Oral health care for the ageing population in Brazil: Trends and potentials in the public health system

Gerodontology ◽  
2017 ◽  
Vol 34 (2) ◽  
pp. 149-150 ◽  
Author(s):  
Mariél de Aquino Goulart ◽  
Renato José De Marchi
Keyword(s):  
Public Health ◽  
Health Care ◽  
Oral Health ◽  
Health System ◽  
Public Health System ◽  
Oral Health Care ◽  
Ageing Population ◽  
The Public

scholarly journals Development of a gender-relevant tobacco cessation intervention for women in Brazil—an intervention mapping approach to planning

2019 ◽  
Vol 34 (5) ◽  
pp. 505-520
Author(s):  
N�dia Kienen ◽  
Tha�s Dist�fano Wiltenburg ◽  
Lorna Bittencourt ◽  
Isabel C Scarinci
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Health Care System ◽  
Tobacco Cessation ◽  
Public Health System ◽  
Intervention Mapping ◽  
The Public ◽  
Cessation Intervention ◽  
Care System

Abstract The purpose of this article is to describe the development of a theory-based, culturally and gender-relevant Community Health Worker (CWH)-led tobacco cessation intervention for low-income Brazilian women who augments the tobacco cessation program offered through the public health system using Intervention Mapping (IM). We began with the establishment of a network of representatives from different segments of society followed by comprehensive needs assessments. We then established a logical planning process that was guided by a theoretical framework (Social Cognitive Theory) and existing evidence-based tobacco cessation programs, taking into account socio-political context of a universal health care system. Given the gender-relevance of our intervention and the importance of social support in tobacco cessation among women, we chose an intervention that would be delivered within the public health system but augmented by CHWs that would be trained in behavior change by researchers. One of major advantages of utilizing IM was that decisions were made in a transparent and supportive manner with involvement of all stakeholders throughout the process. Despite the fact that this process is very taxing on researchers and the health care system as it takes time, resources and negotiation skills, it builds trust and promotes ownership which can assure sustainability.

scholarly journals Progress of health care in rural India: a critical review of National Rural Health Mission

2017 ◽  
Vol 5 (1) ◽  
pp. 4 ◽  
Author(s):  
S. Gopalakrishnan ◽  
A. Immanuel
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Rural Health ◽  
Public Health System ◽  
National Rural Health Mission ◽  
Rural India ◽  
Health Coverage ◽  
The Public ◽  
Public Health Infrastructure

National rural health mission (NRHM) was initiated in the year 2005 in eleventh five year plan, with the objective of providing quality health care services to the rural population. The mission brought out salient strategies by involving various sectors and forging partnerships with various organizations to unify health and family welfare services into a single window. Though the mission strived for a sustainable health care system, it did not envisage certain challenges in implementation. The public health system in India could take off from the foundations laid by the NRHM to overcome these challenges, in order to achieve various goals of health and development and put India on the road map of healthful development. The objective of this review article is to critically evaluate the implementation of national rural health mission and highlight its success and to make recommendations on the future health care planning and implementation in achieving universal health coverage for the rural India. NRHM has been a mammoth effort by the Union Government to build the public health infrastructure of the nation. The mission deserves its credit for empowering the rural India in health care, especially in States with poor health related indicators. NRHM has been a pioneer in reiterating the need for community participation, coupled with intersectoral convergence, to bring about a paradigm shift in the indicators, which has been reasonably achieved in most of the States. Taking forward the foundations laid by the NRHM, it is essential for the forthcoming policies and plans to focus on capacity building, not only on the infrastructure and technical aspects, but also on streamlining the health workforce, which is crucial to sustaining the public health infrastructure. The public health system in India should take off from the foundations laid by the NRHM. There is an imminent need to focus on forging a sustainable public private partnership, which will deliver quality services, and not compromise on the principles and identity of the public health system of the country, in its pursuit to achieve universal health coverage and sustainable development goals.

scholarly journals Tuberculosis and Diabetes Mellitus Comorbidity among the Ageing Population: A Threat to the Public Health System of Nepal

2018 ◽  
Vol 16 (2) ◽  
pp. 110-117 ◽  
Author(s):  
Bijay Maharjan ◽  
Hom Nath Chalise ◽  
Mamta Thapa
Keyword(s):  
Public Health ◽  
Diabetes Mellitus ◽  
Risk Factors ◽  
Health System ◽  
Public Health System ◽  
The Other ◽  
Diabetic Patients ◽  
Ageing Population ◽  
The Public ◽  
The Future

Ageing population is attributable to the growing trend of diabetes mellitus. Diabetic patients are three times greater risk of developing tuberculosis. The review aims to describe the state of tuberculosis and diabetes mellitus comorbidity, risk factors for the comorbidity from the perspective of the ageing in Nepal. It is a systematic narrative review of literature in Google Scholar and Pubmed. At first, title and abstract of an article was reviewed for relevance, and then full article was reviewed for validity. The secondary data was retrieved from the Central Bureau of Statistics of Nepal and WHO, and analysed in the Ms-Excel. In Nepal, the population is ageing. The risk factors associated with diabetes are escalating. On the other hand, tuberculosis is endemic and about 45% of the Nepalese people are infected with tuberculosis bacteria. These circumstances have laid the foundation that fosters tuberculosis and diabetes co-epidemic in the future. The clinical management of patients with the comorbid condition is a difficult task because diabetes and tuberculosis interact with each other, one worsening the other. The upsurge of the co-morbidity needs the provision of more health services threatening the public health system of Nepal. It is fundamental to create a mechanism to integrate diabetes and tuberculosis program such as screening, diagnosis and management of the both diseases at the all levels of health service delivery. Furthermore, increase awareness of healthy lifestyle and the prevention of the risk factors for tuberculosis and diabetes could reduce the occurrence of the comorbidity in the future.

scholarly journals Violencia ginecológica y silencio al interior del Modelo Médico en Chile. Stella Salinero Rates, Manuel Cárdenas Castro

2021 ◽  
Vol 81 (03) ◽  
pp. 226-238
Author(s):  
Stella Salinero-Rates ◽  
Manuel Cárdenas Castro
Keyword(s):  
Public Health ◽  
Health Care ◽  
Sexual Orientation ◽  
Health System ◽  
Key Words ◽  
Public Health System ◽  
Medical Model ◽  
Cross Sectional ◽  
Level Of Education ◽  
The Public

Objective: To investigate the presence of gynecological violence within the health system in Chile, quantify the magnitude of this problem, define its general contours and make visible a phenomenon that has been silenced until now. Methods: The design is cross-sectional and not probabilistic. It included a sample of 4563 women, who were of legal age and who had ever attended gynecological services. A questionnaire was applied between December 18, 2019 and May 10, 2020 using the online platform (SurveyMonkey®). Results: 67% of the participants reported having experienced violence in some way. Such violence occurs most frequently, but not only, in the public health system, in people who belong to native ethnic groups, who consider themselves to be of African descent, whose sexual orientation is lesbian, who are older and who have a lower level of education. Conclusion: The results indicate a high report of violence in gynecological health care Key words: Gynecological violence, Body, Sexuality, Itself, Hegemonic medical model.

scholarly journals The Abolition of User Fees in the Jamaican Public Health System: Impact on Access, Care Provided and the Work of the Professional Nurse

2021 ◽  
Author(s):  
◽  
Adella Campbell
Keyword(s):  
Public Health ◽  
Health Care ◽  
Developing Countries ◽  
Health Services ◽  
Health System ◽  
Public Health System ◽  
User Fees ◽  
Professional Nurse ◽  
The Public ◽  
The Impact

<p>The negative impact of user fees on the utilisation of the health services by the poor in developing countries such as Uganda and Jamaica is well documented. Therefore, various governments have been engaged in reforming public health systems to increase access by underserved populations. One such reform is the introduction of free health services. In Jamaica, user fees were abolished in the public health sector in 2007 for children under 18 years and in 2008 free health care was introduced for all users of the public health system. This study evaluated the impact of the 2008 reform on the Jamaican public health system at 1) the national level, 2) the provider level, and 3) the user level. Perspectives were sought on access to care, the care provided, and the work of the professional nurse. Participants were selected from the Ministry of Health (MOH), the four Regional Health Authorities (RHAs), and urban and rural health facilities. Data collection was done during March – August 2010, using a multi-layered mixed methods evaluation approach, incorporating both qualitative and quantitative methods. Methods included individual interviews with key policymakers (eight) at the MOH and the four RHAs, as well as a senior medical officer of health (one) and pharmacists (three); focus groups with representatives of the main practitioners in the health system including nurses (six groups), pharmacists (one group) and doctors (two groups); document reviews of the MOH and RHAs‘ annual reports, and a survey of patients (200). Views on the impact of the abolition of user charges differed across the three levels and among the health authorities, facilities, and perspectives (policymakers, practitioners and users). Patient utilisation of the public health system increased exponentially immediately following the abolition of user fees, then declined, but remained above the pre-policy level. The work of health care providers, especially the professional nurse, was affected in that they had to provide the expected and required services to the patients despite an increase in workload and constraints such as inadequate resources. The research found that, while policymakers were optimistic about the policy, providers had concerns but patients were satisfied with the increased access and the quality care they were now receiving. Users also encountered challenges that constituted barriers to access. In addition to providing further evidence about the abolition of user fees in the public health system, this research provides important new insights into the impact of the nationwide abolition of user fees, as well as the impact of the policy change on the work of the professional nurse. Equally, the findings highlighted the potential benefits, gaps, and failures of the abolition of user fees‘ policy, and will serve as a catalyst to improve the policy process regarding access to health services and the work of the professional nurse. The findings of this research will be valuable in the planning of health-related programmes for the consumers of health care in developing countries. Despite the need for further research in this area, this research has contributed to the body of knowledge regarding user fees and access to health care in developing countries.</p>

scholarly journals The importance of strengthening public health systems based on primary health care in designing a successful vaccination strategy: an example of qualitative research in three regions of Senegal.

2019 ◽  
Author(s):  
Jacopo Bianchi ◽  
Chiara Milani ◽  
Angela Bechini ◽  
Sara Boccalini ◽  
Maria José Caldes Pinilla ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Public Health System ◽  
Health Workers ◽  
Conventional Medicine ◽  
Specific Information ◽  
The Public ◽  
Primary Health

Abstract Background Because of its low cost and its capability in reducing child mortality and morbidity, vaccination is considered a successful preventive deed in Low and Middle-Income Countries. In Senegal, vaccines are provided free of charge by the public health system, but the provision of the service is not evenly distributed between and within the Regions. Our study aimed at identifying barriers and enabling factors towards vaccination in three Regions of Senegal. Methods We performed 41 face-to-face semi-structured interviews with health services’ workers and three focus groups with local women in nine different structures in three different Regions of Senegal. We combined health workers’ (HW) and mothers’ points of view with direct observation in order to fulfill our purpose. Results We identified three groups of barriers – structural, personal and psychological – and many subthemes for each of them. Structural and personal barriers such as inadequacy of health structures, shortage of HW, lack of money, distance between villages and health facilities and lack of public transport, hamper mothers from utilising the vaccination service, even when they want to. The lack of effective communication between health personnel and mothers, the lack of collaboration between traditional and conventional medicine and the lack of trust in the public health system as a whole, are major problems to the vaccination uptake too. Conclusions The interlink of several elements in conditioning vaccination coverage suggests the need of implementing global and national strategies to overcome them. The key factor is the presence of a solid health system, publicly funded, based on primary health care. On the other hand, context-specific determinants cannot be detected based on global and non-specific information. The role of community health workers (CHWs) is crucial in overcoming wrong beliefs, lack of knowledge and distrust. They must be regarded as a bridge between HW and population. CHWs should be formally included in the organization of the social-health system, adequately formed and enhanced.

scholarly journals The Abolition of User Fees in the Jamaican Public Health System: Impact on Access, Care Provided and the Work of the Professional Nurse

2021 ◽  
Author(s):  
◽  
Adella Campbell
Keyword(s):  
Public Health ◽  
Health Care ◽  
Developing Countries ◽  
Health Services ◽  
Health System ◽  
Public Health System ◽  
User Fees ◽  
Professional Nurse ◽  
The Public ◽  
The Impact

<p>The negative impact of user fees on the utilisation of the health services by the poor in developing countries such as Uganda and Jamaica is well documented. Therefore, various governments have been engaged in reforming public health systems to increase access by underserved populations. One such reform is the introduction of free health services. In Jamaica, user fees were abolished in the public health sector in 2007 for children under 18 years and in 2008 free health care was introduced for all users of the public health system. This study evaluated the impact of the 2008 reform on the Jamaican public health system at 1) the national level, 2) the provider level, and 3) the user level. Perspectives were sought on access to care, the care provided, and the work of the professional nurse. Participants were selected from the Ministry of Health (MOH), the four Regional Health Authorities (RHAs), and urban and rural health facilities. Data collection was done during March – August 2010, using a multi-layered mixed methods evaluation approach, incorporating both qualitative and quantitative methods. Methods included individual interviews with key policymakers (eight) at the MOH and the four RHAs, as well as a senior medical officer of health (one) and pharmacists (three); focus groups with representatives of the main practitioners in the health system including nurses (six groups), pharmacists (one group) and doctors (two groups); document reviews of the MOH and RHAs‘ annual reports, and a survey of patients (200). Views on the impact of the abolition of user charges differed across the three levels and among the health authorities, facilities, and perspectives (policymakers, practitioners and users). Patient utilisation of the public health system increased exponentially immediately following the abolition of user fees, then declined, but remained above the pre-policy level. The work of health care providers, especially the professional nurse, was affected in that they had to provide the expected and required services to the patients despite an increase in workload and constraints such as inadequate resources. The research found that, while policymakers were optimistic about the policy, providers had concerns but patients were satisfied with the increased access and the quality care they were now receiving. Users also encountered challenges that constituted barriers to access. In addition to providing further evidence about the abolition of user fees in the public health system, this research provides important new insights into the impact of the nationwide abolition of user fees, as well as the impact of the policy change on the work of the professional nurse. Equally, the findings highlighted the potential benefits, gaps, and failures of the abolition of user fees‘ policy, and will serve as a catalyst to improve the policy process regarding access to health services and the work of the professional nurse. The findings of this research will be valuable in the planning of health-related programmes for the consumers of health care in developing countries. Despite the need for further research in this area, this research has contributed to the body of knowledge regarding user fees and access to health care in developing countries.</p>

scholarly journals Outbreaks and the management of ‘second-order friction’: Repurposing materials and data from the health care and food systems for public health surveillance

2016 ◽  
Vol 29 (1) ◽  
pp. 52-69
Author(s):  
Angie M. Boyce
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Public Health Surveillance ◽  
Public Health System ◽  
Health Surveillance ◽  
Second Order ◽  
Outbreak Detection ◽  
Order System ◽  
The Public

In the US, the public health system plays a key role in identifying unsafe food in the food supply. This identification work (public health surveillance) entails piecing together and reworking materials and data from the health care and food sectors to identify the ultimate cause of the problem. As such, the public health system depends heavily on infrastructures built for other purposes to achieve its goals. Using the case of foodborne outbreak detection, this article enhances the ethnographic analysis of second-order systems by incorporating the concepts of ‘repurposing’ and ‘friction’ to analyze this dependent relationship, the challenges it entails, and the broader sociopolitical and ethical consequences of connecting heterogeneous infrastructures. I examine how actors within the second order system of public health conduct the practical work of repurposing materials and data from other sectors, and grapple with the inescapable presence of ‘second-order friction’ between their system and infrastructures built to achieve other goals.

Public Health and Health Care: Integration, Disintegration, or Eclipse

2018 ◽  
Vol 46 (4) ◽  
pp. 940-951 ◽  
Author(s):  
Peter D. Jacobson ◽  
Wendy E. Parmet
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Population Health ◽  
Affordable Care Act ◽  
Public Health System ◽  
The Public ◽  
Care Integration ◽  
The Us ◽  
Integration Project

Many observers have argued that the US health care system could be more efficient, and achieve better outcomes if providers focused more on improving the community's health, not just the welfare of individual patients. The passage of the Affordable Care Act (ACA) in 2010 seemed to herald the promise of such reforms, and greater integration of the health care and public systems. In this article, we reassess the quest for integration, a quest we call the “integration project.” After examining the modest steps taken so far toward integration, we consider some conceptual barriers to integration as well as some of the risks it might portend for the public health system. Our assessment contributes to wide-ranging debates among public health advocates, practitioners, and policymakers as to the health care system's role in protecting public health, and how the public health system can best be organized to meet expected population health challenges.

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