It is generally believed that gender inequality and women's lack of decision-making power may restrict women's use of modern contraception, leading to high rates of unwanted pregnancies, abortions, and deaths. Evidence shows that empowered women are more likely to use modern contraception methods, but few studies have investigated this across multiple domains of empowerment.
Study design
This study examined the associations between women's empowerment and modern contraception use in Bangladesh. Data from a sample of 16,834 married women aged 15–49 years from the Bangladesh Demographic and Health Survey 2017–2018 were analysed.
Methods
Complex survey weight adjusted logistic models were fitted to evaluate the associations after adjusting for clusters, strata, and sampling weights.
Results
indicate that just over half of the married women (55.7%) had used modern contraception methods. Women's empowerment was associated with contraceptive use, especially decision-making power. Women who had medium or high autonomy of household decision making were likely to have 20% (AOR = 1.20; 95% CI: 1.04–1.39) and 27% (AOR = 1.27, 95% CI: 1.11–1.45) increased odds of using modern contraceptives compared to those who scored low in the decision-making domain. The findings demonstrated strong evidence of direct influence of women's decision-making power on modern contraception use. The results also found influence of several socio-demographic factors including area of residence, husband's age, wealth index and mobile phone ownership on the use of modern contraceptives.
Discussion
Future interventions can focus on integrating women's empowerment into family planning programming, with a particular focus on enhancing women's autonomy in decision making.
{"title":"Women's decision-making power can influence modern contraceptive use: Evidence from Bangladesh","authors":"Jahar Bhowmik, Raaj Kishore Biswas, Joanne Williams, Sima Rani Dey","doi":"10.1002/hpm.3822","DOIUrl":"10.1002/hpm.3822","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>It is generally believed that gender inequality and women's lack of decision-making power may restrict women's use of modern contraception, leading to high rates of unwanted pregnancies, abortions, and deaths. Evidence shows that empowered women are more likely to use modern contraception methods, but few studies have investigated this across multiple domains of empowerment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study design</h3>\u0000 \u0000 <p>This study examined the associations between women's empowerment and modern contraception use in Bangladesh. Data from a sample of 16,834 married women aged 15–49 years from the Bangladesh Demographic and Health Survey 2017–2018 were analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Complex survey weight adjusted logistic models were fitted to evaluate the associations after adjusting for clusters, strata, and sampling weights.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>indicate that just over half of the married women (55.7%) had used modern contraception methods. Women's empowerment was associated with contraceptive use, especially decision-making power. Women who had medium or high autonomy of household decision making were likely to have 20% (AOR = 1.20; 95% CI: 1.04–1.39) and 27% (AOR = 1.27, 95% CI: 1.11–1.45) increased odds of using modern contraceptives compared to those who scored low in the decision-making domain. The findings demonstrated strong evidence of direct influence of women's decision-making power on modern contraception use. The results also found influence of several socio-demographic factors including area of residence, husband's age, wealth index and mobile phone ownership on the use of modern contraceptives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Future interventions can focus on integrating women's empowerment into family planning programming, with a particular focus on enhancing women's autonomy in decision making.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 5","pages":"1503-1515"},"PeriodicalIF":1.9,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3822","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
With the increase in the world's population, contraception is crucial in population control strategies. Majority of contraceptives produced today are targeted at women; many of whom experience side effects, leading to the discontinuation of these contraceptives after a year of use. As the use of condoms and vasectomies has been subjected to scrutiny, it is necessary for the development of male birth control (BC). Attempts to achieve this include hormonal and non-hormonal contraception. Hormonal contraception prevents the production of the sperm in the testes; but this mode of BC has been found to be ineffective while also causing behavioural changes in men. In contrast, non-hormonal male contraception focuses on rendering the sperm immotile to prevent fertilization post-copulation. Soluble adenylate cyclase is an area of research that has shown promise in this field. Furthermore, two inhibitors, TDI-10299 and TDI-11861, have been developed and tested, with the latter, showing greater potency and longer activity, in mice models. Overall, by developing non-hormonal male contraceptives, men will have more control over their reproductive health. Nonetheless, before such contraceptives can be made widely available, it is important that further research takes place to ensure the safety and effectiveness of these methods.
{"title":"The male birth control pill – A new approach to family planning and population control","authors":"Huda Ahmed, Aaima Memon, Fatimah Hoda, Jenelle Alvares","doi":"10.1002/hpm.3823","DOIUrl":"10.1002/hpm.3823","url":null,"abstract":"<p>With the increase in the world's population, contraception is crucial in population control strategies. Majority of contraceptives produced today are targeted at women; many of whom experience side effects, leading to the discontinuation of these contraceptives after a year of use. As the use of condoms and vasectomies has been subjected to scrutiny, it is necessary for the development of male birth control (BC). Attempts to achieve this include hormonal and non-hormonal contraception. Hormonal contraception prevents the production of the sperm in the testes; but this mode of BC has been found to be ineffective while also causing behavioural changes in men. In contrast, non-hormonal male contraception focuses on rendering the sperm immotile to prevent fertilization post-copulation. Soluble adenylate cyclase is an area of research that has shown promise in this field. Furthermore, two inhibitors, TDI-10299 and TDI-11861, have been developed and tested, with the latter, showing greater potency and longer activity, in mice models. Overall, by developing non-hormonal male contraceptives, men will have more control over their reproductive health. Nonetheless, before such contraceptives can be made widely available, it is important that further research takes place to ensure the safety and effectiveness of these methods.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 5","pages":"1652-1657"},"PeriodicalIF":1.9,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jessica Hanae Zafra-Tanaka, Guillermo Almeida, Jackelyn Elizabeth Andrade Montalvo, Cecilia Anza-Ramirez, Josselyn Jauregui, Silvana Perez-Leon, Maria Lazo-Porras, Nikol Mayo-Puchoc, Alvaro Taype-Rondán, J. Jaime Miranda, David Beran
Background
Engaging diverse stakeholders in developing core outcome sets (COSs) can produce more meaningful metrics as well as research responsive to patient needs. The most common COS prioritisation method, Delphi surveys, has limitations related to selection bias and participant understanding, while qualitative methods like group discussions are less frequently used. This study aims to test a co-creation approach to COS development for type 1 diabetes (T1DM) in Peru.
Methods
Using a co-creation approach, we aimed to prioritise outcomes for T1DM management in Peru, incorporating perspectives from people with T1DM, caregivers, healthcare professionals, and decision-makers. A set of outcomes were previously identified through a systematic review and qualitative evidence synthesis. Through qualitative descriptive methods, including in-person workshops, each group of stakeholders contributed to the ranking of outcomes. Decision-makers also discussed the feasibility of measuring these outcomes within the Peruvian healthcare system.
Results
While priorities varied among participant groups, all underscored the significance of monitoring healthcare system functionality over mortality. Participants recognized the interconnected nature of healthcare system performance, clinical outcomes, self-management, and quality of life. When combining the rankings from all the groups, metrics related to economic impact on the individual and structural support, policies promoting health, and protecting those living with T1DM were deemed more important in comparison to measuring clinical outcomes.
Conclusion
We present the first COS for T1DM focused on low-and-middle-income countries and show aspects of care that are relevant in this setting. Diverse prioritisation among participant groups underscores the need of inclusive decision-making processes. By incorporating varied perspectives, healthcare systems can better address patient needs and enhance overall care quality.
{"title":"Involving different stakeholders in prioritising outcomes to assess healthcare systems response for type 1 diabetes management: Using co-creation approaches in Peru","authors":"Jessica Hanae Zafra-Tanaka, Guillermo Almeida, Jackelyn Elizabeth Andrade Montalvo, Cecilia Anza-Ramirez, Josselyn Jauregui, Silvana Perez-Leon, Maria Lazo-Porras, Nikol Mayo-Puchoc, Alvaro Taype-Rondán, J. Jaime Miranda, David Beran","doi":"10.1002/hpm.3821","DOIUrl":"10.1002/hpm.3821","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Engaging diverse stakeholders in developing core outcome sets (COSs) can produce more meaningful metrics as well as research responsive to patient needs. The most common COS prioritisation method, Delphi surveys, has limitations related to selection bias and participant understanding, while qualitative methods like group discussions are less frequently used. This study aims to test a co-creation approach to COS development for type 1 diabetes (T1DM) in Peru.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a co-creation approach, we aimed to prioritise outcomes for T1DM management in Peru, incorporating perspectives from people with T1DM, caregivers, healthcare professionals, and decision-makers. A set of outcomes were previously identified through a systematic review and qualitative evidence synthesis. Through qualitative descriptive methods, including in-person workshops, each group of stakeholders contributed to the ranking of outcomes. Decision-makers also discussed the feasibility of measuring these outcomes within the Peruvian healthcare system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>While priorities varied among participant groups, all underscored the significance of monitoring healthcare system functionality over mortality. Participants recognized the interconnected nature of healthcare system performance, clinical outcomes, self-management, and quality of life. When combining the rankings from all the groups, metrics related to economic impact on the individual and structural support, policies promoting health, and protecting those living with T1DM were deemed more important in comparison to measuring clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We present the first COS for T1DM focused on low-and-middle-income countries and show aspects of care that are relevant in this setting. Diverse prioritisation among participant groups underscores the need of inclusive decision-making processes. By incorporating varied perspectives, healthcare systems can better address patient needs and enhance overall care quality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 6","pages":"1675-1695"},"PeriodicalIF":1.9,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3821","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Green development is main direction of high-quality economic development in China. Urbanisation and human capital (HC) are important factors affecting green development. This study examines effects of urbanisation and HC on green total factor productivity (GTFP) using least squares dummy variable model, based on provincial data in China from 2001 to 2019. This study then explored impact of urbanisation on GTFP through HC (educated HC, healthy HC, and HC structure), adopting mediating effect and threshold effect model. The results showed that urbanisation and three types of HC promote GTFP in China and coastal region. In inland region, urbanisation has insignificant impact on GTFP, while educated HC and HC structure improve it. The mediating analysis revealed that educated and healthy HC in China and coastal region enhance promotion effect of urbanisation on GTFP, whereas HC structure hinders it. In inland region, only healthy HC stimulates promotion effect of urbanisation on GTFP. Considering threshold effect of educated and healthy HC, promotion effect of urbanisation on GTFP is weaker than threshold value; but effect is stronger above threshold value. The promotion effect of urbanisation on GTFP is stronger when value of HC structure is below the threshold, while effect is weakened as value exceeds threshold value. Policy implications are documented to promote urbanisation in a differentiated manner, increase investment in HC, and strengthen coordination between urbanisation and HC.
绿色发展是中国经济高质量发展的主攻方向。城镇化和人力资本（HC）是影响绿色发展的重要因素。本研究基于 2001 年至 2019 年中国各省数据，采用最小二乘法虚拟变量模型研究了城镇化和人力资本对绿色全要素生产率（GTFP）的影响。然后，本研究采用中介效应和门槛效应模型，通过人机交互（教育人机交互、健康人机交互和人机交互结构）探讨了城镇化对绿色全要素生产率的影响。研究结果表明，在中国和沿海地区，城市化和三类 HC 促进了 GTFP 的增长。在内陆地区，城市化对 GTFP 的影响不显著，而受过教育的 HC 和 HC 结构则改善了 GTFP。中介分析表明，在中国和沿海地区，受过教育和健康的家政服务人员增强了城市化对 GTFP 的促进作用，而家政服务人员结构则阻碍了这一作用。在内陆地区，只有健康的家政服务能刺激城市化对 GTFP 的促进作用。考虑到受教育程度和健康 HC 的阈值效应，城市化对 GTFP 的促进效应弱于阈值，但高于阈值则更强。当 HC 结构值低于临界值时，城市化对 GTFP 的促进作用更强，而当 HC 结构值超过临界值时，促进作用减弱。本文阐述了以差异化方式促进城市化、增加对 HC 的投资以及加强城市化与 HC 之间协调的政策含义。
{"title":"The impact of urbanisation on green total factor productivity: Exploring threshold and mediating effects of human capital","authors":"Guimei Wang, Muhammad Salman, Kuangwei Zhang","doi":"10.1002/hpm.3820","DOIUrl":"10.1002/hpm.3820","url":null,"abstract":"<p>Green development is main direction of high-quality economic development in China. Urbanisation and human capital (HC) are important factors affecting green development. This study examines effects of urbanisation and HC on green total factor productivity (GTFP) using least squares dummy variable model, based on provincial data in China from 2001 to 2019. This study then explored impact of urbanisation on GTFP through HC (educated HC, healthy HC, and HC structure), adopting mediating effect and threshold effect model. The results showed that urbanisation and three types of HC promote GTFP in China and coastal region. In inland region, urbanisation has insignificant impact on GTFP, while educated HC and HC structure improve it. The mediating analysis revealed that educated and healthy HC in China and coastal region enhance promotion effect of urbanisation on GTFP, whereas HC structure hinders it. In inland region, only healthy HC stimulates promotion effect of urbanisation on GTFP. Considering threshold effect of educated and healthy HC, promotion effect of urbanisation on GTFP is weaker than threshold value; but effect is stronger above threshold value. The promotion effect of urbanisation on GTFP is stronger when value of HC structure is below the threshold, while effect is weakened as value exceeds threshold value. Policy implications are documented to promote urbanisation in a differentiated manner, increase investment in HC, and strengthen coordination between urbanisation and HC.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 5","pages":"1482-1502"},"PeriodicalIF":1.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jie Chang, Shan Zhu, Yuting Zhang, Natalie Carvalho, Sen Xu, Yunshu Lu, Xin Liu, Yu Fang, Qingyue Meng
<div> <section> <h3> Background</h3> <p>Several types of human papillomavirus (HPV) vaccines have been approved for use in adolescent girls in China. These vaccines are regulated as non-National Immunisation Program vaccines and are optional and generally fully self-paid by vaccinees.</p> </section> <section> <h3> Objective</h3> <p>To assess parents' demand for HPV vaccination by eliciting their willingness-to-pay for their adolescent daughters to be vaccinated against HPV and to examine the determinants of demand for HPV vaccination in China.</p> </section> <section> <h3> Methods</h3> <p>A contingent valuation survey was conducted across three cities in Shandong Province in eastern China. We selected 11 junior middle schools with different socioeconomic features and randomly selected 6 classes in each school, and questionnaires were distributed to all girls aged 12–16 in the 66 classes for their parents to complete. A payment card approach was used to elicit parental willingness-to-pay for HPV vaccination for their daughters. We also collected a wide array of socioeconomic and psychological variables and interval regressions were applied to examine the determinants of parental willingness-to-pay.</p> </section> <section> <h3> Results</h3> <p>A total of 1074 eligible parents who completed valid questions were included in analyses. Over 85% of parents believed HPV vaccines were, in general, necessary and beneficiary. However, only around 10% believed that their daughters would be infected by HPV. About 8% of parents would not accept HPV vaccine even if the vaccine were free mainly due to concerns about the potential side effects and vaccine safety and quality issues, and 27.37% would only accept the vaccine if it were free. The median willingness-to-pay was 300 CNY (42 USD). Several factors were positively correlated with higher willingness-to-pay: income, urban residence (relative to rural residence), mothers (relative to fathers), parents' beliefs about vaccine benefits, whether they should make decisions for their daughters, and whether their daughters would be susceptible to HPV. Though education-level was not significantly correlated with willingness-to-pay in the main regressions, a subgroup analysis revealed interesting dynamics in the relation between education and willingness-to-pay across different income-levels.</p> </section> <section> <h3> Conclusions</h3> <p>There is a large gap between parents' willingness-to-pay and the market price of HPV vaccine for girls in China. Parents generally believed the HPV vaccines were beneficial and necess
{"title":"Determinants of parental demand of human papillomavirus vaccination for adolescent daughters in China: Contingent valuation survey","authors":"Jie Chang, Shan Zhu, Yuting Zhang, Natalie Carvalho, Sen Xu, Yunshu Lu, Xin Liu, Yu Fang, Qingyue Meng","doi":"10.1002/hpm.3818","DOIUrl":"10.1002/hpm.3818","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Several types of human papillomavirus (HPV) vaccines have been approved for use in adolescent girls in China. These vaccines are regulated as non-National Immunisation Program vaccines and are optional and generally fully self-paid by vaccinees.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess parents' demand for HPV vaccination by eliciting their willingness-to-pay for their adolescent daughters to be vaccinated against HPV and to examine the determinants of demand for HPV vaccination in China.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A contingent valuation survey was conducted across three cities in Shandong Province in eastern China. We selected 11 junior middle schools with different socioeconomic features and randomly selected 6 classes in each school, and questionnaires were distributed to all girls aged 12–16 in the 66 classes for their parents to complete. A payment card approach was used to elicit parental willingness-to-pay for HPV vaccination for their daughters. We also collected a wide array of socioeconomic and psychological variables and interval regressions were applied to examine the determinants of parental willingness-to-pay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1074 eligible parents who completed valid questions were included in analyses. Over 85% of parents believed HPV vaccines were, in general, necessary and beneficiary. However, only around 10% believed that their daughters would be infected by HPV. About 8% of parents would not accept HPV vaccine even if the vaccine were free mainly due to concerns about the potential side effects and vaccine safety and quality issues, and 27.37% would only accept the vaccine if it were free. The median willingness-to-pay was 300 CNY (42 USD). Several factors were positively correlated with higher willingness-to-pay: income, urban residence (relative to rural residence), mothers (relative to fathers), parents' beliefs about vaccine benefits, whether they should make decisions for their daughters, and whether their daughters would be susceptible to HPV. Though education-level was not significantly correlated with willingness-to-pay in the main regressions, a subgroup analysis revealed interesting dynamics in the relation between education and willingness-to-pay across different income-levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There is a large gap between parents' willingness-to-pay and the market price of HPV vaccine for girls in China. Parents generally believed the HPV vaccines were beneficial and necess","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 5","pages":"1456-1481"},"PeriodicalIF":1.9,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141628073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Medicines are the cornerstone of healthcare. Lean methodology approach such as Value Stream Mapping (VSM) is being used in healthcare to manage resources wisely to ensure sustainability of medicines and resources. The aim of this quality improvement study was to evaluate and improve the medication management and hospital imprest supply processes in Australia's first dedicated cardiology hospital using VSM.
Method
We conducted a review of our medicine supply processes at a 180-bed cardiology hospital in Australia. We followed a lean methodology approach over a 4-month period from February to May 2023 and evaluated the outcome of our improvements for another 4 months from July to October 2023. We used VSM to identify non-value adding activities. Cost of medicines holding was calculated, as well as time taken to complete supply processes, pre and post.
Results
Pharmacy department stockholdings reduced by 51%; p = 0.000121 (from $539,662 to $275,406). Time taken to manage the inventory system also reduced by 42%; p = 0.025762 (from 148 h/month to 62 h/month). Lean methodology such as VSM can facilitate cost-effective and sustainable system improvements for pharmacy procurement systems.
{"title":"A lean approach for improving medicines management in Australia's first cardiac hospital inventory system","authors":"Viviane Khalil, Siang Foo","doi":"10.1002/hpm.3819","DOIUrl":"10.1002/hpm.3819","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Medicines are the cornerstone of healthcare. Lean methodology approach such as Value Stream Mapping (VSM) is being used in healthcare to manage resources wisely to ensure sustainability of medicines and resources. The aim of this quality improvement study was to evaluate and improve the medication management and hospital imprest supply processes in Australia's first dedicated cardiology hospital using VSM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We conducted a review of our medicine supply processes at a 180-bed cardiology hospital in Australia. We followed a lean methodology approach over a 4-month period from February to May 2023 and evaluated the outcome of our improvements for another 4 months from July to October 2023. We used VSM to identify non-value adding activities. Cost of medicines holding was calculated, as well as time taken to complete supply processes, pre and post.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pharmacy department stockholdings reduced by 51%; <i>p</i> = 0.000121 (from $539,662 to $275,406). Time taken to manage the inventory system also reduced by 42%; <i>p</i> = 0.025762 (from 148 h/month to 62 h/month). Lean methodology such as VSM can facilitate cost-effective and sustainable system improvements for pharmacy procurement systems.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 5","pages":"1642-1651"},"PeriodicalIF":1.9,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3819","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bernhard Langer, Christian Kunow, Josephine Bolduan, Lea Sackmann, Laura Schreiter, Katja Schüler, Marie Ulrich
Background
In Germany, over-the-counter (OTC) medicines may only be dispensed by community pharmacies (CPs). German CPs must ensure ‘adequate’ counselling, including the cost of medicines. Along with information gathering and advice giving as classic aspects of counselling, the aim was also to investigate counselling indicators of product and price transparency.
Methods
The cross-sectional study was based on the covert simulated patient (SP) methodology and was conducted in a random sample of CPs stratified by districts in the major German city of Munich. Each of the 178 selected CPs was visited once by one of five trained female students. They simulated a symptom-based sub-scenario 1 with a request for an OTC medicine for a headache and a sub-scenario 2 with standardised information regarding product and price transparency. The assessment, completed immediately postvisit by the SPs, included a total of 23 items.
Results
All 178 scheduled visits were completed successfully. The median counselling score with the classic items was 3.0 out of 12 points (interquartile range [IQR] 4.25) and when expanded by items for product and price transparency the score was 4.0 out of 14 points (IQR 4.00). A selection of medicines was offered unsolicited in 38.2% of the visits and in 5.6% of the visits voluntary price information was provided before the transaction. A request for a cheaper medicine led to a significant price reduction (Wilcoxon signed-rank test; p < 0.001, r = 0.869).
Conclusion
Due to the below-average level of counselling, the regional chambers of pharmacists are recommended to initiate measures for improvement. There is also potential for optimisation with regard to product and price transparency as an important extension of the classic counselling aspects. It is therefore recommended that the government raise customers' awareness of the cost of medicines.
{"title":"Counselling with a focus on product and price transparency for over-the-counter headache medicines: A simulated patient study in community pharmacies in Munich, Germany","authors":"Bernhard Langer, Christian Kunow, Josephine Bolduan, Lea Sackmann, Laura Schreiter, Katja Schüler, Marie Ulrich","doi":"10.1002/hpm.3817","DOIUrl":"10.1002/hpm.3817","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In Germany, over-the-counter (OTC) medicines may only be dispensed by community pharmacies (CPs). German CPs must ensure ‘adequate’ counselling, including the cost of medicines. Along with information gathering and advice giving as classic aspects of counselling, the aim was also to investigate counselling indicators of product and price transparency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The cross-sectional study was based on the covert simulated patient (SP) methodology and was conducted in a random sample of CPs stratified by districts in the major German city of Munich. Each of the 178 selected CPs was visited once by one of five trained female students. They simulated a symptom-based sub-scenario 1 with a request for an OTC medicine for a headache and a sub-scenario 2 with standardised information regarding product and price transparency. The assessment, completed immediately postvisit by the SPs, included a total of 23 items.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All 178 scheduled visits were completed successfully. The median counselling score with the classic items was 3.0 out of 12 points (interquartile range [IQR] 4.25) and when expanded by items for product and price transparency the score was 4.0 out of 14 points (IQR 4.00). A selection of medicines was offered unsolicited in 38.2% of the visits and in 5.6% of the visits voluntary price information was provided before the transaction. A request for a cheaper medicine led to a significant price reduction (Wilcoxon signed-rank test; <i>p</i> < 0.001, <i>r</i> = 0.869).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Due to the below-average level of counselling, the regional chambers of pharmacists are recommended to initiate measures for improvement. There is also potential for optimisation with regard to product and price transparency as an important extension of the classic counselling aspects. It is therefore recommended that the government raise customers' awareness of the cost of medicines.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 5","pages":"1434-1455"},"PeriodicalIF":1.9,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3817","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In the digital era, digital literacy is a fundamental indicator of a nation's quality and plays a crucial role in public health. Exploring the theoretical mechanisms and effects of digital literacy on individuals' health is of great practical importance, advancing the initiatives of ‘Digital China’ and ‘Healthy China’.
Methods
The study utilised three-period survey panel data from the China Family Panel Study spanning 2016, 2018, and 2020 to measure and evaluate levels of digital literacy, physical health, mental health, healthy lifestyle, and integrated health among the participants. Subsequently, a series of empirical analyses were conducted to examine the general impact, heterogeneous effects and transmission pathways of digital literacy on various types of health levels.
Results
Digital literacy significantly enhances all aspects of respondents' health, and this conclusion remains valid even after conducting robustness tests and addressing endogeneity through variable substitution and selecting instrumental variables using the 2SLS method. Furthermore, examining heterogeneity by considering individual traits and the makeup of digital literacy reveals that the impact of digital literacy on individuals' health varies according to age, cultural background, personal income, and the components of digital literacy. Pathway analyses also demonstrate that medical accessibility, information access, social network, and planned behaviour are key routes through which digital literacy enhances the health of the population.
Conclusions
It is imperative for the government to actively promote the advancement of the digital healthcare industry, while individuals should strive to enhance their digital literacy. By collectively focussing on these efforts, national health can be significantly improved.
{"title":"The impact of digital literacy on personal health: Evidence from the China family panel study","authors":"Hao Li, Zihan Yang","doi":"10.1002/hpm.3816","DOIUrl":"10.1002/hpm.3816","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In the digital era, digital literacy is a fundamental indicator of a nation's quality and plays a crucial role in public health. Exploring the theoretical mechanisms and effects of digital literacy on individuals' health is of great practical importance, advancing the initiatives of ‘Digital China’ and ‘Healthy China’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study utilised three-period survey panel data from the China Family Panel Study spanning 2016, 2018, and 2020 to measure and evaluate levels of digital literacy, physical health, mental health, healthy lifestyle, and integrated health among the participants. Subsequently, a series of empirical analyses were conducted to examine the general impact, heterogeneous effects and transmission pathways of digital literacy on various types of health levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Digital literacy significantly enhances all aspects of respondents' health, and this conclusion remains valid even after conducting robustness tests and addressing endogeneity through variable substitution and selecting instrumental variables using the 2SLS method. Furthermore, examining heterogeneity by considering individual traits and the makeup of digital literacy reveals that the impact of digital literacy on individuals' health varies according to age, cultural background, personal income, and the components of digital literacy. Pathway analyses also demonstrate that medical accessibility, information access, social network, and planned behaviour are key routes through which digital literacy enhances the health of the population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>It is imperative for the government to actively promote the advancement of the digital healthcare industry, while individuals should strive to enhance their digital literacy. By collectively focussing on these efforts, national health can be significantly improved.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 5","pages":"1411-1433"},"PeriodicalIF":1.9,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The risk of a woman dying as a result of pregnancy or childbirth during her lifetime is about one in six in the poorest parts of the world.
Objectives
The present study aims to determine prevalence of maternal risk and the influencing variables among ever-married women belonging to the reproductive age group (15–49) of Birbhum district, West Bengal.
Methods
A cohort-based retrospective cross-sectional study was carried out among the sample of 229 respondents through a purposive stratified random sampling method and a pre-designed semi-structured questionnaire. The ordinal logistic regression (OLR) model was taken as a tool of assessment. Before developing the proportional OLR model, we have checked the multicollinearity effect among the predictors and the first-order effect modifier was evaluated as well. We performed data analysis using SPSS version 26.
Results
The result shows that illiterate women (Odds ratios [OR] = 2.81, 95% CI, 0.277–1.791), from lower standard of living (OR = 1.14, 95% CI, −0.845–1.116), married before the age of 15 years (OR = 21.96, 95% CI, −0.55–6.73) and between the age of 15–18 years (OR = 24.51. 95% CI, −0.45–6.85) are more likely to be affected by the higher concentration of maternal risk. Other important predictor is the time of pregnancy registration. Considering the transport and related en-route causalities, the result portraying a clear picture where the distance and travel time becoming significant factors in determining the concentration of maternal risk.
Conclusion
Incidences of child marriages should be restricted. Eradicating factors influencing an individual's decision to seek care would be an essential contribution in excluding the dominant maternal risk factors.
{"title":"Socio-demographic and infrastructural variables influencing maternal risk concentration among ever-married women of reproductive age in rural West Bengal, India","authors":"Alokananda Ghosh, Biswaranjan Mistri","doi":"10.1002/hpm.3805","DOIUrl":"10.1002/hpm.3805","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The risk of a woman dying as a result of pregnancy or childbirth during her lifetime is about one in six in the poorest parts of the world.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The present study aims to determine prevalence of maternal risk and the influencing variables among ever-married women belonging to the reproductive age group (15–49) of Birbhum district, West Bengal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cohort-based retrospective cross-sectional study was carried out among the sample of 229 respondents through a purposive stratified random sampling method and a pre-designed semi-structured questionnaire. The ordinal logistic regression (OLR) model was taken as a tool of assessment. Before developing the proportional OLR model, we have checked the multicollinearity effect among the predictors and the first-order effect modifier was evaluated as well. We performed data analysis using SPSS version 26.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The result shows that illiterate women (Odds ratios [OR] = 2.81, 95% CI, 0.277–1.791), from lower standard of living (OR = 1.14, 95% CI, −0.845–1.116), married before the age of 15 years (OR = 21.96, 95% CI, −0.55–6.73) and between the age of 15–18 years (OR = 24.51. 95% CI, −0.45–6.85) are more likely to be affected by the higher concentration of maternal risk. Other important predictor is the time of pregnancy registration. Considering the transport and related en-route causalities, the result portraying a clear picture where the distance and travel time becoming significant factors in determining the concentration of maternal risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Incidences of child marriages should be restricted. Eradicating factors influencing an individual's decision to seek care would be an essential contribution in excluding the dominant maternal risk factors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 5","pages":"1383-1410"},"PeriodicalIF":1.9,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The purpose of this article is to discuss the importance of policy transfer by humanitarian NGOs to post-disaster regions and the effectiveness of mobile Primary Health Care (PHC) services immediately after disasters. This study also focused on analysing the first 3 months aftermath of the earthquake and assessed the changes in the access and needs of vulnerable groups in emergency response creation and systematic interventions after disasters. In disasters that require urgent response such as earthquakes, the importance of the existing NGOs (Such as MdM) capacity in the countries has emerged in terms of rapid response and experience sharing. During the field work, it is observed that MdM Mobile Medical Units (MMU) teams had played a key role in terms of tracking PHC needs, functioning as early warning system for epidemics, and prevention of communicable diseases in the EQ effected areas. In this aspect, the changes in diagnoses in the first trimester is examined using the comparative analysis methods. This study used a cross-sectional mixed-method approach in terms of objective evaluation. The results from a quantitative needs assessment were complemented by qualitative data. Herein, the data were collected in two stages: First, primary data was collected through the field activities of MMU, and second field-based assessments was conducted with health professionals who have been working in the MMU teams since the first moments of the earthquake.
{"title":"Examining primary healthcare services following earthquake shocks in Turkiye: A critical analysis of the initial 3 months and the vital role of humanitarian policy transfer for rapid response","authors":"Cuma Ali Özbek, Cem Hatunoğlu","doi":"10.1002/hpm.3807","DOIUrl":"10.1002/hpm.3807","url":null,"abstract":"<p>The purpose of this article is to discuss the importance of policy transfer by humanitarian NGOs to post-disaster regions and the effectiveness of mobile Primary Health Care (PHC) services immediately after disasters. This study also focused on analysing the first 3 months aftermath of the earthquake and assessed the changes in the access and needs of vulnerable groups in emergency response creation and systematic interventions after disasters. In disasters that require urgent response such as earthquakes, the importance of the existing NGOs (Such as MdM) capacity in the countries has emerged in terms of rapid response and experience sharing. During the field work, it is observed that MdM Mobile Medical Units (MMU) teams had played a key role in terms of tracking PHC needs, functioning as early warning system for epidemics, and prevention of communicable diseases in the EQ effected areas. In this aspect, the changes in diagnoses in the first trimester is examined using the comparative analysis methods. This study used a cross-sectional mixed-method approach in terms of objective evaluation. The results from a quantitative needs assessment were complemented by qualitative data. Herein, the data were collected in two stages: First, primary data was collected through the field activities of MMU, and second field-based assessments was conducted with health professionals who have been working in the MMU teams since the first moments of the earthquake.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"39 5","pages":"1633-1641"},"PeriodicalIF":1.9,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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