Informal Providers, Pluralistic Health Systems, and India's COVID-19 Response: A Cross-Sectional Telephonic Study

2020 ◽  
Author(s):  
Krishna D. Rao ◽  
Japneet Kaur ◽  
Michael A. Peters ◽  
Naveet Kumar ◽  
Priya Nanda
Keyword(s):  
Health Systems ◽  
Cross Sectional ◽  
Informal Providers

scholarly journals Assessment of the Implementation of Tuberculosis and Diabetes Care in health systems: A Situational Analysis in Western Nigeria for consideration

2019 ◽  
Author(s):  
ASAGA MAC PETER ◽  
JUDE OSAGIE Aighobahi.
Keyword(s):  
Health Care ◽  
Health Systems ◽  
Health Care Providers ◽  
Health Facilities ◽  
Situational Analysis ◽  
Care Providers ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Low Middle Income Countries ◽  
Diabetes Patients

Abstract Background: Tuberculosis (TB) coexists with other non-communicable diseases (NCDs), including Diabetes Mellitus (DM). Smoking increases the risk of TB as well as DM. Health systems are poorly prepared in many low middle income countries (LMICs) and are currently facing the "triple burden of smoking, TB, and DM" that drives these countries into the vicious cycle of poverty. Methods: A cross-sectional study method was carried out to assess the proportion of TB care centers that included integration measures for diabetic care as well as those providing DM care that included integration measures for TB. A list of 49 health care centers in Lagos offering TB care and managing Diabetes patients were recruited. A focus Group Discussion(FGD) and Individual interviews were conducted to investigate health care providers ' knowledge, attitudes and practices and the barriers encountered in the process of integrating TB and DM care. Results: Out of the 49 health care centres recruited in this study, 6% of health care units are aware of a surveillance to screen for diabetes in tuberculosis patients, while 2% of health facilities confirmed awareness of a surveillance to screen for tuberculosis in diabetes patients. 91% of health centres either verified the lack of or no understanding of monitoring of both diseases. The percentage of health facilities that have existing guideline on TB and DM screening was evaluated, it was perceived that 8% of health facilities had implemented a guideline to screen for DM in TB patients, while 4% of these Care Centres have implemented a guideline for diabetes patients to be screened for TB. Conclusion TB/DM integrative screening, treatment and management could be better attained if both co-morbidities integration program is initiated in the healthcare centres and policies of western states and Nigeria as a whole.

scholarly journals The Association between Socioeconomic Factors and Visual Function among Patients with Age-Related Cataracts

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Yu Wan ◽  
Yinhao Wang ◽  
Liming Zhao ◽  
Zhenyu Wang ◽  
Min Sun ◽  
...  
Keyword(s):  
Socioeconomic Factors ◽  
Health Systems ◽  
Visual Function ◽  
Population Based ◽  
Energy Industry ◽  
Socioeconomic Indicators ◽  
Cross Sectional ◽  
Age Related ◽  
The Status ◽  
Per Capita

Background. With the development of the economy, socioeconomic factors, such as inequalities in the status of regional economies and the subsequent effects on health systems, have influenced the status of health. We explored the association between age-related cataracts and socioeconomic indicators, including the regional economy, health systems, and energy industries. Methods. This was a prospective, multicenter, Chinese population-based, cross-sectional study. A total of 830 participants from seven centers were enrolled. Data on the best-corrected visual acuity (BCVA), Lens Opacities Classification System III (LOCS III) score, Visual Function Index-14 (VF-14) score, total and subscale scores of the 25-item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25), per capita disposable income (PCDI), medical resource-related indicators, and investments in the energy industry were obtained. Associations among these parameters were analyzed. Results. The PCDI ranking was correlated with the VF-14 score (R = −0.426, P < 0.01 ), total score of NEI-VFQ-25 (r = −0.500, P < 0.01 ), and BCVA (r = 0.278, P < 0.01 ). The number of health agencies (r1 = 0.267, r2 = −0.303, r3 = −0.291,), practicing or assistant practicing doctors (r1 = -0.283, r2 = 0.427, r3 = 0.502,), registered nurses (r1 = −0.289, r2 = 0.409, r3 = 0.469, P < 0.01 ), and health technicians (r1 = −0.278, r2 = 0.426, r3 = 0.500, P < 0.01 ) per 10,000 of the population was each correlated with the BCVA, VF-14 score, and total score of NEI-VFQ-25, respectively. Health expenditure per capita was correlated with the VF-14 score (r = 0.287, P < 0.01 ) and total score of NEI-VFQ-25 (r = 0.459, P < 0.01 ). The LOCS III P score was correlated with investments in the energy industry (r = 0.485, P < 0.001 ). Conclusions. Patients in higher economic regions with greater medical resources show a greater demand to undergo cataract surgery at a better subjective and objective visual function. The energy industry has a significant effect on cataracts, especially the posterior subcapsular cataract, and thus more attention should be paid to people in regions with abundant energy industries.

FAIRNESS OF UTILIZING HEALTH CARE FACILITIES AND OUT-OF-POCKET PAYMENT BURDEN: EVIDENCE FROM CAMBODIA

2012 ◽  
Vol 45 (3) ◽  
pp. 345-357 ◽  
Author(s):  
KOUSTUV DALAL ◽  
OLATUNDE AREMU
Keyword(s):  
Health Care ◽  
Health Systems ◽  
Health Care Facilities ◽  
Care Utilization ◽  
Cross Sectional ◽  
Middle Income ◽  
Distinct Level ◽  
Out Of Pocket Payments ◽  
Care Facilities ◽  
Low And Middle Income

SummaryCatastrophic spending on health care through out-of-pocket payment is a huge problem in most low- and middle-income countries all over the world. The collapse of health systems and poverty have resulted in the proliferation of the private health sector in Cambodia, but very few studies have examined the fairness in ease of utilization of these services based on mode of payment. This study examined the utilization of health services for sickness or injury and identified its relationship with people's ability to pay for treatment seeking at various instances. Based on cross-sectional data from the Cambodian 2007 Demographic and Health Survey, the economic index estimated through principal component analysis and Lorenz curve was used to quantify the degree of fairness and equality in utilization and payment burden among the respondents. A distinct level of fairness was found in health care utilization and out-of-pocket payments. Specifically, use of private health care facilities and over-the-counter remedies dominate, and out-of-pocket payments cut across all socioeconomic strata. As many countries in low- and middle-income regions, and most importantly those in transition such as Cambodia, are repositioning their health systems, efforts should be made towards maintaining equitable access through adoption of finance mechanisms that make utilization of health care services fair and equitable.

scholarly journals Motivating doctors into leadership and management: a cross-sectional survey

BMJ Leader ◽  
2020 ◽  
Vol 4 (4) ◽  
pp. 196-200
Author(s):  
Agnes Bäker ◽  
Mickael Bech ◽  
Jaason Geerts ◽  
Susanne Maigaard Axelsen ◽  
Henrik Ullum ◽  
...  
Keyword(s):  
Leadership Development ◽  
Health Systems ◽  
Leadership Training ◽  
Cross Sectional Survey ◽  
Motivation To Lead ◽  
Cross Sectional ◽  
Leadership And Management ◽  
Leadership Pipeline ◽  
Medical Leadership ◽  
Motivation To Participate

PurposeCalls for doctors to enter management are louder as the benefits of medical leadership become clearer. However, supply is not meeting demand. This study asks doctors (physicians): what might encourage you to go into leadership, and what are the disincentives? The same was asked about leadership training. First, the paper tries to understand doctors’ motivation to lead, specifically, to explore the job characteristics that act as incentives and disincentives. Second, the study points to organisational obstacles that further shrink the medical leadership pipeline.MethodDoctors were surveyed through the Organization of Danish Medical Societies. Our key variables included: (1) the incentives and disincentives for doctors of going into leadership and management and (2) the motivation to participate in leadership training. Our sample of 3534 doctors (17% response) is representative of the population of doctors in Denmark.FindingsThe main reason why doctors are motivated towards leadership is to make a difference. They are put off by fears of extra administration, longer hours, burnout, lack of resources and by organisational cultures resistant to change. However, doctors are aware of their need for leadership development prior to entering management.Practical implicationsTo improve succession planning, health systems should adapt to reflect the incentives of their potential medical leaders. Leadership training is also essential. These changes are especially important now; medical leaders are linked positively to organisational and patient outcomes and have been central in responding to COVID-19, stress and burnout among clinical staff continues to rise, and health systems face recruitment and retention challenges.

scholarly journals Parental Activation and Obesity-Related Health Behaviors Among a Racially and Ethnically Diverse Population of Low-Income Pediatric Patients: Protocol for a Cross-Sectional Survey Study (Preprint)

2017 ◽  
Author(s):  
Nakiya N Showell ◽  
Corinna Koebnick ◽  
Lisa R DeCamp ◽  
Margo Sidell ◽  
Tatiahna Rivera Rodriguez ◽  
...  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Health Care ◽  
Health Behaviors ◽  
Health Systems ◽  
Low Income ◽  
Screen Time ◽  
Aged Patients ◽  
Cross Sectional ◽  
Primary Care Settings

BACKGROUND Despite a recent decline in the obesity prevalence among preschool-aged children, obesity remains disproportionately high among children from low-income racial or ethnic minority families. Promoting healthy lifestyles (eg, obesity-preventative behaviors) in primary care settings is particularly important for young children, given the frequency of preventative health visits and parent-provider interactions. Higher adoption of specific health behaviors is correlated with increased patient activation (ie, skill, confidence, and knowledge to manage their health care) among adults. However, no published study, to date, has examined the relationship between parental activation and obesity-related health behaviors among young children. OBJECTIVE The goal of this study is to measure parental activation in low-income parents of preschoolers in 2 large health systems and to examine the association with diet, screen-time, and physical activity behaviors. METHODS We will conduct a cross-sectional study of parents of preschool-aged patients (2-5 years) receiving primary care at multiple clinic sites within 2 large health care systems. Study participants, low-income black, Hispanic, and white parents of preschool-aged patients, are being recruited across both health systems to complete orally administered surveys. RESULTS Recruitment began in December 2017 and is expected to end in May 2018. A total of 267 low-income parents of preschool-aged children have been enrolled across both clinic sites. We are enrolling an additional 33 parents to reach our goal sample size of 300 across both health systems. The data analysis will be completed in June 2018. CONCLUSIONS This protocol outlines the first study to fully examine parental activation and its relationship with parent-reported diet, physical activity, and screen-time behaviors among low-income preschool-aged patients. It involves recruitment across 2 geographically distinct areas and resulting from a partnership between researchers at 2 different health systems with multiple clinical sites. This study will provide new knowledge about how parental activation can potentially be incorporated as a strategy to address childhood obesity disparities in primary care settings. INTERNATIONAL REGISTERED REPOR RR1-10.2196/9688

scholarly journals Knowledge and Awareness of Saudi Public Regarding the Outbreak and Prevention of COVID-19 in Saudi Arabia; a Questionnaire-Based Study

2020 ◽  
Vol 12 (13) ◽  
pp. 67
Author(s):  
Reem Al Madani ◽  
Shahzeb H. Ansari
Keyword(s):  
Saudi Arabia ◽  
Health Systems ◽  
General Public ◽  
Online Survey ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Demographic Information ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Male And Female

INTRODUCTION: The dispersion of severe COVID-19 has already occupied on pandemic extents, disturbing over 100 nations in a matter of months. A worldwide response to formulate health systems global is imperious. MATERIALS &amp; METHODS: This is a cross sectional study conducted among the Saudi general public using an online survey. Saudis (male and female) of all ages willing to participate in this study were requested to fill up the survey. An online questionnaire was designed using Google Forms with questions related to personal and demographic information followed by COVID-10 related questions. RESULTS: A total of N=1026 subjects participated in this study and responded by completing the online survey. They were divided into groups including gender, age, education and profession type. As far as gender was concerned, 243 (23.7%) males and 783 (76.3%) females took part. CONCLUSION: Overall knowledge of Saudis regarding COVID-19 is above average.

scholarly journals Person-centred care in complementary medicine for individuals with chronic conditions in Australia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
H Foley ◽  
A Steel ◽  
J Adams
Keyword(s):  
Public Health ◽  
Complementary Medicine ◽  
Health Systems ◽  
Chronic Conditions ◽  
Clinical Care ◽  
Medical Doctors ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Public Health Burden ◽  
Public Health Systems

Abstract Background Increasing chronic condition diagnoses burden public health systems, individuals and communities. The duration and complexity of chronic conditions require ongoing, multifaceted care - such as person-centred care (PCC) - to address the individual needs and quality of life for patients. Many patients with chronic conditions seek additional care outside mainstream medicine, often consulting complementary medicine (CM) practitioners. This study examines the extent of PCC being experienced by patients with chronic conditions who consult CM practitioners. Methods Cross-sectional survey (n = 191), conducted nationally, November 2018 to March 2019, in clinics of the five CM professions most commonly consulted by individuals with chronic conditions in Australia (massage, chiropractic, osteopathy, acupuncture, naturopathy). Participants with chronic conditions (n = 153) were surveyed about experiences of PCC during CM consultation, and regarding consultation with medical doctors, using four validated measures. Results During consultation with CM practitioners, patient perceptions of PCC were consistently high. Ratings of PCC were consistently higher for consultations with any CM practitioners (summary mean 3.33) than consultations with medical doctors (summary mean 2.95). The highest mean scores for PCC were reported by patients of naturopaths (summary mean 4.04). Variations in perceived PCC for different items between professions indicate nuance in the experience of consultation across different CM professions. Conclusions This study indicates PCC is characteristic of CM consultation, which may reflect CM philosophies such as holism. CM practitioners may present an existing resource of PCC. Further attention should be given to CM professions regarding the potential to address unmet needs of individuals with chronic conditions, and subsequently to better manage the public health burden associated with chronic conditions. Key messages Person-centred care appears to be a consistent characteristic of complementary medicine clinical care for individuals with chronic conditions. Due to rising rates of chronic conditions and the associated burden on public health systems, complementary medicine professions should be considered as a resource to optimise chronic illness care.

scholarly journals Unmet supportive care needs and its relation to quality of life among adult acute leukaemia patients in China: a cross-sectional study

2020 ◽  
Author(s):  
Jie Yan ◽  
Ying Wang ◽  
Jingyi Chen ◽  
Chunfeng Wang ◽  
Yingchun Lin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Supportive Care ◽  
Health Systems ◽  
Acute Leukaemia ◽  
Cross Sectional Study ◽  
Supportive Care Needs ◽  
Sectional Study ◽  
Care Needs ◽  
Cross Sectional

Abstract Background: Patients with acute leukaemia (AL) usually require prolonged periods of hospitalisation. The treatment and clinical symptoms may lead to patients’ supportive care needs (SCNs) not being met and impairs their quality of life (QoL). Studies on QoL and SCNs among AL patients are limited. This study aimed to identify the unmet SCNs and its relation to QoL of adult AL patients in China.Methods: This multicentre cross-sectional study recruited 346 participants to complete a self-developed questionnaire, detailing demographic information and disease-related variables. A 34-item Supportive Care Needs Survey (SCNS-SF34) was used to identify unmet SCNs, and the Functional Assessment of Cancer Therapy-Leukaemia (FACT-Leu) questionnaire measured patients’ QoL.Results: Unmet SCN rates for the 34 items ranged from17.6% to 81.7%. Patients’ needs were high for health systems and information, but low in the sexual domain. The results reveal nine factors associated with the unmet SCNs of adult AL patients, including marital status, original residence, age, education, occupation, other diseases, chemotherapy course, disease course, and treatment stage (p <0.05). The total score of the FACT-Leu negatively correlated with the SCNS-SF34 in the physical/daily living (r = - 0.527, p <0.01), psychological (r = - 0.688, p <0.01), sexual (r = - 0.170, p <0.01), patient care and support (r = - 0.352, p <0.01), and health systems and information (r = - 0.220, p <0.01) domains.Conclusions: Adult AL patients exhibit a high demand for unmet SCNs, especially in the domain of health systems and information. There was a significant association between patients’ unmet SCNs and QoL. Future research should develop tailored interventions to address the unmet SCNs of adult AL patients, to further improve their QoL.

scholarly journals Barriers to Childhood Immunization in Sub-Saharan Africa: A Systematic Review

2020 ◽  
Author(s):  
Joseph Benjamin Bangura ◽  
Shui-yuan Xiao ◽  
Dan Qiu ◽  
Feiyun Ouyang ◽  
Lei Chen
Keyword(s):  
Systematic Review ◽  
Health Systems ◽  
Immunization Coverage ◽  
Case Control ◽  
Sub Saharan Africa ◽  
Immunization Programs ◽  
Childhood Immunization ◽  
Cross Sectional ◽  
National Immunization ◽  
Sub Saharan

Abstract Background Immunization to prevent infectious diseases is a core strategy to improve childhood health as well as survival. It remains a challenge for some African countries to attain the required childhood immunization coverage. We aim at identifying individual barriers confronting parents/caretakers, providers, and health systems that hinder childhood immunization coverage in Sub-Saharan Africa. Method This systematic review searched PubMed/MEDLINE, Web of Science and EMBASE. We restricted to published articles in English that focused on childhood immunization barriers in Sub-Saharan Africa from January 1988 to February 2019. We excluded studies if: focused on barriers to immunization for children in other regions of the world, studied adult immunization barriers; studies not available on the university library, they were editorial, reports, reviews, supplement, and bulletins. Study designs included were cross-sectional, second-hand data analysis; and case control. Results Of the 2,538 items identified, 40 met inclusion criteria. Parents/caretakers were the most common subjects. Eight articles were of moderate and 32 were of high methodological quality. Seven studies analyzed secondary data; 30 used cross-sectional designs and three employed case control method. Twenty-five studies reported national immunization coverage of key vaccines for children under one, fifteen did not. When reported, national immunization coverages of childhood vaccines were reported to be low. Parents/caretaker’s barriers included lack of knowledge of immunization, distance to access point, financial deprivation, lack of partners support, and distrust in vaccines and immunization programs. Other associated factors for low vaccine rates included the number of off-springs, life style, migration and occupation. Barriers at health system level cited by healthcare providers included limited human resources and inadequate infrastructures to maintain the cold chain and adequate supply of vaccines. Conclusion In this review we identified more thoroughly the parents/caretakers’ barriers than those of providers and health systems. Factors that influenced decisions to get children vaccinated were mainly their gender, beliefs, socio-economic and socio-culture factors in the communities in which they live. Thus it is vital that immunization programs consider these barriers and address the people and societies in their communities across Sub-Saharan Africa.

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