic's impact through a comparative study of the service before, during, and after the pandemic's height. Using IP addresses, this study evaluated the impact of geographical location on the user’s access to virtual library resources, as well as identified any barriers, shifts, or trends in the service. The COVID-19 pandemic has changed the face of education and remote learning indefinitely. The hope of this study is to assess the overall success and pitfalls of our current virtual reference services and suggest future improvement areas.

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Niu, Hongli, Miaomiao Tian, Anning Ma, Chunping Wang et Liang Zhang. « Differences and determinants in access to essential public health services in China : a case study with hypertension people and under-sixes as target population ». Chinese Medical Journal 127, n^o 9 (5 mai 2014) : 1626–32. http://dx.doi.org/10.3760/cma.j.issn.0366-6999.20132786.

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Background Since 2009, health reform had launched in China and essential public health services were provided for all residents to ensure service equity and accessibility, and to achieve sustained population-wide health improvement. This study aimed to investigate the differences and determinants among populations with different characteristics access to essential public health services in China, especially hypertension people and children aged 0-6 years. Methods A cross-sectional study with socio-demographic data analysis was undertaken to estimate distribution characteristics of receiving essential public health services of hypertension patients and children. Regular follow-ups and effective blood pressure control reflected the effective management for hypertension patients, and for children, public services provided were vaccination on schedule and regular physical check-up. Logistic regression was used to determine the predictors for effective management. Results A total of 1 505 hypertension patients and 749 children were involved; 39.14% of hypertension participants could control their blood pressure in the normal range, and the rate in urban areas (43.61%) was higher than that in rural (31.88%). And 34.68% of them could receive more than 4 times follow-ups by the medical technician. Of 754 children, 79.84% could receive the periodic physical examination and 98.40% had vaccinated regularly. Children living in rural areas were more likely to have regular check-ups (83.96%) and regular vaccination (nearly 99%). Overall, geographic location and education level were the determinants of people access to essential public health services. Conclusions Implementation of the health reform since 2009 has headed China’s public health system in the right direction and promoted the improvement of public health system development. Our study highlights the growing needs for more public health services in China, and China’s public health system needs to be greatly improved in terms of its quality and accessibility.

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Lim, Xuxin, Madhumitha Ayyappan, Ma Wai Wai Zaw, Nikita Kanumoory Mandyam, Hui Xiang Chia et Don Eliseo Lucero-Prisno. « Geospatial mapping of 2-hour access to timely essential surgery in the Philippines ». BMJ Open 13, n^o 12 (décembre 2023) : e074521. http://dx.doi.org/10.1136/bmjopen-2023-074521.

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ObjectivesTimely access to safe and affordable surgery is essential for universal health coverage. To date, there are no studies evaluating 2-hour access to Bellwether procedures (caesarean section, laparotomy, open fracture management) in the Philippines. The objectives of this study were to measure the proportion of the population able to reach a Bellwether hospital within 2 hours in the Philippines and to identify areas in the country with the most surgically underserved populations.MethodsAll public hospitals with Bellwether capacities were identified from the Philippines Ministry of Health website. The service area tool in ArcGIS Pro was used to determine the population within a 2-hour drive time of a Bellwether facility. Finally, suitability modelling was conducted to identify potential future sites for a surgical facility that targets the most underserved regions in the Philippines.Results428 Bellwether capable hospitals were identified. 85.1% of the population lived within 2 hours of one of these facilities. However, 6 regions had less than 80% of its population living within 2 hours of a Bellwether capable facility: Bicol, Eastern Visayas, Zamboanga, Autonomous region of Muslim Mindanao, Caraga and Mimaropa. Suitability analysis identified four regions—Caraga, Mimaropa, Calabarzon and Zamboanga—as ideal locations to build a new hospital with surgical capacity to improve access rates.Conclusion85.1% of the population of the Philippines are able to reach Bellwether capable hospitals within 2 hours, with regional disparities in terms of access rates. However, other factors such as weather, traffic conditions, financial access, availability of 24-hour surgical services and access to motorised vehicles should also be taken into consideration, as they also affect actual access rates.

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Shah, Divyang, et Shyam Pingle. « SS06-02 DELIVERING OCCUPATIONAL HEALTH AS A UNIVERSAL FUNDAMENTAL RIGHT AT WORK – THE LMIC DILEMMA ». Occupational Medicine 74, Supplement_1 (1 juillet 2024) : 0. http://dx.doi.org/10.1093/occmed/kqae023.0073.

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Abstract Introduction The ILO has now recognized safety and health as a universal fundamental right at work. In low- and middle-income countries (LMICs), it is a long and daunting task. India, with almost 25% of the global labour force, is a glaring example of challenges in achieving this objective among LMICs. Methods India faces unique challenges in occupational health (OH) service delivery. Limited resources and disparities in healthcare infrastructure can hinder access to quality OH services, especially for marginalized populations. India is a country of paradoxes with the best and worst examples. Its diverse economic landscape encompasses large, medium, small, and microenterprises. Larger organizations have more resources and infrastructure to support OH programs, while smaller entities may struggle to implement comprehensive OH services, leaving many workers without access. Results In India, OH is the mandate of the labour and employment ministry, while delivery of health services is the mandate of the health ministry. And these two ministries seldom interact. OH service delivery varies significantly across different sectors. Organized industries have established OH programs, while the service and agricultural sectors lag behind. Conclusion Capacity building, infrastructure and awareness are the main challenges. Promoting OH as a fundamental right at work requires collaboration between government, industry, and civil society to ensure that all workers, regardless of their economic status, organization size, work model, or occupational sector, have equitable access to essential OH services and protections. The Indian Association of Occupational Health is a professional organization engaged in advocacy and awareness creation and is playing the role of a facilitator.

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Hu, Qinglin, Xiaobing Li, Gregg Bell et Lea G. Yerby. « The impacts of internet and transportation access on patients’ health conditions : a cross-sectional study ». International Journal Of Community Medicine And Public Health 9, n^o 2 (28 janvier 2022) : 565. http://dx.doi.org/10.18203/2394-6040.ijcmph20220213.

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Background: Use of internet and transportation to access to healthcare resources are 2 essential and effective ways to promote health outcomes and ameliorate health disparities. Despite general widespread availability of internet and transportation, disparities still exist among specific groups and regions. Little is known about the spatial patterns of extents of 2 access determinants on healthcare resources, nor for their compound effects on patient’s health outcomes.Methods: The study uses 2018 health information national trends survey (HINTS) data, geographic information techniques and multiple ordered logistic regression model were applied.Results: The results show that States in West and Midwest tend to have higher proportions on both perspectives, where states in South and Mideast had a relatively low percentage on the healthcare access determinants. Those states had similar socio-economic patterns with underserved population and low development progress in public healthcare system. Another finding is urban people had outstripped its rural neighbors on both internet (79% vs 57%) and transport (74% vs 62%) access to healthcare resources. Furthermore, our study suggests that, when considering compound effects of internet access for healthcare information and transport access to healthcare service, people who had greater barriers tend to have decreased likelihood (-21.30%) towards their health conditions, compare to those with sufficient accesses.Conclusions: Additional work and policy are needed to ensure that internet and public transportation resources and services are prioritized for underserved populations and areas.

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Kokarevica, A., A. Villerusa, D. Behmane, U. Berkis et V. Cauce. « Latvian health care competitiveness in relation to its infrastructure and available resources ». SHS Web of Conferences 40 (2018) : 02003. http://dx.doi.org/10.1051/shsconf/20184002003.

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Resources are one of the essential indicators for the functioning of the health care system. Better health care provision is an essential prerequisite for the export of services. Traditionally a competitive health care system is linked to a number of factors (price, quality, reliability, products and services) largely determined by the new technologies, innovations and implementation the new methods. The authors of this article analyzed and collected data from the European Commission Eurostat and OECD data. Current situation in health care in Latvia is characterized by populations’ restricted access to health care services, high out-of-pocket payments and poor health outcomes of the population. More than 10% of Latvian population can’t afford medical care. The ratio of public funding for healthcare in Latvia is among the lowest in EU countries. Latvia spends 5.3% (USD PPP 1217) of GDP on health, lower than the OCED country average of 8.9% (USD PPP 3453). Latvia is facing a dramatic gap between the availability of hospital beds and long term care beds and the lowest prevalence of general medical practitioners among all Baltic States 321.6 per 100 000. These mentioned factors may hinder the development of health care in Latvia and reduce the ability to participate in international health service market.

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Adhikari, Shiva Raj, Diksha Sapkota, Arjun Thapa et Achyut Raj Pandey. « Evaluation of Nepal’s Free Health Care Scheme from Health System Perspective : A Qualitative Analysis ». Journal of Nepal Health Research Council 16, n^o 41 (28 janvier 2019) : 372–77. http://dx.doi.org/10.33314/jnhrc.v16i41.1584.

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Background: Access to high quality medicines is often considered as one of the main obstacle in achieving health for all. With the objective of increasing access to health services of poor segment of population, government of Nepal has implemented free health care program. However, there is strong need for evaluating the performance and coverage of free health Care scheme. In this context, this study aims to provide better understanding on the implementation status of free health care scheme in context of Nepal.Methods: It is a qualitative study conducted in 7 districts of Nepal. Total of 14 focused group discussion were conducted among service providers and service users. All the discussions were carried in neutral and natural setting making sure that each of participants feels free to express their opinion. Focused group discussions were transcribed, translated into English, coded and analyzed manually.Results: Participants shared that free health care has contributed positively in making essential health services reachable, affordable and accessible to all specially benefiting poor segment of population. However, multitude of factors like geographical access, perception of community people towards health services, availability of medicines, laboratory services and human resources come into play determining the utilization of health services. Service providers recommended that there need to be improvements in procurement and supply system for uninterrupted supply of services.Conclusions: Despite having some problems in availability of medicines, human resource and diagnostic services, free health care has improved access to health services specially for poor population. Decentralizing the procurement process can be one promising option to overcome the inappropriate supply of medicines.Keywords: Access to medicine; financial risk; free health care; Nepal; poor.

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Khatiwada, Sanjita. « Utilization Postnatal Care Services in Hyolmo Community ». Kutumbha vani 5, n^o 1 (22 octobre 2024) : 89–99. http://dx.doi.org/10.3126/kv.v5i1.70979.

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Postnatal care (PNC) utilization among the Hyolmo community highlights significant gaps in existing literature and underscores the critical need for targeted healthcare interventions in remote and ethnically distinct populations. This study reveals that, while considerable attention is given to urban and accessible rural populations, remote communities face unique challenges that can impede access to essential maternal health services. The results demonstrate that age, education, and socio-economic factors significantly influence PNC uptake, suggesting disparities that are compounded in remote areas like the Helambu Rural Municipality of Sindhupalchowk District. This study shows that younger mothers, often less aware or hindered by accessibility barriers, are less likely to utilize PNC services compared to their older counterparts. This disparity highlights the necessity for community-specific educational programs that can enhance understanding and encourage the use of PNC services among younger women. Additionally, the influence of education and socio-economic status on PNC utilization points to the broader implications of systemic inequities in healthcare access. Moreover, the study brings to light the role of cultural practices and beliefs in shaping healthseeking behaviors, which varies significantly across different communities. In the traditional beliefs may conflict with modern healthcare practices, there is a clear need for culturally sensitive health interventions that respect and integrate local customs and practices. This research not only contributes to a deeper understanding of the factors affecting PNC service uptake in a specific Nepalese community but also calls for comprehensive policy responses. By addressing the multifaceted challenges faced by the Hyolmo community ranging from geographic isolation to cultural and educational barriers the study advocates for a holistic approach to healthcare. This should include the development of policies that ensure equitable access to health services, enhance community health education, and promote cultural competence among healthcare providers. Ultimately, such efforts are essential for improving maternal and infant health outcomes in remote communities, ensuring that every individual, regardless of their socio-economic or cultural background, has access to the necessary postnatal care.

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Zhang, Xiaohe, et Haixiao Pan. « Community Resilience in Accessing Essential Service Facilities Considering Equity and Aging Demand : A Case of Shanghai, China ». Land 12, n^o 12 (14 décembre 2023) : 2167. http://dx.doi.org/10.3390/land12122167.

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The COVID-19 lockdown has deepened inequity among vulnerable groups, such as the elderly. Reducing inequity in access to essential service facilities is an effective way to improve community resilience in dealing with pandemics. In this research, three indexes were created to measure community resilience in accessing essential services. Specifically, we have considered the different walking capacity and different needs of the elderly and the general population. We selected Shanghai as the case for our research and analyzed the spatial patterns of both space-based and population-based essential service facilities. The Lorenz curve and the Gini coefficient were used to measure the spatial equity. And, we attempted to reveal the relationships between the population density and three indexes through bivariate Local Indicators of Spatial Association. The results suggest that the Diversity Index enjoys the highest equity, followed by the Demand Accessibility Index, and the equity of the Per Capita Quantity Index is the lowest. Furthermore, the accessibility of essential services in urban areas is excellent, while in some suburban areas it is low. Our findings contribute valuable scientific insights for policy makers to strengthen community resilience and address inequities for immediate or long-term measures.

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Hill, Dustin T., et David A. Larsen. « Using geographic information systems to link population estimates to wastewater surveillance data in New York State, USA ». PLOS Global Public Health 3, n^o 1 (26 janvier 2023) : e0001062. http://dx.doi.org/10.1371/journal.pgph.0001062.

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Sewer systems provide many services to communities that have access to them beyond removal of waste and wastewater. Understanding of these systems’ geographic coverage is essential for wastewater-based epidemiology (WBE), which requires accurate estimates for the population contributing wastewater. Reliable estimates for the boundaries of a sewer service area or sewershed can be used to link upstream populations to wastewater samples taken at treatment plants or other locations within a sewer system. These geographic data are usually managed by public utilities, municipal offices, and some government agencies, however, there are no centralized databases for geographic information on sewer systems in New York State. We created a database for all municipal sewersheds in New York State for the purpose of supporting statewide wastewater surveillance efforts to support public health. We used a combination of public tax records with sewer access information, physical maps, and municipal records to organize and draw digital boundaries compatible with geographic information systems. The methods we employed to create these data will be useful to inform similar efforts in other jurisdictions and the data have many public health applications as well as being informative for water/environmental research and infrastructure projects.

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Ekezie, Winifred, Enemona Emmanuel Adaji et Rachael L. Murray. « Essential healthcare services provided to conflict-affected internallydisplaced populations in low and middle-income countries : A systematicreview ». Health Promotion Perspectives 10, n^o 1 (28 janvier 2020) : 24–37. http://dx.doi.org/10.15171/hpp.2020.06.

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Background: Conflict and violent crises have resulted in over 40 million of internally displaced persons (IDPs). Most affected regions lack access to basic health resources and generally rely on humanitarian support. The objective of this review was to appraise primary health service interventions among conflict-induced internally displaced populations in low and middle income countries between 2000 and 2019. Methods: A systematic review of literature in the following databases: Embase, MEDLINE, PsyArticles, PsycINFO, Scopus, Web of Science, LILAC and CAB Articles, was performed to identify interventions implemented in conflict IDP settings. Results: Initial searches yielded 4578 papers and 30 studies met the inclusion criteria. Descriptivesynthesis analysis was used, and the final selections were assessed using a customized CriticalAppraisal Skills Programme (CASP) checklist. Included papers were from Sub-Saharan Africa, South Asia and the Middle East regions. Most studies were on prevention interventions, especially water treatment and maternal health. Treatment interventions mostly focused on onmalaria and mental health. Only one food and nutrition study with outcome data was identified, indicating limitations in IDP health-related intervention publications. Reported interventions were conducted between one week to five years, and the study qualities were moderate. The most effective interventions were integrated programmes and common challenges were weakstudy methodology and data reporting. Conclusion: Regardless of the intervention types and durations, the services offered were beneficial to the IDPs. More intervention evidence are, however required as shown in gaps around food and nutrition, health education and disease surveillance.

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Phalatse, N., D. Casteleijn, E. du Plooy, H. Msimango et V. Ramodike. « Occupational therapists' perspectives on the impact of COVID-19 lockdowns on their clients in Gauteng, South Africa - a qualitative retrospective study ». South African Journal of Occupational Therapy 52, n^o 3 (décembre 2022) : 24–33. http://dx.doi.org/10.17159/2310-3833/2022/vol52n3a4.

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INTRODUCTION: In March 2020, the South African government responded to the threat of the COVID-19 pandemic by issuing a national lockdown, calling a halt to all non-essential services and movements, including most occupational therapy services. Occupational therapy clients had no access to treatment during this time and may have experienced occupational injustices. AIM: We explore occupational therapists' perceptions of the influence of COVID-19 lockdowns on rehabilitation clients in Gauteng, South Africa. METHODOLOGY: We analysed secondary data collected in July 2020. The original qualitative study assessed occupational therapists' perceptions of the influence of COVID-19 on their service delivery. Sixteen occupational therapists participated in asynchronous on-online focus group discussions. The therapists worked in public and private settings in Gauteng. This study focussed on the influence of COVID-19 lockdowns on clients as perceived by occupational therapists. All data relating to the influence of COVID-19 lockdowns on clients were extracted from the original dataset using ATLAS. ti and then thematically analysed using deductive reasoning. RESULTS: Five themes emerged from the data. Occupational therapists felt that clients had altered clinical presentation due to infection prevention and control measures (Theme 1). Therapists also felt that the quality of services was negatively impacted, which was detrimental for clients (Theme 2); that their clients experienced occupational injustice due to disrupted services (Theme 3) that vulnerable populations experienced the greatest challenges (Theme 4) and that clients' experienced positive impacts or benefits during the COVID-19 lockdown (Theme 5). CONCLUSIONS: In future pandemics, decision-makers need to carefully consider the impact of disrupted service delivery for occupational therapy clients, especially vulnerable populations. A syndemic approach is recommended for occupational therapy service delivery during a pandemic. Tailor-made recommendations that are needed for vulnerable populations in South Africa are proposed.

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Kuupiel, Desmond, Kwame M. Adu, Vitalis Bawontuo, Duncan A. Adogboba, Paul K. Drain, Mosa Moshabela et Tivani P. Mashamba-Thompson. « Geographical Accessibility to Glucose-6-Phosphate Dioxygenase Deficiency Point-of-Care Testing for Antenatal Care in Ghana ». Diagnostics 10, n^o 4 (16 avril 2020) : 229. http://dx.doi.org/10.3390/diagnostics10040229.

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Background: Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency screening test is essential for malaria treatment, control, and elimination programs. G6PD deficient individuals are at high risk of severe hemolysis when given anti-malarial drugs such as primaquine, quinine, other sulphonamide-containing medicines, and chloroquine, which has recently been shown to be potent for the treatment of coronavirus disease (COVID-19). We evaluated the geographical accessibility to POC testing for G6PD deficiency in Ghana, a malaria-endemic country. Methods: We obtained the geographic information of 100 randomly sampled clinics previously included in a cross-sectional survey. We also obtained the geolocated data of all public hospitals providing G6PD deficiency testing services in the region. Using ArcGIS 10.5, we quantified geographical access to G6PD deficiency screening test and identified clinics as well as visualize locations with poor access for targeted improvement. The travel time was estimated using an assumed speed of 20 km per hour. Findings: Of the 100 clinics, 58% were Community-based Health Planning and Services facilities, and 42% were sub-district health centers. The majority (92%) were Ghana Health Service facilities, and the remaining 8% were Christian Health Association of Ghana facilities. Access to G6PD deficiency screening test was varied across the districts, and G6PD deficiency screening test was available in all eight public hospitals. This implies that the health facility-to-population ratio for G6PD deficiency testing service was approximately 1:159,210 (8/1,273,677) population. The spatial analysis quantified the current mean distance to a G6PD deficiency testing service from all locations in the region to be 34 ± 14 km, and travel time (68 ± 27 min). The estimated mean distance from a clinic to a district hospital for G6PD deficiency testing services was 15 ± 11 km, and travel time (46 ± 33 min). Conclusion: Access to POC testing for G6PD deficiency in Ghana was poor. Given the challenges associated with G6PD deficiency, it would be essential to improve access to G6PD deficiency POC testing to facilitate administration of sulphadoxine-pyrimethamine to pregnant women, full implementation of the malaria control program in Ghana, and treatment of COVID-19 patients with chloroquine in malaria-endemic countries. To enable the World Health Organization include appropriate G6PD POC diagnostic tests in its list of essential in-vitro diagnostics for use in resource-limited settings, we recommend a wider evaluation of available POC diagnostic tests for G6PD deficiency, particularly in malaria-endemic countries.

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Cardoso, Maria Adriana, Rita Salgado Brito, Catarina Silva, Susana Rodrigues, Rute Rodrigues, Alexandra Costa, Joana Cardoso, Catarina Jorge, Helena Alegre et Maria João Rosa. « Quality of Urban Water Services Provided to Users : Assessment System and the Portuguese Path through Four Generations, Lessons Learned and New Challenges ». Sustainability 15, n^o 21 (25 octobre 2023) : 15273. http://dx.doi.org/10.3390/su152115273.

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Public water supply, urban wastewater and stormwater management, and urban waste management are structural public services, essential to well-being, public health, and the safety of populations as well as to economic activities and environmental protection. These services must be guided by principles of universal access, continuity and quality of service, and efficiency and fairness of applied tariffs. The main concern of the regulation of these services is the protection of the interests of the users through the promotion of the quality of the service provided by the water utilities and the guarantee of balance in the practiced tariffs, materialized in the principles of universality, equity, reliability, and cost-efficiency. The quality of the urban water services has been assessed by ERSAR (the Portuguese regulator) since 2004, when the first generation of the assessment system was developed, and has undergone three periodical critical revisions. The fourth generation, developed in 2021, entered in force in 2022. This paper presents the fourth generation of ERSAR’s system for assessing the quality of urban water services in Continental Portugal, focusing on the path followed and addressing the experience of its application over almost two decades, the lessons learned, and the new challenges for the water sector.

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Hashtarkhani, Soheil, David L. Schwartz et Arash Shaban-Nejad. « Enhancing Health Care Accessibility and Equity Through a Geoprocessing Toolbox for Spatial Accessibility Analysis : Development and Case Study ». JMIR Formative Research 8 (21 février 2024) : e51727. http://dx.doi.org/10.2196/51727.

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Background Access to health care services is a critical determinant of population health and well-being. Measuring spatial accessibility to health services is essential for understanding health care distribution and addressing potential inequities. Objective In this study, we developed a geoprocessing toolbox including Python script tools for the ArcGIS Pro environment to measure the spatial accessibility of health services using both classic and enhanced versions of the 2-step floating catchment area method. Methods Each of our tools incorporated both distance buffers and travel time catchments to calculate accessibility scores based on users’ choices. Additionally, we developed a separate tool to create travel time catchments that is compatible with both locally available network data sets and ArcGIS Online data sources. We conducted a case study focusing on the accessibility of hemodialysis services in the state of Tennessee using the 4 versions of the accessibility tools. Notably, the calculation of the target population considered age as a significant nonspatial factor influencing hemodialysis service accessibility. Weighted populations were calculated using end-stage renal disease incidence rates in different age groups. Results The implemented tools are made accessible through ArcGIS Online for free use by the research community. The case study revealed disparities in the accessibility of hemodialysis services, with urban areas demonstrating higher scores compared to rural and suburban regions. Conclusions These geoprocessing tools can serve as valuable decision-support resources for health care providers, organizations, and policy makers to improve equitable access to health care services. This comprehensive approach to measuring spatial accessibility can empower health care stakeholders to address health care distribution challenges effectively.

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Chang, Man-Huei, Ramal Moonesinghe et Benedict I. Truman. « Health Care Use among Medicare Beneficiaries with HIV and Depression during the COVID-19 Pandemic—United States, 2020 ». Healthcare 11, n^o 8 (13 avril 2023) : 1126. http://dx.doi.org/10.3390/healthcare11081126.

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Access and use of health care services are essential to health and well-being for people with HIV and HIV-related comorbidities. Health care use during the COVID-19 pandemic among Medicare beneficiaries (MBs) with concurrent HIV and depression has not been investigated. We used 2020 Medicare data to assess the percentage of MBs with claims for HIV and depression who also received hospitalization, outpatient diagnostic services, drug treatment, and outpatient procedures. We assessed person-level association between service receipt and HIV and depression, adjusting for known risk factors. MBs with claims for HIV and depression were more likely than those with neither claim to have claims for short-stay hospitalization, long-stay hospitalization, outpatient diagnostic services, prescription drugs, or outpatient procedures, supplies, and products. Non-White beneficiaries were more likely than White beneficiaries to be hospitalized but were less likely to receive drug treatment, outpatient diagnostic services, or outpatient procedures, supplies, and products during the pandemic. Significant disparities in health care use by race/ethnicity existed among MBs. Policymakers and practitioners can use these findings to implement public health policies and programs that reduce disparities in health care access and optimize use among vulnerable populations during a public health emergency.

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Buro, Rahma, Irura Nganga, Julius M. Huho, David Karienye et Kevin Macharia. « The Impact of Covid-19 Pandemic on Reproductive Health in Kenya : Challenges, Lessons and Opportunities ». Africa Journal of Technical and Vocational Education and Training 9, n^o 1 (28 mai 2024) : 84–96. http://dx.doi.org/10.69641/afritvet.2024.91117.

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Health systems and healthcare delivery around the world have been greatly affected by the COVID-19 pandemic. In Kenya, the attainment of universal health coverage (UHC) has been hampered by the pandemic, particularly in the areas of reproductive, maternal, newborn, and child health (RMNCH). This paper examines the effect of COVID-19 on RMNCH in Kisumu, Isiolo, Machakos, and Nyeri counties in Kenya. The objective of the study was to determine if there was a significant change in service delivery under reproductive, maternal, newborn, and child health in hospitals under the Universal Health Coverage Program. The target population was the patients seeking RMNCH services in these hospitals. The study arrived at a sample of 78 respondents achieving a response rate of 84%. The study used a mixed-methods approach, comprising both quantitative and qualitative data collection methods. The quantitative data were collected through a retrospective analysis of RMNCH indicators from January 2019 to June 2021, while the qualitative data were collected through in-depth interviews with healthcare workers and community members. The key finding of the study was that there was a significant decrease in the quality of RMNCH services during the COVID-19 period compared to before the pandemic. This conclusion is based on the results of a Wilcoxon Signed Ranks Test, which produced a test statistic Z of -4.321 and an Asymp. Sig. (2-tailed) value of 0. The challenges identified as hindering access to and provision of RMNCH services during the pandemic include inadequate personal protective equipment, inadequate supply of essential medicine, and reduced funding for RMNCH services. The study concluded that COVID-19 pandemic had a significant negative impact on RMNCH in the four counties. The pandemic led to disruptions in health service delivery, resulting in reduced access to essential RMNCH services. Consequently, there was an increase in maternal and child deaths. Recommendations include strengthening health systems, improving access to essential RMNCH services, and providing necessary resources and support to healthcare workers for delivering high-quality care.

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Amchang, Chompoonut, et Juthathip Suraraksa. « Healthcare Logistics System Planning for Facility Location of Aging Society ». International Journal of Membrane Science and Technology 10, n^o 2 (14 août 2023) : 3340–58. http://dx.doi.org/10.15379/ijmst.v10i2.3119.

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Healthcare facility location management is essential to the public infrastructure, particularly as it relates to access to the healthcare system. Therefore, the locations of primary healthcare centers (PHCs) must be sufficient to accommodate the size of the elderly population in the future. Thailand is entering an aging society. Most of research studied to improve service quality of healthcare more than consider amount of location of PHCs. So, the purpose of this study was to applied a geographic information system (GIS) to study coverage area of accessing to health facility location under condition of increasing elderly population. It analyzed by using the Dijkstra Algorithm and concept of last mile delivery center. For the elderly population, this research applied auto regression to forecast elderly population. The study found the population of elderly people will increase in every district by 2025, with the highest increase being in Khlong Sam Wa. The original locations point of PHCs in Bangkok included 145 locations, which can accommodate an area for the elderly to access a PHC. Health services need to be easily accessible by walking in 5-15 minutes [1]. Thus, the problem is the current locations of PHCs are insufficient to support a future aging society. This research applied the location of Covid-19 vaccine distribution model (CVDM) to support the positioning of healthcare services. The CVDM comprised 191 pharmacies/clinics then analysis the service coverage area. The point of location CVDM and PHCs which showed health services coverage by comparing walking times. This modal can increase service covering of walking in 5 minutes, 10 minutes, and 15 minutes of 4.34%, 11.78% and 20.35%, respectively. The efficiency of service cover-age for primary and secondary medical care for elder can be improved if the location of health service centers is increased.

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Ruiz-Rodríguez, Myriam, Veronika J. Wirtz, Alvaro J. Idrovo et Mary Lupe Angulo. « Access to medicines among internally displaced and non-displaced people in urban areas in Colombia ». Cadernos de Saúde Pública 28, n^o 12 (décembre 2012) : 2245–56. http://dx.doi.org/10.1590/s0102-311x2012001400004.

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This study analyzes access to medicines among displaced and non-displaced populations in urban areas in Bucaramanga, Colombia. A household survey was carried out to study access to medicines for self-reported and medically diagnosed health conditions. Multiple Poisson regression with robust variance was used to determine factors associated with access to medicines. Two thousand and sixty individuals from 514 families participated. Only 29.1% (95%CI: 22.04-37.08) of the individuals in the sample with prescriptions and 44.3% (95%CI: 40.42-48.25) with self-reported needs for pharmacotherapy were taking medicines. Greater access was associated with the perceived severity of the illness, higher income, having a health center nearby and not perceiving barriers in accessing services. Social security affiliation and being displaced were not related. Social security coverage alone does not have an effect on access to medicines because it does not include essential medicines that correspond to the health needs of this population. Resolving administrative and geographical barriers is likely to improve access to medicines.

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Mnkandla, Mayibongwe Mkhaliphi Abel, Takalani Grace Tshitangano et Azwinndini Gladys Mudau. « Healthcare-Seeking Behaviors of Homeless Substance Users During the COVID-19 Lockdowns in Gauteng, South Africa : A COREQ-Based Report ». Social Sciences 12, n^o 8 (20 août 2023) : 464. http://dx.doi.org/10.3390/socsci12080464.

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Substance use continues to be a social problem globally. Around the world, approximately 275 million people use drugs, including 15% of South Africans, with over 36 million succumbing to drug disorders. In the Gauteng Province, about 55% of autopsies of deceased medicolegal cases (2003–2012) showed the presence of one or more illicit drugs in Pretoria. Most research shows that around one-third of people who have problems with alcohol and drugs are homeless. Evidence suggests that homeless people are often denied access to even the most essential assistance, including healthcare. This study assessed the healthcare-seeking behaviors of homeless substance users during the COVID-19 lockdowns in Gauteng, South Africa. A qualitative approach using an exploratory design assessed referrals based on those suffering from symptoms of COVID-19 during the lockdown period between 2020 and 2022. Data were collected from 25 homeless substance users in the City of Tshwane, Gauteng, through unstructured interviews. Three themes based on the study objectives included the types of healthcare services consulted, the determinants of health-seeking behaviors, and challenges experienced while seeking healthcare. Of the twenty-five participants, aged twenty-one to fifty, thirteen suffered from COVID-19 symptoms. Five used formal healthcare systems and eight used informal healthcare systems. Older participants access healthcare services, while less of the younger population use them. Barriers that are encountered while seeking medical services entail marginalization, stigmatization, and a lack of social support. Despite the formidable barriers posed by homelessness and substance use, homeless individuals demonstrated remarkable resilience in their efforts to access healthcare services during the COVID-19 lockdowns. This study highlights the importance and urgent need for harm reduction strategies and policy development for long-term service provision to this population, as well, as the literature on equity, diversity, and inclusion as a foundation for the rights of marginalized populations and groups. Future research directions should focus on harm reduction among this population group of homeless substance users.

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Nasio, Akinyi Kibii. « Current Landscape and Challenges of Ultrasound Services in Uganda ». NEWPORT INTERNATIONAL JOURNAL OF SCIENTIFIC AND EXPERIMENTAL SCIENCES 5, n^o 3 (14 juin 2024) : 30–32. http://dx.doi.org/10.59298/nijses/2024/10.5.330327.

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Ultrasound imaging is indispensable in modern healthcare for its non-invasive diagnostic capabilities. However, in Uganda, access to reliable ultrasound services remains challenging due to disparities in accessibility, infrastructure limitations, and financial barriers. This review examines the current landscape and challenges of ultrasound services in Uganda, drawing from recent literature to highlight key issues and propose pathways for improvement. Significant disparities in ultrasound accessibility across Uganda exacerbate healthcare inequalities, stemming from inadequate infrastructure and a scarcity of trained personnel in rural areas. Efforts to enhance accessibility and distribution necessitate expanding infrastructure, improving training programs, and implementing effective maintenance protocols. Collaboration with international organizations is crucial for sustainable improvements in service delivery. Quality assurance in ultrasound services is essential for accurate diagnostics. This review article synthesizes recent literature on ultrasound services in Uganda, focusing on accessibility, quality, and financial barriers, through a systematic review and analysis of relevant studies and reports. Financial accessibility remains a critical barrier, with out-of-pocket expenses hindering access, especially for low-income populations. Addressing these challenges requires healthcare financing reforms and targeted subsidies to reduce financial burdens on patients. Progress has been made, sustaining and improving ultrasound services in Uganda demands comprehensive strategies to enhance accessibility, maintain high standards, and ensure affordability, thereby advancing healthcare equity nationwide. Keywords: Ultrasound imaging, Healthcare inequalities, Infrastructure development, Quality assurance, financial accessibility.

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Kominski, Gerald F., Narissa J. Nonzee et Andrea Sorensen. « The Affordable Care Act's Impacts on Access to Insurance and Health Care for Low-Income Populations ». Annual Review of Public Health 38, n^o 1 (20 mars 2017) : 489–505. http://dx.doi.org/10.1146/annurev-publhealth-031816-044555.

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The Patient Protection and Affordable Care Act (ACA) expands access to health insurance in the United States, and, to date, an estimated 20 million previously uninsured individuals have gained coverage. Understanding the law's impact on coverage, access, utilization, and health outcomes, especially among low-income populations, is critical to informing ongoing debates about its effectiveness and implementation. Early findings indicate that there have been significant reductions in the rate of uninsurance among the poor and among those who live in Medicaid expansion states. In addition, the law has been associated with increased health care access, affordability, and use of preventive and outpatient services among low-income populations, though impacts on inpatient utilization and health outcomes have been less conclusive. Although these early findings are generally consistent with past coverage expansions, continued monitoring of these domains is essential to understand the long-term impact of the law for underserved populations.

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Palikhe, Amin, Rita Bhandari, Shreeram Phuyal et Shiva Prasad Sharma Paudel. « Student's Perception Regarding Quality of Public Service Marketing on Service Delivery ». Kanya Journal 4, n^o 1 (3 août 2023) : 1–20. http://dx.doi.org/10.3126/kanyaj.v4i1.57018.

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Public Service Marketing has been used as game plan to enhance service delivery in the public sector. A gap has been seen in using quality service dimensions and public service marketing concept for enhancing service delivery in public sector. This study therefore assessed the citizen’s perception regarding the quality of public service marketing on service delivery in public sector of Nepal. Special references have been taken from students studying master degree in Management at Prithvi Narayan Campus, Pokhara. Descriptive and quantitative research design has been employed for this study. Out of 180 total populations under study, 50 samples have been taken by using simple random sampling. Data were collected via questionnaires using Google Form. Data were analyzed using SPSS 26 statistical tools. Quantitative statistical results were analyzed. The practical implications is to assess the perception of citizens i.e. students of master degree in this study towards quality service delivery and customer satisfaction. The study revealed that the perception of students towards quality service delivery and customer satisfaction is different among the groups but there have been positive impact of quality of public service marketing factors on service delivery with customer satisfaction. However, overall perception towards the service quality and satisfaction is not good. Additionally, easy access to service and good behaviors of employees in public sector were deemed to be essential for positive enhancement in citizen's perceptions regarding the quality of public service marketing on service delivery. The study was limiting only two service delivery factors therefore, it will be recommended to study numerous additional influencing elements like cost, time and communication that can be used in research in future as quality of service delivery factors.

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Assebe, Lelisa Fekadu, et Ole Norheim. « Distributional impact of infectious disease interventions in the Ethiopian Essential Health Service Package : a modelling study ». BMJ Open 13, n^o 7 (juillet 2023) : e067658. http://dx.doi.org/10.1136/bmjopen-2022-067658.

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ObjectivesReducing inequalities in health and financial risk are key goals on the path toward universal health coverage, particularly in low-income and middle-income countries. The design of the health benefit package creates an opportunity to select interventions through established criteria. The aim of this study is to examine the health equity and financial protection impact of selected interventions, along with their costs, at the national level in Ethiopia.DesignDistributional cost-effectiveness analysis.PopulationThe eligible population for all selected interventions is assumed to be 10 million.Data sourcesData on disease prevalence and population size were gathered from the Global Burden of Disease database, and average health benefits and program costs are sourced from the Ethiopian Essential Health Service Package (EHSP) database, national surveys and other publicly available sources.InterventionA total of 30 interventions were selected from the latest EHSP revision and analysed over a 1-year period.Outcome measuresHealth benefits, social welfare indices and financial protection metrics across income quintiles were reported.ResultsWe found 23 interventions that improve population health and reduce health inequality and four interventions reduce both population health and health inequality. Additionally, three interventions improve population health while increasing health inequality. Overall, the EHSP interventions provide a 0.021 improvement in health-adjusted life expectancy (HALE) per person, with a positive distributional equity impact: 0.029 (26.9%) HALE gained in the poorest and 0.015 (14.0%) in the richest quintile. Similarly, a total of 1 79 475 cases of catastrophic health expenditure were averted, including 82 100 (46.0%) cases in the poorest and 17 900 (10.0%) in the richest quintile.ConclusionIncreasing access to the EHSP improves health equity and financial protection. Improved access to selected EHSP interventions also has the potential to provide greater benefits to the poorest and thereby improve social welfare.

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Bustos Villarreal, Mónica Alexandra. « Factors associated with malnutrition in children under 5 years of age in the el baboso community ». Salud, Ciencia y Tecnología - Serie de Conferencias 2 (20 décembre 2023) : 925. http://dx.doi.org/10.56294/sctconf2023925.

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This study examines the factors associated with malnutrition in children under five years of age in the community of El Baboso, Ecuador. The objective was to identify and relate socioeconomic, cultural, and health service access factors with the prevalence of child malnutrition in this vulnerable population. A mixed-methods research design was used, combining qualitative and quantitative approaches, with a sample of 20 children and 16 parents. The results revealed that 80% of the children were underweight, 75% of the caregivers had no formal education, and 90% of the children did not receive exclusive breastfeeding during the first six months. Additionally, irregular access to health check-ups and a lack of nutritional knowledge were significant factors. It is concluded that implementing educational strategies and improving access to health services is essential to address child malnutrition in this community

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Wang, Jin, Lan Bai et Xinpeng Xu. « Disparities in awareness and utilisation of National Essential Public Health Services between the floating population and the registered residents : a cross-sectional study in China ». BMJ Open 14, n^o 4 (avril 2024) : e080756. http://dx.doi.org/10.1136/bmjopen-2023-080756.

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ObjectiveThere are differences between the floating population and the registered population in the awareness and use of the National Essential Public Health Services (NEPHS) due to the influence of China’s household registration system. The Equalization of Basic Public Health and Family Planning Services (EBPHFPS) policy aims to reduce disparities among populations by enhancing the migrant population’s access to basic public health services. The aim of this study is to examine the relationship between the EBPHFPS targeted at the floating population and the disparities in access to and utilisation of NEPHS between registered residents and the floating population.DesignA cross-sectional study.Setting8 cities (regions, autonomous prefectures) in China.Participants13 998 floating population and 14 000 registered residents in eight cities (regions, autonomous prefectures) were included in the analysis.Outcome measuresThree binomial variables, including awareness of NEPHS, acceptance of health education and establishment of health records, were used as outcome indicators to examine the relationship between the EBPHFPS and the disparities between the floating and registered populations.MethodsA linear regression model, fairness gap calculation and propensity score matching were used to explore the associations.ResultsThe areas that implemented EBPHFPS exhibited an 8.3% increase in awareness of the NEPHS (p<0.01) and a 4.0% increase (p<0.05) in the likelihood of individuals having received health education within the previous year compared with the areas without the policy implementation. In contrast to registered residents, however, the floating population still faces significant disparities in NEPHS awareness and utilisation. Compared with areas without the equalisation policy, the inequality of opportunity in health education of the floating population in implementation areas is significantly lower (p<0.01), whereas no significant difference is observed in the inequality of opportunity regarding NEPHS awareness among the floating population (p>0.1). The floating population in the pilot areas of the policy encountered greater disparities in the establishment of health records (p<0.01).ConclusionsPositive associations between the EBPHFPS policy and NEPHS awareness and utilisation among the floating population were demonstrated to some extent; however, the floating population was still confronted with a degree of inequality of opportunity. The government needs to develop target-oriented policies and a guaranteed mechanism to ensure access to NEPHS among the floating population.

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Bello, Isah Mohammed. « A Robust Approach to Determining Under-served Settlements for Health Using Geographic and Spatial Coverage Modelling in Bauchi Local Government Area ». TEXILA INTERNATIONAL JOURNAL OF PUBLIC HEALTH 10, n^o 2 (30 juin 2022) : 196–207. http://dx.doi.org/10.21522/tijph.2013.10.02.art017.

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Access to health care services with the assurance of affordable, low-cost, and quality services that is available to people is one of the core components of universal health coverage (UHC). The United Nations (UN) has included the achievement of UHC by the year 2030 as part of the 3rd component of the SDG, which is aimed at ensuring healthy lives and promoting well-being for all ages, in the overall Sustainable Development Goals (SDG). The number of people lack-ing access to essential health services continues to increase. Hence, the need for close monitor-ing of the mode and pattern of accessibility to basic health care services becomes crucial as population growth continues to expand in many of the low-and-middle-income countries (LMIC). This study examined the geographic and spatial accessibility of the primary health care network in the Bauchi Local Government area of Bauchi State – Nigeria through open data and geospatial analysis techniques. The study identified settlements/populations that are not covered (under-served) by any health facility (HF) in the local government and the geographical net-work coverage of the HFs in the LGA. It also highlights the factors that are influencing accessi-bility to guide policymakers on equal distribution of health care facilities towards reducing ine-quality in accessibility. Different data sets on HF locations, population, and settlement point was used. The study opens ways to closing inequality in access to health care services, which will further support the effective and efficient delivery of health care services in similar resource settings towards achieving UHC.

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Kotval-K, Zeenat, Annabelle Wilkinson, Andy Brush et Eva Kassens-Noor. « Impacts of Local Transit Systems on Vulnerable Populations in Michigan ». Urban Science 7, n^o 1 (31 janvier 2023) : 16. http://dx.doi.org/10.3390/urbansci7010016.

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Residents in small urban and rural areas frequently depend on unreliable personal transportation to maintain their lifestyle and get to essential destinations within their society. Especially, vulnerable populations, such as seniors and low-income residents, have lower access to personal vehicles and therefore are mobility-challenged. Being challenged in terms of mobility has effects on the health of the population concerned as this constraint not only limits economic activity that leads to perpetuation of lower means and poverty but also social activity that leads to physical and mental isolation. In a study of Michigan public and nonprofit transit systems, the customer satisfaction, particularly of vulnerable populations, with transit services is analyzed through on-board intercept surveys. Results illustrate the significance of employment, age, income, disability, and demand-response services in public transit planning and ultimately public health.

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Min, Hye Sook, Saerom Kim, Seulgi Kim, Taeho Lee, Sun-Young Kim, Hyeong Sik Ahn et Seung-Ah Choe. « Is limited access to obstetric services associated with adverse birth outcomes ? A cross-sectional study of Korean national birth data ». BMJ Open 12, n^o 5 (mai 2022) : e056634. http://dx.doi.org/10.1136/bmjopen-2021-056634.

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ObjectivesThe geographical disparity in the access to essential obstetric services is a public health issue in many countries. We explored the association between timely access to obstetric services and the individual risk of adverse birth outcomes.DesignRepeated cross-sectional design.SettingSouth Korean national birth data linked with a medical service provision database.Participants1 842 718 singleton livebirths from 2014 to 2018.Primary outcome measuresPreterm birth (PTB), post-term birth, low birth weight (LBW) and macrosomia.ResultsIn the study population, 9.3% of mothers lived in districts where the Time Relevance Index (TRI) was as low as the first quartile (40.6%). Overall PTB and post-term birth rates were 5.0% and 0.1%, respectively. Among term livebirths, LBW and macrosomia occurred in 1.0% and 3.3%, respectively. When the TRI is lower, representing less access to obstetric care, the risk of macrosomia was higher (adjusted OR=1.15, 95% CI 1.11 to 1.20 for Q1 compared with Q4). Similarly, PTB is more likely to occur when TRI is lower (1.05, 95% CI 1.00 to 1.10 for Q1; 1.03, 95% CI 1.01 to 1.05 for Q2). There were some inverse associations between TRI and post-term birth (0.80, 95% CI 0.71 to 0.91, for Q2; 0.84, 95% CI 0.76 to 0.93, for Q3).ConclusionsWe observed less accessibility to obstetric service is associated with higher risks of macrosomia and PTB. This finding supports the role of obstetric service accessibility in the individual risk of adverse birth outcomes.

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Jadhav, Sachin Kumar, BC Manjunath, Neha Chauhan et Zainab Akram. « Patterns, barriers, and utilization of oral healthcare provided at primary health centers (PHCs) and its association with oral health status among rural population in Rohtak district, Haryana : A household cross-sectional study ». Journal of Family Medicine and Primary Care 13, n^o 3 (mars 2024) : 944–51. http://dx.doi.org/10.4103/jfmpc.jfmpc_883_23.

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ABSTRACT Introduction: Access to oral healthcare is limited in rural areas, resulting in disparities in oral health services. Primary health centers (PHCs) are essential for providing integrated oral healthcare to rural populations. This study examines the patterns, barriers, and utilization of oral healthcare at PHCs in Rohtak district, Haryana. Materials and Methods: In this 6-month household cross-sectional study, data were collected from a sample of 600 participants residing in rural areas under the jurisdiction of three randomly selected PHCs in Rohtak district. The study employed multistage cluster systematic random sampling procedures. Data collection included structured questionnaires and clinical oral examinations following the type-III ADA classification. Participants’ oral health status was evaluated using the WHO oral health assessment form for adults (2013). Descriptive and analytical statistics were used for data analysis. Results and Discussion: Dental caries and periodontal diseases were more common in older age groups. Barriers to oral healthcare among the elderly include fear of dental procedures and low dental literacy. Proximity to PHCs influenced dental service utilization, with higher rates among participants living near a PHC, that is, within 5 km of a PHC. Conclusion: Age, gender, proximity to PHCs, household size, and socioeconomic status play crucial roles in the utilization of oral health services among the rural population. Addressing these factors is essential for improving oral healthcare and overcoming barriers. It is crucial to enhance the accessibility, affordability, and availability of oral health services at PHCs to promote better oral health and overall well-being in rural areas.

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Jyotsna, Manish Chaturvedi et Aanchal Pancholi. « Ensuring excellence : A deep dive into the quality monitoring of Ayushman Bharat health and wellness Centre ». International Journal of Science and Research Archive 12, n^o 2 (30 août 2024) : 2787–801. http://dx.doi.org/10.30574/ijsra.2024.12.2.1582.

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This review evaluates the quality monitoring mechanisms of Ayushman Bharat Health and Wellness Centres, integral to India's pursuit of Universal Health Coverage. AB-HWCs are designed to deliver comprehensive primary healthcare, particularly targeting undeserved communities. Despite the significant expansion and progress in healthcare access, the review identifies persistent service quality and infrastructure disparities. The study underscores the necessity of a robust quality monitoring framework, incorporating standardized checklists to ensure consistent and high-quality service delivery. These checklists play a crucial role in systematically assessing the availability of medical supplies, infrastructure adequacy and others, facilitating timely interventions and modification. Additionally, the integration of cultural competence into healthcare delivery is emphasized to enhance the acceptance and effectiveness of services among diverse populations. The review also highlights the critical roles of Community Health Officers and mid-level healthcare providers in the successful operation of HWCs. While acknowledging the commendable progress made by the AB-HWCs initiative, the study concludes that achieving sustainable and equitable health outcomes necessitates ongoing quality monitoring, strategic resource allocation, and adaptive policy measures. The consistent application of checklists in quality assurance processes is essential for maintaining high care standards and advancement of India towards its UHC objectives.

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Timilsina, Amit, Buna Bhandari, Alexandra Johns et Subash Thapa. « Barriers and facilitators to self-care practices for sexual and reproductive health among women of reproductive age ». PLOS ONE 19, n^o 5 (22 mai 2024) : e0303958. http://dx.doi.org/10.1371/journal.pone.0303958.

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Introduction Sexual and Reproductive Health and Rights (SRHR) have been promoted globally, yet sexual and reproductive health (SRH) interventions are seldom evaluated from the perspective of service users and service providers. Very little is known about whether and why various target groups including general women are (or are not) practicing SRH -related self-care practices. This study explored SRH self-care practices and facilitators and barriers to the adoption of SRH self-care among reproductive-age women of Nepal. Methods In this descriptive qualitative study, we conducted in-depth interviews in June 2022 with ten married women of reproductive age (service users) and four SRHR service providers (program managers and health service providers) in Nepal. Thematic analysis was conducted for data analysis. Results We found that commonly practiced self-care practices were self-administration of contraceptives, self-management of pain, self-monitoring of pregnancy, self-awareness and seeking medical abortions (tele-abortion), self-medication for pre-exposure prophylaxis for HIV, and self-testing for HIV and pregnancy. The multi-level barriers to SRH self-care were poor knowledge and perceived lack of need for SRH self-care, limited access, and negative behaviors from the service providers. The program-related barriers included lack of evidence, limited financial resources, lack of accountability, and limited knowledge and skills among service providers on SRH self-care measures. Peer support, an increasing number of service sites, and access to and use of digital (health) tools emerged as the facilitators of SRH self-care. Conclusions The findings of this study suggest that addressing barriers such as poor knowledge, limited access, and negative attitudes while leveraging facilitators such as peer support and digital tools is essential for promoting and enabling effective SRH self-care among women. Population-wide awareness programs supplemented by increasing service sites are essential for increasing SRH self-care practices.

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Li, Zhili, Yiqun Xie, Xiaowei Jia, Kara Stuart, Caroline Delaire et Sergii Skakun. « Point-to-Region Co-learning for Poverty Mapping at High Resolution Using Satellite Imagery ». Proceedings of the AAAI Conference on Artificial Intelligence 37, n^o 12 (26 juin 2023) : 14321–28. http://dx.doi.org/10.1609/aaai.v37i12.26675.

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Despite improvements in safe water and sanitation services in low-income countries, a substantial proportion of the population in Africa still does not have access to these essential services. Up-to-date fine-scale maps of low-income settlements are urgently needed by authorities to improve service provision. We aim to develop a cost-effective solution to generate fine-scale maps of these vulnerable populations using multi-source public information. The problem is challenging as ground-truth maps are available at only a limited number of cities, and the patterns are heterogeneous across cities. Recent attempts tackling the spatial heterogeneity issue focus on scenarios where true labels partially exist for each input region, which are unavailable for the present problem. We propose a dynamic point-to-region co-learning framework to learn heterogeneity patterns that cannot be reflected by point-level information and generalize deep learners to new areas with no labels. We also propose an attention-based correction layer to remove spurious signatures, and a region-gate to capture both region-invariant and variant patterns. Experiment results on real-world fine-scale data in three cities of Kenya show that the proposed approach can largely improve model performance on various base network architectures.

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Akachukwu Obianuju Mbata, Eigbokhan Gilbert Ogbewele et Nelly Tochi Nwosu. « Innovative healthcare solutions for resource-limited settings expanding pharmaceutical care to remote populations ». International Journal of Frontiers in Medicine and Surgery Research 6, n^o 2 (30 octobre 2024) : 029–37. http://dx.doi.org/10.53294/ijfmsr.2024.6.2.0045.

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Access to essential healthcare and pharmaceutical services remains a significant challenge in resource-limited settings. This paper explores innovative strategies for expanding pharmaceutical care to remote populations, focusing on the integration of mobile health technologies and community-based interventions. Mobile health (mHealth) technologies, including telemedicine and mobile pharmacies, offer a cost-effective means of delivering healthcare services, enhancing access, and improving real-time monitoring. Community-based interventions, such as the deployment of community health workers, health education campaigns, and peer support groups, play a critical role in addressing healthcare disparities and improving health literacy and medication adherence. The paper also discusses the integration of pharmaceutical care models, emphasizing the importance of collaboration among healthcare providers, pharmacists, and community health workers. Future directions highlight emerging innovations like AI and blockchain technology, while policy recommendations emphasize the need for investment in healthcare infrastructure, professional training, and regulatory support. By leveraging these strategies and innovations, healthcare outcomes and equity in resource-limited settings can significantly improve.

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Garrett, John Alden, et Jean Lee Stewart. « Hearing Loss and Otitis Media on Guam : Impact of Professional Services ». Asia Pacific Journal of Public Health 3, n^o 3 (juillet 1989) : 213–18. http://dx.doi.org/10.1177/101053958900300307.

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In less than two decades, there has been a dramatic reduction in the prevalence of otitis media and perforations among Guam's school-aged children. In addition, hearing loss due to chronic middle ear disease as a cause of disqualification from military service has dropped from a first rank order cause to next-to-last. However, there has been no reduction in the prevalence of otitis media in the preschool population. The reduction in chronic ear disease is the result of improved access to primary care, intensive hearing screening, wide availability of audiologic diagnostic and follow-up services, and comprehensive otologic care. It is essential that these services continue to be available to Guam's children to avoid a reversal of these dramatic gains. Attention must now focus on how to achieve similar gains for Micronesian children who remain restricted in their access to these resources.

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Nayah Gazelle Abang. « An Assessment of “Cheque Sante” as a Policy Instrument in Cameroon ». International Journal of Law and Politics Studies 6, n^o 5 (11 septembre 2024) : 20–29. http://dx.doi.org/10.32996/ijlps.2024.6.5.2.

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Health checks (“cheque sante”) have been used throughout the developing world including countries in Asia, Africa, and Latin America. This system has gained prominence in Africa as a mechanism to improve access to essential healthcare services, especially among vulnerable population and are designed to subsidize the cost of healthcare services for targeted populations, typically the poor and underserved. In Cameroon, the health cheque policy or voucher system which was launched in 2015 aimed at reducing maternal and infant mortality in the sahel regions. The main objective of this paper is to assess “cheque sante” as a policy instrument to combat high neo-natal rate in the priority regions of Cameroon. As tool of analysis, the group model was used to examine the said policy instrument. A mixed method of data collection was adopted consisting of both qualitative and quantitative data collection using the descriptive design. Data for this study was collected from both primary and secondary sources. The primary source involved key informant interviews specifically beneficiaries of the project. To further assess the health check in Cameroon, personal observations, reports from service providers and researchers’ were adopted while the secondary source was obtained from documentary sources. A myriad of actors both nationally and internationally are involved in the successful implementation of the health check as an instrument to solve the infant mortality rate. The “Cheque sante” policy instrument has increased access to maternal and child care services in the priority regions yet an extension, in particular to the East, North West and South West is imminent and envisaged in all regions within the framework of UHC.

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