Pub Date : 2021-07-01DOI: 10.4103/WHO-SEAJPH.WHO-SEAJPH_58_21
D. Safari, N. Widhidewi, W. Paramaiswari, Anak Lila Paramasatiari, H.F. Maharani Putri, I. A. Asih Ratnadi, I. Agus Sastrawan
We investigated the nasopharyngeal (NP) carriage and antimicrobial susceptibility profile of Streptococcus pneumoniae among adults and children with acute respiratory tract infection (ARTI). NP swabs were collected from ARTI patients in Tabanan, Bali, Indonesia, in 2017. Serotyping of S. pneumoniae and antibiotic susceptibility profile were performed by multiplex sequential PCR and the disk diffusion method, respectively. Out of 200 ARTI patients, S. pneumoniae strains were carried by 22.6% and 2.4% of children (36/159) and adults (1/41), respectively. Serotype 6A/6B was the most common serotype among cultured strains (21%) followed by 19F (18%) and 14 (8%). Most isolates were susceptible to chloramphenicol (87%), followed by clindamycin (74%), erythromycin (72%), sulfamethoxazole-trimethoprim (59%), and tetracycline (44%). This finding provides baseline information on the serotype distribution of S. pneumoniae carriage among ARTI patients in Indonesia.
{"title":"Prevalence, serotype distribution, and antimicrobial susceptibility profile of Streptococcus pneumoniae among patients with acute respiratory tract infection","authors":"D. Safari, N. Widhidewi, W. Paramaiswari, Anak Lila Paramasatiari, H.F. Maharani Putri, I. A. Asih Ratnadi, I. Agus Sastrawan","doi":"10.4103/WHO-SEAJPH.WHO-SEAJPH_58_21","DOIUrl":"https://doi.org/10.4103/WHO-SEAJPH.WHO-SEAJPH_58_21","url":null,"abstract":"We investigated the nasopharyngeal (NP) carriage and antimicrobial susceptibility profile of Streptococcus pneumoniae among adults and children with acute respiratory tract infection (ARTI). NP swabs were collected from ARTI patients in Tabanan, Bali, Indonesia, in 2017. Serotyping of S. pneumoniae and antibiotic susceptibility profile were performed by multiplex sequential PCR and the disk diffusion method, respectively. Out of 200 ARTI patients, S. pneumoniae strains were carried by 22.6% and 2.4% of children (36/159) and adults (1/41), respectively. Serotype 6A/6B was the most common serotype among cultured strains (21%) followed by 19F (18%) and 14 (8%). Most isolates were susceptible to chloramphenicol (87%), followed by clindamycin (74%), erythromycin (72%), sulfamethoxazole-trimethoprim (59%), and tetracycline (44%). This finding provides baseline information on the serotype distribution of S. pneumoniae carriage among ARTI patients in Indonesia.","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78759803","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}
Pub Date : 2021-07-01DOI: 10.4103/WHO-SEAJPH.WHO_SEAJPH_233_21
Dalmacito A. Cordero
{"title":"Emergency alert for philippine education! Exploring the negative impact of prolonged cancellation of in-person schooling","authors":"Dalmacito A. Cordero","doi":"10.4103/WHO-SEAJPH.WHO_SEAJPH_233_21","DOIUrl":"https://doi.org/10.4103/WHO-SEAJPH.WHO_SEAJPH_233_21","url":null,"abstract":"","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85138156","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}
Pub Date : 2021-07-01DOI: 10.4103/WHO-SEAJPH.WHO_SEAJPH_149_21
Nhung Quynh Nguyen, Van Ngoc Huynh, Q. To, K. To
This study investigates the prevalence of and associated factors with depression and anxiety among chronic obstructive pulmonary disease (COPD) outpatients at Pham Ngoc Thach Hospital, Ho Chi Minh City, Vietnam. A cross-sectional study was conducted between March and May 2020 at the hospital's outpatient department. Those aged ≥18 years, diagnosed with COPD and undergoing COPD treatment, were eligible. The Hospital Anxiety and Depression Scale was used to measure depression and anxiety. Dyspnea was assessed using the modified Medical Research Council (mMRC) dyspnea scale. Among 392 patients, 381 (97%) participated in the study. The number of patients with depression and anxiety was 33.1% and 21.3%, respectively. Compared to men, women were more likely to experience depression (adjusted odds ratio [aOR] = 2.12, 95% confidence interval [CI] = 1.06–4.24) and anxiety (aOR = 4.11, 95% CI = 1.90–8.87). Those not having caregivers were more likely to experience depression (aOR = 3.03, 95% CI = 1.27–7.20) and anxiety (aOR = 3.47, 95% CI = 1.26–9.60). Having mMRC dyspnea scale ≥2 was associated with higher odds of experiencing depression (aOR = 5.94, 95% CI = 3.63–9.72) and anxiety (aOR = 6.78, 95% CI = 3.48–13.18). Those not adhering to medication treatment (aOR = 2.32, 95% CI = 1.15–4.70) and having comorbidity (aOR = 2.02, 95% CI = 1.10–3.73) were more likely to experience anxiety. Routine screening of COPD patients for depression and anxiety is necessary so that early interventions could be provided.
本研究调查了越南胡志明市范玉达医院慢性阻塞性肺疾病(COPD)门诊患者抑郁和焦虑的患病率及其相关因素。2020年3月至5月期间，在医院门诊部进行了一项横断面研究。年龄≥18岁，诊断为COPD并正在接受COPD治疗的患者入选。采用医院焦虑抑郁量表对抑郁和焦虑进行测量。呼吸困难采用改良的医学研究委员会(mMRC)呼吸困难量表进行评估。在392例患者中，381例(97%)参加了研究。抑郁和焦虑患者分别占33.1%和21.3%。与男性相比，女性更容易经历抑郁(调整优势比[aOR] = 2.12, 95%可信区间[CI] = 1.06-4.24)和焦虑(aOR = 4.11, 95% CI = 1.90-8.87)。那些没有照顾者的人更有可能经历抑郁(aOR = 3.03, 95% CI = 1.27-7.20)和焦虑(aOR = 3.47, 95% CI = 1.26-9.60)。mMRC呼吸困难量表≥2与出现抑郁(aOR = 5.94, 95% CI = 3.63-9.72)和焦虑(aOR = 6.78, 95% CI = 3.48-13.18)的几率较高相关。那些不坚持药物治疗(aOR = 2.32, 95% CI = 1.15-4.70)和有合并症(aOR = 2.02, 95% CI = 1.10-3.73)的人更容易感到焦虑。对慢性阻塞性肺病患者进行抑郁和焦虑的常规筛查是必要的，以便提供早期干预措施。
{"title":"Factors associated with anxiety and depression among chronic obstructive pulmonary disease outpatients in Ho Chi Minh City, Vietnam","authors":"Nhung Quynh Nguyen, Van Ngoc Huynh, Q. To, K. To","doi":"10.4103/WHO-SEAJPH.WHO_SEAJPH_149_21","DOIUrl":"https://doi.org/10.4103/WHO-SEAJPH.WHO_SEAJPH_149_21","url":null,"abstract":"This study investigates the prevalence of and associated factors with depression and anxiety among chronic obstructive pulmonary disease (COPD) outpatients at Pham Ngoc Thach Hospital, Ho Chi Minh City, Vietnam. A cross-sectional study was conducted between March and May 2020 at the hospital's outpatient department. Those aged ≥18 years, diagnosed with COPD and undergoing COPD treatment, were eligible. The Hospital Anxiety and Depression Scale was used to measure depression and anxiety. Dyspnea was assessed using the modified Medical Research Council (mMRC) dyspnea scale. Among 392 patients, 381 (97%) participated in the study. The number of patients with depression and anxiety was 33.1% and 21.3%, respectively. Compared to men, women were more likely to experience depression (adjusted odds ratio [aOR] = 2.12, 95% confidence interval [CI] = 1.06–4.24) and anxiety (aOR = 4.11, 95% CI = 1.90–8.87). Those not having caregivers were more likely to experience depression (aOR = 3.03, 95% CI = 1.27–7.20) and anxiety (aOR = 3.47, 95% CI = 1.26–9.60). Having mMRC dyspnea scale ≥2 was associated with higher odds of experiencing depression (aOR = 5.94, 95% CI = 3.63–9.72) and anxiety (aOR = 6.78, 95% CI = 3.48–13.18). Those not adhering to medication treatment (aOR = 2.32, 95% CI = 1.15–4.70) and having comorbidity (aOR = 2.02, 95% CI = 1.10–3.73) were more likely to experience anxiety. Routine screening of COPD patients for depression and anxiety is necessary so that early interventions could be provided.","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83545729","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}
Pub Date : 2021-07-01DOI: 10.4103/WHO-SEAJPH.WHO-SEAJPH_62_21
Mohiul Chowdhury, Fiorella A Heald, K. Turk-Adawi, M. Supervia, A. Babu, B. Radi, S. Grace
Background: The aims of this study were to establish cardiac rehabilitation (CR) availability and density, as well as the nature of programs in South-East Asian Region (SEAR) countries, and to compare this with other regions globally. Methods: In 2016/2017, the International Council of Cardiovascular Prevention and Rehabilitation engaged cardiac associations to facilitate program identification globally. An online survey was administered to identify programs using REDCap, assessing capacity and characteristics. CR density was computed using Global Burden of Disease study annual ischemic heart disease (IHD) incidence estimates. The program audit was updated in 2020. Results: CR was available in 6/11 (54.5%) SEAR countries. Data were collected in 5 countries (83.3% country response); 32/69 (68.1% response rate from 2016/2017) programs completed the survey. These data were compared to 1082 (32.1%) programs in 93/111 (83.3%) countries with CR. Across SEAR countries, there was only one CR spot per 283 IHD patients (vs. 12 globally), with an unmet regional need of 4,258,968 spots annually. Most programs were in tertiary care centers (n = 25, 78.1%; vs. 46.1% globally, P < 0.001). Most were funded privately (n = 17, 56.7%; vs. 17.9%, P < 0.001), and 22 (73.3%) patients were paying out of pocket (vs. 36.2% globally; P < 0.001). The mean number of staff on the multidisciplinary teams was 5.5 ± 3.0 (vs. 5.9 ± 2.8 globally P = 0.268), offering 8.6 ± 1.7/11 core components (consistent with other countries) over 16.8 ± 12.6 h (vs. 36.2 ± 53.3 globally, P = 0.01). Conclusion: Funded CR capacity must be augmented in SEAR. Where available, services were consistent with guidelines, and other regions of the globe, despite programs being shorter than other regions.
{"title":"Availability and delivery of cardiac rehabilitation in South-East Asia: How does it compare globally?","authors":"Mohiul Chowdhury, Fiorella A Heald, K. Turk-Adawi, M. Supervia, A. Babu, B. Radi, S. Grace","doi":"10.4103/WHO-SEAJPH.WHO-SEAJPH_62_21","DOIUrl":"https://doi.org/10.4103/WHO-SEAJPH.WHO-SEAJPH_62_21","url":null,"abstract":"Background: The aims of this study were to establish cardiac rehabilitation (CR) availability and density, as well as the nature of programs in South-East Asian Region (SEAR) countries, and to compare this with other regions globally. Methods: In 2016/2017, the International Council of Cardiovascular Prevention and Rehabilitation engaged cardiac associations to facilitate program identification globally. An online survey was administered to identify programs using REDCap, assessing capacity and characteristics. CR density was computed using Global Burden of Disease study annual ischemic heart disease (IHD) incidence estimates. The program audit was updated in 2020. Results: CR was available in 6/11 (54.5%) SEAR countries. Data were collected in 5 countries (83.3% country response); 32/69 (68.1% response rate from 2016/2017) programs completed the survey. These data were compared to 1082 (32.1%) programs in 93/111 (83.3%) countries with CR. Across SEAR countries, there was only one CR spot per 283 IHD patients (vs. 12 globally), with an unmet regional need of 4,258,968 spots annually. Most programs were in tertiary care centers (n = 25, 78.1%; vs. 46.1% globally, P < 0.001). Most were funded privately (n = 17, 56.7%; vs. 17.9%, P < 0.001), and 22 (73.3%) patients were paying out of pocket (vs. 36.2% globally; P < 0.001). The mean number of staff on the multidisciplinary teams was 5.5 ± 3.0 (vs. 5.9 ± 2.8 globally P = 0.268), offering 8.6 ± 1.7/11 core components (consistent with other countries) over 16.8 ± 12.6 h (vs. 36.2 ± 53.3 globally, P = 0.01). Conclusion: Funded CR capacity must be augmented in SEAR. Where available, services were consistent with guidelines, and other regions of the globe, despite programs being shorter than other regions.","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75522689","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}
Pub Date : 2021-07-01DOI: 10.4103/WHO-SEAJPH.WHO_SEAJPH_54_21
Lourenço Camnahas, E. Willis, P. Dettwiller, J. Shipman
Background: Since 2005, stockout of pharmaceuticals has been a constant issue at all health services in Timor-Leste (TL). Aim: This study identifies factors that contribute to the ongoing pharmaceutical stockout as perceived by various stakeholders. Methods: A mixed-method approach was implemented, including face-to-face interviews with 46 Timorese health professionals involved in the pharmaceutical supply chain, along with documentational review and analysis. The field study was conducted in four locations (Dili, Liquiça, Aileu, and Ermera) from July to October 2018. This paper draws on qualitative accounts of participants' perceptions, which were investigated through an interview schedule in the Tetum language, with transcripts translated into English for analysis. Results: The responses gathered were consistent among various groups of employees. Perceptions of stakeholder views on factors contributing to pharmaceutical stockout were identified. These included issues such as poor coordination, failure to adhere to policy guidelines, significant difficulties, and lack of knowledge with inventory management, quantification, forecasting, and budgetary constraints. A weak logistic management information system and a lack of capacity in inventory management resulted in a lack of reliable data. Other factors, such as political intervention, work ethics and lack of basic infrastructure, such as internet connectivity, were also reported by participants. Conclusion: The findings highlighted that there are multiple factors contributing to the ongoing pharmaceutical stockout. This may be addressed by implementing more culturally appropriate education and training on forecasting methods.
{"title":"Perceptions of barriers to addressing pharmaceutical stockout in timor-leste","authors":"Lourenço Camnahas, E. Willis, P. Dettwiller, J. Shipman","doi":"10.4103/WHO-SEAJPH.WHO_SEAJPH_54_21","DOIUrl":"https://doi.org/10.4103/WHO-SEAJPH.WHO_SEAJPH_54_21","url":null,"abstract":"Background: Since 2005, stockout of pharmaceuticals has been a constant issue at all health services in Timor-Leste (TL). Aim: This study identifies factors that contribute to the ongoing pharmaceutical stockout as perceived by various stakeholders. Methods: A mixed-method approach was implemented, including face-to-face interviews with 46 Timorese health professionals involved in the pharmaceutical supply chain, along with documentational review and analysis. The field study was conducted in four locations (Dili, Liquiça, Aileu, and Ermera) from July to October 2018. This paper draws on qualitative accounts of participants' perceptions, which were investigated through an interview schedule in the Tetum language, with transcripts translated into English for analysis. Results: The responses gathered were consistent among various groups of employees. Perceptions of stakeholder views on factors contributing to pharmaceutical stockout were identified. These included issues such as poor coordination, failure to adhere to policy guidelines, significant difficulties, and lack of knowledge with inventory management, quantification, forecasting, and budgetary constraints. A weak logistic management information system and a lack of capacity in inventory management resulted in a lack of reliable data. Other factors, such as political intervention, work ethics and lack of basic infrastructure, such as internet connectivity, were also reported by participants. Conclusion: The findings highlighted that there are multiple factors contributing to the ongoing pharmaceutical stockout. This may be addressed by implementing more culturally appropriate education and training on forecasting methods.","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82700782","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}
Pub Date : 2021-02-01DOI: 10.4103/2224-3151.309875
Soonman Kwon
{"title":"Financing health in the new normal: issues and opportunities","authors":"Soonman Kwon","doi":"10.4103/2224-3151.309875","DOIUrl":"https://doi.org/10.4103/2224-3151.309875","url":null,"abstract":"","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73493813","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}
Pub Date : 2021-02-01DOI: 10.4103/2224-3151.309872
S. Bezbaruah, Polly Wallace, M. Zakoji, Wagawatta Padmini Perera, Masaya Kato
To enhance public health emergency preparedness, countries have strengthened core capacities required by the International Health Regulations (2005). In addition, recent major public health emergencies, including the coronavirus disease 2019 (COVID-19) pandemic, have reiterated the critical importance of underlying health systems and their resilience, including the roles of community health workers (CHWs). The aim of this study was to summarize the situation of CHWs in the World Health Organization South-East Asia Region, including their roles and the challenges they have faced during the COVID-19 pandemic response. We reviewed journal articles, policy documents, national guidelines, reports and online publications from development agencies, governments and media houses. Our review results, including three identified case studies, suggest that CHWs in the region have expanded their usual roles to meet the need for both maintenance of regular health services and demand for COVID-19 response activities. During the response, the regular role of a CHW in health education and promotion focused on awareness-raising and the promotion of “new normal” behaviours; CHWs also played critical roles in assisting in surveillance and contact tracing, and in ensuring that people followed isolation and quarantine guidelines. Concurrently, CHWs ensured continuity of essential health services. However, there were challenges, such as stigma, a lack of adequate training or protective equipment, and limited levels of incentives and recognition. Based on these findings, we recommend the development and implementation of long-term plans across the region to strengthen and support CHWs and recognize CHWs as an integral component of resilient health systems. Planning for CHWs as part of the primary health care system will enable local authorities to ensure that an adequate level of resources (including capacity-building, incentives, necessary equipment and consumables) is allocated to CHWs.
{"title":"Roles of community health workers in advancing health security and resilient health systems: emerging lessons from the COVID-19 response in the South-East Asia Region","authors":"S. Bezbaruah, Polly Wallace, M. Zakoji, Wagawatta Padmini Perera, Masaya Kato","doi":"10.4103/2224-3151.309872","DOIUrl":"https://doi.org/10.4103/2224-3151.309872","url":null,"abstract":"To enhance public health emergency preparedness, countries have strengthened core capacities required by the International Health Regulations (2005). In addition, recent major public health emergencies, including the coronavirus disease 2019 (COVID-19) pandemic, have reiterated the critical importance of underlying health systems and their resilience, including the roles of community health workers (CHWs). The aim of this study was to summarize the situation of CHWs in the World Health Organization South-East Asia Region, including their roles and the challenges they have faced during the COVID-19 pandemic response. We reviewed journal articles, policy documents, national guidelines, reports and online publications from development agencies, governments and media houses. Our review results, including three identified case studies, suggest that CHWs in the region have expanded their usual roles to meet the need for both maintenance of regular health services and demand for COVID-19 response activities. During the response, the regular role of a CHW in health education and promotion focused on awareness-raising and the promotion of “new normal” behaviours; CHWs also played critical roles in assisting in surveillance and contact tracing, and in ensuring that people followed isolation and quarantine guidelines. Concurrently, CHWs ensured continuity of essential health services. However, there were challenges, such as stigma, a lack of adequate training or protective equipment, and limited levels of incentives and recognition. Based on these findings, we recommend the development and implementation of long-term plans across the region to strengthen and support CHWs and recognize CHWs as an integral component of resilient health systems. Planning for CHWs as part of the primary health care system will enable local authorities to ensure that an adequate level of resources (including capacity-building, incentives, necessary equipment and consumables) is allocated to CHWs.","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74515124","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}
Pub Date : 2021-02-01DOI: 10.4103/2224-3151.309873
Kiran Durgad, TSravan Kumar Reddy, A. Kunwar, F. Tullu, Chintala Sreedhar, Abdul Wassey, A. Pathni, L. Swasticharan, Meenakshi Sharma, M. Madhavi
The India Hypertension Control Initiative (IHCI) was launched in Telangana, India, with the vision of maintaining the continuum of care for hypertensive patients and improving treatment outcomes through provision of free hypertension medication. Decentralization of the IHCI towards more patient-centred services was undertaken to bring free medication and follow-up services closer to the community in the hopes of improving follow-up and control rates for hypertensive patients. To determine if decentralization of hypertension follow-up services and free medication to peripheral health centres improved continuity of care and treatment outcomes in hypertensive patients and helped to mitigate disruption during the coronavirus disease 2019 (COVID-19) pandemic, hypertension outcomes were reviewed before and during the COVID-19 pandemic, for patients registered in health centres that decentralized free medication and follow-up services to subcentres – the intervention group – and in health centres that did not decentralize these services – the non-intervention group. Hypertensive patients had higher rates of monthly follow-up and controlled blood pressure in the decentralized facilities than in the non-decentralized facilities, where these services were limited to primary and secondary health centres. Comparing follow-up rates and blood pressure control rates before and during the COVID-19 pandemic, these were maintained for patients in the decentralized facilities whereas they were significantly lower for patients in the non-decentralized facilities. The IHCI decentralized model appears to have contributed to continuity of care for people with hypertension and to have maintained this continuity against system shocks such as that of the COVID-19 pandemic. Decentralization of free medicines and follow-up services to the first and most peripheral point of contact in the primary health care system brings these essential services closer to home, which can encourage patients to seek services from the public sector – capturing a strong case for a primary health care foundation to the strengthening of systems for universal health coverage.
{"title":"Decentralization of India Hypertension Control Initiative services to maintain continuum of care for hypertensive patients during COVID-19 pandemic in Telangana","authors":"Kiran Durgad, TSravan Kumar Reddy, A. Kunwar, F. Tullu, Chintala Sreedhar, Abdul Wassey, A. Pathni, L. Swasticharan, Meenakshi Sharma, M. Madhavi","doi":"10.4103/2224-3151.309873","DOIUrl":"https://doi.org/10.4103/2224-3151.309873","url":null,"abstract":"The India Hypertension Control Initiative (IHCI) was launched in Telangana, India, with the vision of maintaining the continuum of care for hypertensive patients and improving treatment outcomes through provision of free hypertension medication. Decentralization of the IHCI towards more patient-centred services was undertaken to bring free medication and follow-up services closer to the community in the hopes of improving follow-up and control rates for hypertensive patients. To determine if decentralization of hypertension follow-up services and free medication to peripheral health centres improved continuity of care and treatment outcomes in hypertensive patients and helped to mitigate disruption during the coronavirus disease 2019 (COVID-19) pandemic, hypertension outcomes were reviewed before and during the COVID-19 pandemic, for patients registered in health centres that decentralized free medication and follow-up services to subcentres – the intervention group – and in health centres that did not decentralize these services – the non-intervention group. Hypertensive patients had higher rates of monthly follow-up and controlled blood pressure in the decentralized facilities than in the non-decentralized facilities, where these services were limited to primary and secondary health centres. Comparing follow-up rates and blood pressure control rates before and during the COVID-19 pandemic, these were maintained for patients in the decentralized facilities whereas they were significantly lower for patients in the non-decentralized facilities. The IHCI decentralized model appears to have contributed to continuity of care for people with hypertension and to have maintained this continuity against system shocks such as that of the COVID-19 pandemic. Decentralization of free medicines and follow-up services to the first and most peripheral point of contact in the primary health care system brings these essential services closer to home, which can encourage patients to seek services from the public sector – capturing a strong case for a primary health care foundation to the strengthening of systems for universal health coverage.","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72400119","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}
Pub Date : 2021-02-01DOI: 10.4103/2224-3151.309874
M. Khan, Afifah Rahman-Shepherd, Nina van der Mark, O. Dar, R. Hasan
{"title":"Pandemic preparedness requires better regulation and stewardship of private providers that dominate provision of primary health care","authors":"M. Khan, Afifah Rahman-Shepherd, Nina van der Mark, O. Dar, R. Hasan","doi":"10.4103/2224-3151.309874","DOIUrl":"https://doi.org/10.4103/2224-3151.309874","url":null,"abstract":"","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75980643","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}
Pub Date : 2021-02-01DOI: 10.4103/2224-3151.309868
M. Zakoji, T. Sundararaman
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