A. Hamid, Raymond Yovelanyine Suonyir, Salomey Frimpomaa, K. Agyeman-Duah, Kwapong Yaw Kissiedu, Evans Ewusie Cudjoe, S. Nanga, P. K. Kwadzokpui, R. Duneeh, A. T. Bawah, Kenneth Owusu Agyemang, Samuel Akoliga, Israel Tordzro Agudze, Rosemary Dormenyo Amenuvor, V. Orish, E. S. Kasu, E. Ofori, S. Owusu-Agyei, A. Wahab, Mawuko Hamid
Introduction: The proliferation of non-falciparum species of plasmodium into a predominant falciparum population compromises the utility of monobiomarker-based Malaria Rapid Diagnostic Test (mRDT). This study evaluated the clinical utility of a monobiomarker-based Carestart and Paracheck mRDTs, which were in routine use at a Military Medical Centre in Ghana at the time of the study. Methods: The study was designed to assess the validity of candidate mRDTs among population risk of exposure to nonfalciparum species of plasmodium in Ghana. Blood samples collected from a consecutive series of 207 febrile patients in the months of June and July 2020, were tested for malaria parasites, using the mRDTs and microscopy as the gold standard. Prevalence, validity, and reliability metrics were determined using Frequentist, Receiver Operating Characteristics (ROC), and Kappa statistics, respectively. Results: The prevalence was 23.2% and 12.3% using microscopy and candidate mRDT, respectively. Sensitivities and specificities were 53.2% and 98.1% (Carestart) 45.8% and 99.4% (Paracheck), respectively. Neither ROC analysis showed a significant disparity between mRDTs (Carestart: AUROC=0.75 vs Paracheck: AUROC=0.73), nor the reliability index showed disagreement between both mRDTs (Cronbach’s α = 0.92). However, there was significant disagreement between microscopy and mRDTs (Carestart: Kappa=0.58 vs Paracheck: Kappa=0.55). Conclusion: The use of a monobiomaker mRDTs in this study led to a significant variation between the ‘internal’ and ‘ecological’ validity metrics. Averagely, 84% of mRDT false negatives were confirmed by microscopy as non-falciparum species of plasmodium. The observed trends have and research policy implications. It is therefore, critical to accelerate the implementation of WHO’s recommendation to switch from mono to multiple biomarker (s) based mRDTs for detecting both falciparum and non-falciparum species. Extended research is needed to consolidate our understanding on the dynamics of malaria among our military personnel exposed to non-falciparum plasmodium.
非恶性疟原虫向恶性疟原虫主要种群的增殖影响了基于单生物标记物的疟疾快速诊断试验(mRDT)的应用。本研究评估了基于单生物标志物的Carestart和Paracheck mRDTs的临床应用，这两种mRDTs在研究期间在加纳的一个军事医疗中心常规使用。方法:本研究旨在评估候选mrdt在加纳非恶性疟原虫种群暴露风险中的有效性。使用mrdt和显微镜作为金标准，从2020年6月和7月连续收集的207例发热患者的血液样本进行了疟疾寄生虫检测。患病率、效度和信度指标分别采用频率统计、受试者工作特征(ROC)和Kappa统计来确定。结果:镜检和候选mRDT检出率分别为23.2%和12.3%。敏感性为53.2%，特异性为98.1% (Carestart);敏感性为45.8%，特异性为99.4% (Paracheck)。ROC分析均未显示mrdt之间存在显著差异(Carestart: AUROC=0.75 vs Paracheck: AUROC=0.73)，可靠性指标也未显示mrdt之间存在差异(Cronbach 's α = 0.92)。然而，显微镜和mrdt之间存在显著差异(Carestart: Kappa=0.58 vs Paracheck: Kappa=0.55)。结论:在本研究中使用单一生物制造商的mrdt导致了“内部”和“生态”有效性指标之间的显著差异。平均而言，84%的mRDT假阴性经显微镜检查证实为非恶性疟原虫。观察到的趋势具有和研究政策意义。因此，必须加快实施世卫组织的建议，将检测恶性疟原虫和非恶性疟原虫的基于单一生物标志物的mrdt转变为基于多种生物标志物的mrdt。需要进行更广泛的研究，以巩固我们对接触非恶性疟原虫的军事人员中疟疾动态的了解。
{"title":"Clinical Utility of Mono-Biomarker based Malaria Rapid Diagnostic Test Kits at a Military Medical Centre in Ghana: A Prospective Pilot Study","authors":"A. Hamid, Raymond Yovelanyine Suonyir, Salomey Frimpomaa, K. Agyeman-Duah, Kwapong Yaw Kissiedu, Evans Ewusie Cudjoe, S. Nanga, P. K. Kwadzokpui, R. Duneeh, A. T. Bawah, Kenneth Owusu Agyemang, Samuel Akoliga, Israel Tordzro Agudze, Rosemary Dormenyo Amenuvor, V. Orish, E. S. Kasu, E. Ofori, S. Owusu-Agyei, A. Wahab, Mawuko Hamid","doi":"10.33140/ijhpp.02.02.06","DOIUrl":"https://doi.org/10.33140/ijhpp.02.02.06","url":null,"abstract":"Introduction: The proliferation of non-falciparum species of plasmodium into a predominant falciparum population compromises the utility of monobiomarker-based Malaria Rapid Diagnostic Test (mRDT). This study evaluated the clinical utility of a monobiomarker-based Carestart and Paracheck mRDTs, which were in routine use at a Military Medical Centre in Ghana at the time of the study. Methods: The study was designed to assess the validity of candidate mRDTs among population risk of exposure to nonfalciparum species of plasmodium in Ghana. Blood samples collected from a consecutive series of 207 febrile patients in the months of June and July 2020, were tested for malaria parasites, using the mRDTs and microscopy as the gold standard. Prevalence, validity, and reliability metrics were determined using Frequentist, Receiver Operating Characteristics (ROC), and Kappa statistics, respectively. Results: The prevalence was 23.2% and 12.3% using microscopy and candidate mRDT, respectively. Sensitivities and specificities were 53.2% and 98.1% (Carestart) 45.8% and 99.4% (Paracheck), respectively. Neither ROC analysis showed a significant disparity between mRDTs (Carestart: AUROC=0.75 vs Paracheck: AUROC=0.73), nor the reliability index showed disagreement between both mRDTs (Cronbach’s α = 0.92). However, there was significant disagreement between microscopy and mRDTs (Carestart: Kappa=0.58 vs Paracheck: Kappa=0.55). Conclusion: The use of a monobiomaker mRDTs in this study led to a significant variation between the ‘internal’ and ‘ecological’ validity metrics. Averagely, 84% of mRDT false negatives were confirmed by microscopy as non-falciparum species of plasmodium. The observed trends have and research policy implications. It is therefore, critical to accelerate the implementation of WHO’s recommendation to switch from mono to multiple biomarker (s) based mRDTs for detecting both falciparum and non-falciparum species. Extended research is needed to consolidate our understanding on the dynamics of malaria among our military personnel exposed to non-falciparum plasmodium.","PeriodicalId":337809,"journal":{"name":"International Journal of Health Policy Planning","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128440685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Mwaisengela, R. Ngowi, Y. Msigwa, M. Degeh, L. Marandu, Chrisogone J. German, J. Hokororo, E. Kinyenje, R. Bahegwa, T. Yahya, M. Mohamed, O. Nassoro, Bushi Lugoba, E. Mkwama, L. D. Lyakurwa, A. E. Cholobi, Michael Habtu, E. Eliakimu, G. Saguti, Yoti Zabulon
Background: In many countries, health facility autonomy has been a crucial component of health sector reform. Reducing direct government control over public health facilities and increasing their exposure to the market and market-like forces are part of this reform strategy. The degree of financial independence is a crucial characteristic that determines health facility financing and it has an impact on how well public health facilities function. This study aims at ascertaining Primary Health Facilities autonomy in the context of Star Rating Assessment (SRA) in Tanzania. Methods: This is a quantitative secondary data analysis using the SRA re-assessment data collected in the fiscal year 2017/18. Facility autonomy was measured by the desirable performance of six indicators, namely submission of a health facility plan, having operational bank account, competent handling of funds and financial reporting, deposit of self-generated funds in a facility bank account, health facility receiving any part of budgeted funds for Other Charges (OC) or Health Sector Basket Funds (HSBF) and appropriate expenditure on health commodities as stipulated in Health Facility Plans guidelines. The proportions were compared by using one and two sample proportion Z and chi-square tests. We employed Poisson regression to ascertain factors influencing facility autonomy among public primary health facilities. Results: This study involved 3,666 PHC facilities, the majority of which were dispensaries (97.6%) and rural located (85.9%). On average, 23.3% of health facilities were autonomous. 60.8% of urban located health facilities (95% CI=56.6%- 65.0%) are autonomous which is higher than 56.7% of health facilities that are located in rural areas (95% CI=55.0%- 58.5%), this difference is statistically significant (p=0.008). On the other hand, 84.6% of district hospitals were autonomous (95% CI=73.3%-96.0%) which is significantly higher compared to 57.0% of autonomous lower-level health facilities (health centers and dispensaries) (95% CI=55.4%-58.7%, p<0.001). Conclusions: In Tanzanian PHC facilities, public primary health facility autonomy is a challenge. The challenge is more prevalent in rural located health facilities and lower-level PHC facilities (dispensaries and Health centers). Enhancing the effectiveness of Quality Improvement Teams (QITs) and Health Management Teams (HMTs) should be one of the measures considered in order to increase the autonomy of PHC facilities
{"title":"Public Primary Health Facilities Autonomy: Findings from Tanzania Star Rating Assessment","authors":"S. Mwaisengela, R. Ngowi, Y. Msigwa, M. Degeh, L. Marandu, Chrisogone J. German, J. Hokororo, E. Kinyenje, R. Bahegwa, T. Yahya, M. Mohamed, O. Nassoro, Bushi Lugoba, E. Mkwama, L. D. Lyakurwa, A. E. Cholobi, Michael Habtu, E. Eliakimu, G. Saguti, Yoti Zabulon","doi":"10.33140/ijhpp.02.02.04","DOIUrl":"https://doi.org/10.33140/ijhpp.02.02.04","url":null,"abstract":"Background: In many countries, health facility autonomy has been a crucial component of health sector reform. Reducing direct government control over public health facilities and increasing their exposure to the market and market-like forces are part of this reform strategy. The degree of financial independence is a crucial characteristic that determines health facility financing and it has an impact on how well public health facilities function. This study aims at ascertaining Primary Health Facilities autonomy in the context of Star Rating Assessment (SRA) in Tanzania. Methods: This is a quantitative secondary data analysis using the SRA re-assessment data collected in the fiscal year 2017/18. Facility autonomy was measured by the desirable performance of six indicators, namely submission of a health facility plan, having operational bank account, competent handling of funds and financial reporting, deposit of self-generated funds in a facility bank account, health facility receiving any part of budgeted funds for Other Charges (OC) or Health Sector Basket Funds (HSBF) and appropriate expenditure on health commodities as stipulated in Health Facility Plans guidelines. The proportions were compared by using one and two sample proportion Z and chi-square tests. We employed Poisson regression to ascertain factors influencing facility autonomy among public primary health facilities. Results: This study involved 3,666 PHC facilities, the majority of which were dispensaries (97.6%) and rural located (85.9%). On average, 23.3% of health facilities were autonomous. 60.8% of urban located health facilities (95% CI=56.6%- 65.0%) are autonomous which is higher than 56.7% of health facilities that are located in rural areas (95% CI=55.0%- 58.5%), this difference is statistically significant (p=0.008). On the other hand, 84.6% of district hospitals were autonomous (95% CI=73.3%-96.0%) which is significantly higher compared to 57.0% of autonomous lower-level health facilities (health centers and dispensaries) (95% CI=55.4%-58.7%, p<0.001). Conclusions: In Tanzanian PHC facilities, public primary health facility autonomy is a challenge. The challenge is more prevalent in rural located health facilities and lower-level PHC facilities (dispensaries and Health centers). Enhancing the effectiveness of Quality Improvement Teams (QITs) and Health Management Teams (HMTs) should be one of the measures considered in order to increase the autonomy of PHC facilities","PeriodicalId":337809,"journal":{"name":"International Journal of Health Policy Planning","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114573319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
William N. Okedi1, Caroline O. Wakoli2, Prudence Yawetsi3, W. Okedi
Universal Health Coverage (UHC) has received renewed attention in Global Health because it is seen as the vehicle to deliver goal 3 of the SDGs of having all people receiving quality health services without financial hardships by 2030. Despite strong political pronouncements about commitments to UHC both at national and county levels, the status of UHC in Busia County is unknown. This study assessed the planning, implementation and management of UHC in Angoromo ward based on the four categories of essential services namely Reproductive, Maternal, Newborn and Child Health; Infectious Diseases; Non-Communicable Diseases; and, Service Capacity and Access. A cross – sectional descriptive and analytical study design was used. A systematic sample size of 103 heads of households was taken. Data collection methods used included document analysis, interviews and key informant interviews. Quantitative data was analysed using the SPSS social science programme while qualitative data was analysed using thematic analysis. The study found that initiation of UHC had not taken place in Angoromo ward. This was attributed to the poor leadership and governance in the Department of Health at the County level. Despite this finding, the study found that UHC in Angoromo wards stood at 50%, no data was available for Busia County. The study recommends that issues of leadership and governance be addressed urgently; establishment of a disease surveillance system at Alupe Hospital which has served as treatment Centre for cross border diseases including Covid-19 and Ebola; and that a comprehensive county-wide UHC study be conducted to establish the status of UHC in Busia County.
{"title":"Trucking Universal Health Coverage in Ang'orom Ward, Teso-South Sub-County - Busia County, Kenya","authors":"William N. Okedi1, Caroline O. Wakoli2, Prudence Yawetsi3, W. Okedi","doi":"10.33140/ijhpp.02.02.03","DOIUrl":"https://doi.org/10.33140/ijhpp.02.02.03","url":null,"abstract":"Universal Health Coverage (UHC) has received renewed attention in Global Health because it is seen as the vehicle to deliver goal 3 of the SDGs of having all people receiving quality health services without financial hardships by 2030. Despite strong political pronouncements about commitments to UHC both at national and county levels, the status of UHC in Busia County is unknown. This study assessed the planning, implementation and management of UHC in Angoromo ward based on the four categories of essential services namely Reproductive, Maternal, Newborn and Child Health; Infectious Diseases; Non-Communicable Diseases; and, Service Capacity and Access. A cross – sectional descriptive and analytical study design was used. A systematic sample size of 103 heads of households was taken. Data collection methods used included document analysis, interviews and key informant interviews. Quantitative data was analysed using the SPSS social science programme while qualitative data was analysed using thematic analysis. The study found that initiation of UHC had not taken place in Angoromo ward. This was attributed to the poor leadership and governance in the Department of Health at the County level. Despite this finding, the study found that UHC in Angoromo wards stood at 50%, no data was available for Busia County. The study recommends that issues of leadership and governance be addressed urgently; establishment of a disease surveillance system at Alupe Hospital which has served as treatment Centre for cross border diseases including Covid-19 and Ebola; and that a comprehensive county-wide UHC study be conducted to establish the status of UHC in Busia County.","PeriodicalId":337809,"journal":{"name":"International Journal of Health Policy Planning","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116638794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Intrauterine contraceptive devices (IUCDs) are made of T-shaped plastic and are inserted into women’s uteruses to prevent unwanted pregnancies. Despite the improvement in the availability and utilization of intrauterine contraceptive devices, discontinuation is becoming a public health concern. A significant proportion of women discontinue the method before its due date, which poses a concern in the health system, and its consequences may lead to the failure of a programme. As a result, the purpose of this study was to investigate the issues related to IUCD discontinuation rates among IUCD users IN twelve months ago in Kembata Tembaro Zone, Southern Ethiopia, in 2022. Methods: A community-based, cross-sectional study was conducted. 415 women who had inserted an IUD from July 2021 to June 2022 in the Kembata Tembaro Zone were selected using a multistage sampling technique included in the analysis. This study's data collection instruments were pre-tested structured questionnaires. The coded data was entered into Epi Data version 4.6 and exported to SPSS version 25 for analysis. Finally, binary logistic regression analysis was carried out to identify independently associated factors and odds ratios at a 95% confidence interval with a significance level of p-value less than 0.05. Results: Analysis revealed that 21% (95% CI 16.5-22.8) of women discontinued the use of their intrauterine contraceptive device in the last year. Issues like not being counselled about the intrauterine contraceptive device before insertion [AOR = 3.7; 95% CI: 1.23–7.30], not being appointed for follow-up [AOR = 2.8; 95% CI: 1.12–6.70], being married [AOR = 2.9; 95% CI: 1.35–6.23], and needing to have more children [AOR = 3.2; 95% CI: 1.5–7.0]. Conclusions: The findings of this study conclude that the overall magnitude of the IUCD discontinuation rates in the study area were found to be high when compared with different studies conducted in Ethiopia. Many of the factors that are attributed to the high magnitude of IUCD discontinuation are changeable. Appropriate counseling prior to insertion, including an appointment for follow-up visits, the preference to have more children, and marital status for the choice of service, will improve the continuation rate of IUCD.
{"title":"Issues Related to IUCD Discontinuation Rates among IUCD Users in Kembata Tembaro Zone, Southern Ethiopia","authors":"Tessema Yoseph, Aiggan Tamene, A. Abera, Tsegaye Damissie, Terefe Lafore, Dejene Ermias","doi":"10.33140/ijhpp.02.02.02","DOIUrl":"https://doi.org/10.33140/ijhpp.02.02.02","url":null,"abstract":"Background: Intrauterine contraceptive devices (IUCDs) are made of T-shaped plastic and are inserted into women’s uteruses to prevent unwanted pregnancies. Despite the improvement in the availability and utilization of intrauterine contraceptive devices, discontinuation is becoming a public health concern. A significant proportion of women discontinue the method before its due date, which poses a concern in the health system, and its consequences may lead to the failure of a programme. As a result, the purpose of this study was to investigate the issues related to IUCD discontinuation rates among IUCD users IN twelve months ago in Kembata Tembaro Zone, Southern Ethiopia, in 2022. Methods: A community-based, cross-sectional study was conducted. 415 women who had inserted an IUD from July 2021 to June 2022 in the Kembata Tembaro Zone were selected using a multistage sampling technique included in the analysis. This study's data collection instruments were pre-tested structured questionnaires. The coded data was entered into Epi Data version 4.6 and exported to SPSS version 25 for analysis. Finally, binary logistic regression analysis was carried out to identify independently associated factors and odds ratios at a 95% confidence interval with a significance level of p-value less than 0.05. Results: Analysis revealed that 21% (95% CI 16.5-22.8) of women discontinued the use of their intrauterine contraceptive device in the last year. Issues like not being counselled about the intrauterine contraceptive device before insertion [AOR = 3.7; 95% CI: 1.23–7.30], not being appointed for follow-up [AOR = 2.8; 95% CI: 1.12–6.70], being married [AOR = 2.9; 95% CI: 1.35–6.23], and needing to have more children [AOR = 3.2; 95% CI: 1.5–7.0]. Conclusions: The findings of this study conclude that the overall magnitude of the IUCD discontinuation rates in the study area were found to be high when compared with different studies conducted in Ethiopia. Many of the factors that are attributed to the high magnitude of IUCD discontinuation are changeable. Appropriate counseling prior to insertion, including an appointment for follow-up visits, the preference to have more children, and marital status for the choice of service, will improve the continuation rate of IUCD.","PeriodicalId":337809,"journal":{"name":"International Journal of Health Policy Planning","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127272993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There is a global prerequisite for making and implementing a diminution strategy in the want of drugs of addiction, both legal and banned, which may otherwise lead to plentiful negative health, family, socio-economic and mental consequences. During the 63rd session of the WHA (World Health Assembly), held at Geneva in May 2010, including India the 193 global member states reached on mutual consensus for global strategies to trim down the detrimental use of alcohol by adopting resolution WHA 63.13. The (GoI) Government of India enforced, The Narcotic Drugs and Psychotropic Substances Act, 1985, Act No. 61 of 1985 with guidelines, protocols and essential framework to reduce drug abuse and sale in India. Alcohol causes 3 million deaths per annum globally; responsible for 5.1% of the global burden of disease, gender wise harmful consumption of alcohol is about 7.1% in males compared to 2.2% in females. The Bihar Excise Act, 1915 was amended and new amendment Act, 2016 was enforced from 01.04.2016, vide Gazette Notification No. 1485 dated 05.04.2016. Absolute Prohibition of sale and consumption of liquor in any form was declared in the State of Bihar. Bihar Prohibition and Excise Act, 2016 was notified on 2 October 2016 to put into effect complete ban of alcohol consumption/sale in the territory of Bihar. The key objective of this study is to find out impact of alcohol ban on the prevalence of under trial, Prisoners of Liquor & Narcotics Drugs related Acts violation before the intervention (i.e. alcohol ban) and after alcohol ban. This novel cross sectional research study revealed that there is 1190.39 percent increase in the Under trial, prisoners violating Bihar Liquor & Narcotics Drugs Excise Act after absolute prohibition of sale and consumption of liquor in Bihar, India. Added to this the research study also revealed that there is 355.12 percent and 169.30 percent increase in violation of Liquor & Narcotics Drugs Prohibition Act as well as Liquor & Narcotics Drugs NDPS Act respectively during the period when alcohol is banned in the state of Bihar as compared to same period before alcohol ban.
{"title":"What is the Impact of Alcohol Ban on Prevalence of Undertrial Prisoners of Liquor & Narcotics Drugs Related Acts Violation in Bihar - A Twelve Year (2010-2021) Comparative Cross-Sectional Study?","authors":"","doi":"10.33140/ijhpp.02.02.01","DOIUrl":"https://doi.org/10.33140/ijhpp.02.02.01","url":null,"abstract":"There is a global prerequisite for making and implementing a diminution strategy in the want of drugs of addiction, both legal and banned, which may otherwise lead to plentiful negative health, family, socio-economic and mental consequences. During the 63rd session of the WHA (World Health Assembly), held at Geneva in May 2010, including India the 193 global member states reached on mutual consensus for global strategies to trim down the detrimental use of alcohol by adopting resolution WHA 63.13. The (GoI) Government of India enforced, The Narcotic Drugs and Psychotropic Substances Act, 1985, Act No. 61 of 1985 with guidelines, protocols and essential framework to reduce drug abuse and sale in India. Alcohol causes 3 million deaths per annum globally; responsible for 5.1% of the global burden of disease, gender wise harmful consumption of alcohol is about 7.1% in males compared to 2.2% in females. The Bihar Excise Act, 1915 was amended and new amendment Act, 2016 was enforced from 01.04.2016, vide Gazette Notification No. 1485 dated 05.04.2016. Absolute Prohibition of sale and consumption of liquor in any form was declared in the State of Bihar. Bihar Prohibition and Excise Act, 2016 was notified on 2 October 2016 to put into effect complete ban of alcohol consumption/sale in the territory of Bihar. The key objective of this study is to find out impact of alcohol ban on the prevalence of under trial, Prisoners of Liquor & Narcotics Drugs related Acts violation before the intervention (i.e. alcohol ban) and after alcohol ban. This novel cross sectional research study revealed that there is 1190.39 percent increase in the Under trial, prisoners violating Bihar Liquor & Narcotics Drugs Excise Act after absolute prohibition of sale and consumption of liquor in Bihar, India. Added to this the research study also revealed that there is 355.12 percent and 169.30 percent increase in violation of Liquor & Narcotics Drugs Prohibition Act as well as Liquor & Narcotics Drugs NDPS Act respectively during the period when alcohol is banned in the state of Bihar as compared to same period before alcohol ban.","PeriodicalId":337809,"journal":{"name":"International Journal of Health Policy Planning","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135429030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
What is Vicarious Trauma Vicarious Trauma (VT) is ubiquitous and may be defined as the cumulative impact on the therapist of repeated exposure to traumatic client imagery and material. Therefore, VT may be viewed as a natural and inevitable consequence of working with trauma clients. Although only a relatively new area of study, findings suggest that VT effects can have a profound impact on both personal and professional domains of functioning.
{"title":"Vicarious Trauma: The Next Pandemic?","authors":"","doi":"10.33140/ijhpp.02.01.06","DOIUrl":"https://doi.org/10.33140/ijhpp.02.01.06","url":null,"abstract":"What is Vicarious Trauma Vicarious Trauma (VT) is ubiquitous and may be defined as the cumulative impact on the therapist of repeated exposure to traumatic client imagery and material. Therefore, VT may be viewed as a natural and inevitable consequence of working with trauma clients. Although only a relatively new area of study, findings suggest that VT effects can have a profound impact on both personal and professional domains of functioning.","PeriodicalId":337809,"journal":{"name":"International Journal of Health Policy Planning","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127908696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Performance-based financing (PBF) is an important mechanism for improving the quality of health services in low- and middle- income countries. In 2014, Tanzania launched a countrywide quality approach known as Star Rating Assessment (SRA) which aims to assess the quality of healthcare service delivery in all Primary Health Care (PHC) Facilities in the country. Furthermore, by 2018 (2015-2018), the country rolled out RBF initiatives into eight regions in which PHC facilities were paid incentives based on their level of achievement in SRA assessments. This study aims to compare performance in quality between PHC facilities under RBF regions and non-RBF regions using the findings from the twophases SRA assessments; baseline (2015/16) and follow-up (2017/18). Methods: Analysis of performance of SRA indicators in the SRA service areas were identified based on the star rating tool that was used. The star rating tool had 12 service areas. For the sake of this implementation study, only seven service areas were included. The purposive sampling of the areas was used to select the areas that had direct influence of RBF in health facilities improvement. We used a t-test to determine whether there were differences in assessment star rating scores between the regions that implemented RBF and those, which did not at each assessment (both baseline and reassessment). All results were considered significant at p<0.05. The 95% Confidence Interval was also reported. Results: The mean value was found to be 61.26 among facilities exposed to RBF compared to 51.28 among those not exposed to RBF. The study showed the mean difference score to be 10.79, with a confidence interval at 95% to be -1.24 to 22.84, suggesting that there was (no) a significant difference in the facilities based on RBF exposure during baseline assessment. The p-value of 0.07 was not statistically significant. Overall, there was an increment in facilities scoring the recommended 3+stars and above by 17.39% between the assessments, the difference was significant (p=0.0001). When the regions were stratified based on RBF intervention; facilities under RBF improved in 3+ stars by 10.63% higher compared to those that were not under RBF; however, the difference was not statistically significant (p=0.06) Conclusion: Improvement of Health services needs to adhere to all six WHO building blocks and not to a sole financing. The six WHO building blocks are 1. Service delivery 2. Health workforce 3. Health information systems 4. Access to essential medicines 5. Financing 6. Leadership/governance. Probably, RBF found not to influence star rating because other blocks were not considered in this intervention. We need to integrate all the six WHO building blocks whenever we want to improve health services provision.
{"title":"Contribution of Results-Based Financing in Quality Improvement of Health Services at Primary Healthcare Facilities: Findings from Tanzania Star Rating Assessment","authors":"","doi":"10.33140/ijhpp.02.01.05","DOIUrl":"https://doi.org/10.33140/ijhpp.02.01.05","url":null,"abstract":"Background: Performance-based financing (PBF) is an important mechanism for improving the quality of health services in low- and middle- income countries. In 2014, Tanzania launched a countrywide quality approach known as Star Rating Assessment (SRA) which aims to assess the quality of healthcare service delivery in all Primary Health Care (PHC) Facilities in the country. Furthermore, by 2018 (2015-2018), the country rolled out RBF initiatives into eight regions in which PHC facilities were paid incentives based on their level of achievement in SRA assessments. This study aims to compare performance in quality between PHC facilities under RBF regions and non-RBF regions using the findings from the twophases SRA assessments; baseline (2015/16) and follow-up (2017/18). Methods: Analysis of performance of SRA indicators in the SRA service areas were identified based on the star rating tool that was used. The star rating tool had 12 service areas. For the sake of this implementation study, only seven service areas were included. The purposive sampling of the areas was used to select the areas that had direct influence of RBF in health facilities improvement. We used a t-test to determine whether there were differences in assessment star rating scores between the regions that implemented RBF and those, which did not at each assessment (both baseline and reassessment). All results were considered significant at p<0.05. The 95% Confidence Interval was also reported. Results: The mean value was found to be 61.26 among facilities exposed to RBF compared to 51.28 among those not exposed to RBF. The study showed the mean difference score to be 10.79, with a confidence interval at 95% to be -1.24 to 22.84, suggesting that there was (no) a significant difference in the facilities based on RBF exposure during baseline assessment. The p-value of 0.07 was not statistically significant. Overall, there was an increment in facilities scoring the recommended 3+stars and above by 17.39% between the assessments, the difference was significant (p=0.0001). When the regions were stratified based on RBF intervention; facilities under RBF improved in 3+ stars by 10.63% higher compared to those that were not under RBF; however, the difference was not statistically significant (p=0.06) Conclusion: Improvement of Health services needs to adhere to all six WHO building blocks and not to a sole financing. The six WHO building blocks are 1. Service delivery 2. Health workforce 3. Health information systems 4. Access to essential medicines 5. Financing 6. Leadership/governance. Probably, RBF found not to influence star rating because other blocks were not considered in this intervention. We need to integrate all the six WHO building blocks whenever we want to improve health services provision.","PeriodicalId":337809,"journal":{"name":"International Journal of Health Policy Planning","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127181129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Alcohol based hand cleaners are installed throughout almost every health care facility in support of hand hygiene. However, despite numerous attempts, no study has ever demonstrated this strategy is effective for the stethoscope, which carries the same pathogens. Recently, a touch free disposable barrier stethoscope diaphragm system became available (The Disk Cover; Aseptiscope, Inc, San Diego, CA). Our objective was to perform a pilot feasibility trial to evaluate the impressions and perceived workflow consequences of its installation in the clinical environment. Patients and Methods: Beginning in 2020, we performed a volunteer survey given to aseptic stethoscope diaphragm barrier users in multiple US healthcare facilities. A 10-question survey was presented on an iPad near the aseptic barrier dispenser, which was usually located in the patient’s exam room, to be available immediately after the practitioner completed their examination, which included the use of the stethoscope barrier. This evaluation was considered as a quality improvement project and was exempt from IRB approval. For this analysis, only one survey per practitioner was included. Data presented as means (standard deviation). Results: Overall 147 surveys obtained from seven institutions geographically distributed across the US, shortly after placement of the Disk Cover system in the patient care environment. Responses were generally positive, and included ease of use (93.5% rated easy or very easy), comparison to a disposable stethoscope (100% as similar to, improved over, or significant improvement), work-flow changes (63.9% improvement, 97.6% no impact or improved) and perceived effect on patient safety (93.5% felt patient safety was improved or significantly improved). Conclusions: The use of a touch-free aseptic stethoscope barrier system was reported as easy to use, superior to a disposable stethoscope, and was an improvement to practitioner workflow and perceived patient safety
背景:几乎每个卫生保健机构都安装了含酒精的洗手液，以支持手部卫生。然而，尽管进行了多次尝试，但没有研究表明这种策略对携带相同病原体的听诊器有效。最近，一种免触摸的一次性屏障式听诊器隔膜系统问世(The Disk Cover;Aseptiscope, Inc, San Diego, CA)。我们的目标是进行试点可行性试验，以评估其在临床环境中安装的印象和感知工作流程后果。患者和方法:从2020年开始，我们对美国多个医疗机构的无菌听诊器隔膜屏障使用者进行了一项志愿者调查。无菌屏障分配器(通常位于患者的检查室)附近的iPad上显示了一份10个问题的调查，以便在医生完成检查后立即可用，其中包括使用听诊器屏障。该评价被认为是一个质量改进项目，并免于审查委员会的批准。对于这个分析，每个从业者只包括一个调查。数据以平均值(标准差)表示。结果:在患者护理环境中放置磁盘盖系统后不久，从分布在美国各地的七个机构获得了147项调查。总的来说，反馈是积极的，包括易用性(93.5%认为容易或非常容易)，与一次性听诊器相比(100%认为与一次性听诊器相似，改进或显著改善)，工作流程的改变(63.9%改善，97.6%没有影响或改善)以及对患者安全的感知影响(93.5%认为患者安全得到改善或显著改善)。结论:使用无接触无菌听诊器屏障系统易于使用，优于一次性听诊器，并改善了医生的工作流程和患者的安全性
{"title":"Stethoscope Hygiene, Workflow, and Patient Safety: The Crux of Healthcare Associated Infections","authors":"","doi":"10.33140/ijhpp.02.01.04","DOIUrl":"https://doi.org/10.33140/ijhpp.02.01.04","url":null,"abstract":"Background: Alcohol based hand cleaners are installed throughout almost every health care facility in support of hand hygiene. However, despite numerous attempts, no study has ever demonstrated this strategy is effective for the stethoscope, which carries the same pathogens. Recently, a touch free disposable barrier stethoscope diaphragm system became available (The Disk Cover; Aseptiscope, Inc, San Diego, CA). Our objective was to perform a pilot feasibility trial to evaluate the impressions and perceived workflow consequences of its installation in the clinical environment. Patients and Methods: Beginning in 2020, we performed a volunteer survey given to aseptic stethoscope diaphragm barrier users in multiple US healthcare facilities. A 10-question survey was presented on an iPad near the aseptic barrier dispenser, which was usually located in the patient’s exam room, to be available immediately after the practitioner completed their examination, which included the use of the stethoscope barrier. This evaluation was considered as a quality improvement project and was exempt from IRB approval. For this analysis, only one survey per practitioner was included. Data presented as means (standard deviation). Results: Overall 147 surveys obtained from seven institutions geographically distributed across the US, shortly after placement of the Disk Cover system in the patient care environment. Responses were generally positive, and included ease of use (93.5% rated easy or very easy), comparison to a disposable stethoscope (100% as similar to, improved over, or significant improvement), work-flow changes (63.9% improvement, 97.6% no impact or improved) and perceived effect on patient safety (93.5% felt patient safety was improved or significantly improved). Conclusions: The use of a touch-free aseptic stethoscope barrier system was reported as easy to use, superior to a disposable stethoscope, and was an improvement to practitioner workflow and perceived patient safety","PeriodicalId":337809,"journal":{"name":"International Journal of Health Policy Planning","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121534767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Health care financing is primarily about paying for health care. It motivates health care providers to increase the supply of health care goods and services to ensure that all individuals have access to effective public health and personal health care services and goods. The ultimate intent is to improve the health of individuals and the general population in line with the principles of Universal Health Coverage. When patients’ OOP reaches a certain level, some people forgo health care due to the price, and others who access services face financial difficulties. Objective: The specific objective of the present study is to determine access to essential health services by households and the financial burden posed as a result of their intent to utilize theses services. Methods: The paper uses data from the national household income and expenditure survey (2018/19). It provides an insight into the health care expenditure and evidence on whose health service needs the health system meets and the household financial burden by health payments. Results: Out-of-pocket health expenditure (OOP) as a share of total health expenditure on average stands at 11.1% in 2018/19. About 3.3 % of households or 4,295 households that corresponds to about 17,180 individuals spend 52.1 % of their net of food income (non-subsistence income) on healthcare – a catastrophic level of household spending. Conclusion: Despite the low rate of out-of-pocket investing by families, and moderately expanding domestic investing in health care, Lesotho health care system requires a combination of policies to ensure fair financing of health care.
{"title":"Assessing Lesotho's Financial Burden of Household Payments and Access to Healthcare, 2022","authors":"","doi":"10.33140/ijhpp.02.01.03","DOIUrl":"https://doi.org/10.33140/ijhpp.02.01.03","url":null,"abstract":"Background: Health care financing is primarily about paying for health care. It motivates health care providers to increase the supply of health care goods and services to ensure that all individuals have access to effective public health and personal health care services and goods. The ultimate intent is to improve the health of individuals and the general population in line with the principles of Universal Health Coverage. When patients’ OOP reaches a certain level, some people forgo health care due to the price, and others who access services face financial difficulties. Objective: The specific objective of the present study is to determine access to essential health services by households and the financial burden posed as a result of their intent to utilize theses services. Methods: The paper uses data from the national household income and expenditure survey (2018/19). It provides an insight into the health care expenditure and evidence on whose health service needs the health system meets and the household financial burden by health payments. Results: Out-of-pocket health expenditure (OOP) as a share of total health expenditure on average stands at 11.1% in 2018/19. About 3.3 % of households or 4,295 households that corresponds to about 17,180 individuals spend 52.1 % of their net of food income (non-subsistence income) on healthcare – a catastrophic level of household spending. Conclusion: Despite the low rate of out-of-pocket investing by families, and moderately expanding domestic investing in health care, Lesotho health care system requires a combination of policies to ensure fair financing of health care.","PeriodicalId":337809,"journal":{"name":"International Journal of Health Policy Planning","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122358179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aims at exploring new directions for research on Government of Karnataka’s role in enhancing Quality of Life (QOL) of people through better service delivery process. Citizen Service delivery is one of the most important functionaries of the government. Various governments to deliver better services have tailored Citizen Charters and Acts. However, the effective implementation and gauge of measurement is still questionable. Although Governments can have a greater impact on Citizen’s happiness, very few studies have been able to systematically examine the qualitative and quantitative attributes of Governing bodies in happiness enhancement through service delivery, compared with greater volume of researches carried on economic, political and cultural attribute’s impact on quality of life of citizens. Existing studies have focused on quantitative sides of Government, there are still various attributes that needs to be focused upon. Social surveys on happiness, citizen well- being has provided new stimulus to utilitarian political-theory through statistical reliable measure of happiness that can be co-related to various variables. One of the general findings define that happiness does not strongly co-relate with increase in wealth above modest level, this has led to governments to shift priorities towards other social values which contribute to Citizen happiness and well-being. Moreover, in this research we consider composite & non-linear attribute to gauge the happiness defining factors of citizens in service delivery system. The question of how much happiness research findings can contribute to happiness maximization in public service delivery policy and hence increasing the volume of happier population within the state of Karnataka is the main objective of this research.
{"title":"Citizen Service Satisfaction in Government Service Delivery System of KarnatakaSakala","authors":"","doi":"10.33140/ijhpp.02.01.02","DOIUrl":"https://doi.org/10.33140/ijhpp.02.01.02","url":null,"abstract":"This study aims at exploring new directions for research on Government of Karnataka’s role in enhancing Quality of Life (QOL) of people through better service delivery process. Citizen Service delivery is one of the most important functionaries of the government. Various governments to deliver better services have tailored Citizen Charters and Acts. However, the effective implementation and gauge of measurement is still questionable. Although Governments can have a greater impact on Citizen’s happiness, very few studies have been able to systematically examine the qualitative and quantitative attributes of Governing bodies in happiness enhancement through service delivery, compared with greater volume of researches carried on economic, political and cultural attribute’s impact on quality of life of citizens. Existing studies have focused on quantitative sides of Government, there are still various attributes that needs to be focused upon. Social surveys on happiness, citizen well- being has provided new stimulus to utilitarian political-theory through statistical reliable measure of happiness that can be co-related to various variables. One of the general findings define that happiness does not strongly co-relate with increase in wealth above modest level, this has led to governments to shift priorities towards other social values which contribute to Citizen happiness and well-being. Moreover, in this research we consider composite & non-linear attribute to gauge the happiness defining factors of citizens in service delivery system. The question of how much happiness research findings can contribute to happiness maximization in public service delivery policy and hence increasing the volume of happier population within the state of Karnataka is the main objective of this research.","PeriodicalId":337809,"journal":{"name":"International Journal of Health Policy Planning","volume":"117 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130045729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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