Pub Date : 2025-09-09DOI: 10.1016/j.hlpt.2025.101115
Pablo Gaitán-Rossi , Jair Yañez-Santaolalla , Andrea Jiménez-Ortiz , Brenda Zaira Tapia-Hernández , Hortensia Reyes-Morales
Objective
Robust monitoring systems are essential for resilient health systems and effective crisis management. This study examines the design and implementation of a health monitoring system during the early months of the COVID-19 pandemic in Mexico City, highlighting lessons for future crises.
Methods
Using a descriptive case study approach, we triangulated official documents, press conference reviews, and 13 hour interviews with key informants.
Results
At the onset of the pandemic, the Mexico City government established a Health Council, necessitating a system to provide reliable information for hospital capacity management and timely decision-making. The locally developed monitoring system centralized data from multiple sources, estimated and forecasted key indicators, and served as a foundation for communicating pandemic status and guiding policy. The system’s dashboard became a critical tool for intersectoral collaboration to reduce hospital burden and improve decision-making —facilitating coordination among government ministries, non-health sectors, and the general population.
Conclusions
The implementation of Mexico City’s monitoring system demonstrates how a shared framework can incentivize intersectoral collaboration and provides critical insights for strengthening preparedness and resilience in future emergencies. Key lessons for fostering intersectoral collaboration included the importance of strong leadership within a governance structure, consensus on emergency assessment tools, provision of actionable information, and adaptability to partner capacities.
Lay summary
During the COVID-19 pandemic, Mexico City developed a health monitoring system that helped manage hospital capacity and coordinate decisions across different government sectors. This system provided reliable and timely information, making it easier for authorities to act quickly and effectively. The research shows how working together—health authorities, commerce groups, and others—can lead to better outcomes in a crisis. It also highlights the importance of clear communication and transparency. These lessons can help cities be better prepared for future health emergencies, ultimately protecting the wellbeing of the public.
{"title":"Mexico city monitoring system during the COVID-19 pandemic: A case-study","authors":"Pablo Gaitán-Rossi , Jair Yañez-Santaolalla , Andrea Jiménez-Ortiz , Brenda Zaira Tapia-Hernández , Hortensia Reyes-Morales","doi":"10.1016/j.hlpt.2025.101115","DOIUrl":"10.1016/j.hlpt.2025.101115","url":null,"abstract":"<div><h3>Objective</h3><div>Robust monitoring systems are essential for resilient health systems and effective crisis management. This study examines the design and implementation of a health monitoring system during the early months of the COVID-19 pandemic in Mexico City, highlighting lessons for future crises.</div></div><div><h3>Methods</h3><div>Using a descriptive case study approach, we triangulated official documents, press conference reviews, and 13 hour interviews with key informants.</div></div><div><h3>Results</h3><div>At the onset of the pandemic, the Mexico City government established a Health Council, necessitating a system to provide reliable information for hospital capacity management and timely decision-making. The locally developed monitoring system centralized data from multiple sources, estimated and forecasted key indicators, and served as a foundation for communicating pandemic status and guiding policy. The system’s dashboard became a critical tool for intersectoral collaboration to reduce hospital burden and improve decision-making —facilitating coordination among government ministries, non-health sectors, and the general population.</div></div><div><h3>Conclusions</h3><div>The implementation of Mexico City’s monitoring system demonstrates how a shared framework can incentivize intersectoral collaboration and provides critical insights for strengthening preparedness and resilience in future emergencies. Key lessons for fostering intersectoral collaboration included the importance of strong leadership within a governance structure, consensus on emergency assessment tools, provision of actionable information, and adaptability to partner capacities.</div></div><div><h3>Lay summary</h3><div>During the COVID-19 pandemic, Mexico City developed a health monitoring system that helped manage hospital capacity and coordinate decisions across different government sectors. This system provided reliable and timely information, making it easier for authorities to act quickly and effectively. The research shows how working together—health authorities, commerce groups, and others—can lead to better outcomes in a crisis. It also highlights the importance of clear communication and transparency. These lessons can help cities be better prepared for future health emergencies, ultimately protecting the wellbeing of the public.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101115"},"PeriodicalIF":3.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-30DOI: 10.1016/j.hlpt.2025.101108
Casper Craamer , Thomas Timmers , Walter van der Weegen , Rudolf B Kool
Background
Computer-assisted history taking (CAHT) could increase patient flow efficiency and healthcare resources optimization. By assessing reported clinical and patient-reported outcomes, we can clarify the benefits, limitations, and practical considerations of CAHT in clinical care. This systematic review synthesizes literature on CAHT in acute and elective care.
Methods
This systematic review followed PRISMA guidelines. A comprehensive search of MEDLINE, Embase, CINAHL, and Web of Science identified studies published between January 2014 and December 2024. Two reviewers independently screened articles, assessed study quality, and extracted data narratively.
Results
In total, 19 studies (involving 11,885 unique patients and 151 healthcare providers) were included. CAHT-questionnaire completion rates were high (75–95%) in larger samples but lower (51–67%) in smaller ones. Satisfaction was consistently high across different delivery methods and devices. Positive outcomes on patient engagement, such as active involvement and enhanced communication, were demonstrated. Clinical efficiency did improve in terms of streamlined workflows and resource utilization. Mixed results were reported on consultation duration. Finally, improved diagnostic accuracy was reported through comprehensive data capture and better alignment with clinical standards.
Conclusion
CAHT offers opportunities to contribute to patient engagement, workflows, and diagnostic accuracy, with high completion rates. We need sound implementation studies to explore how CAHT-systems can streamline processes and minimize needed resources. Future implementations should ensure integration into electronic health records and address digital inclusion across age groups and regions to realize CAHT’s potential in routine, patient-centered care.
计算机辅助历史记录（CAHT）可以提高患者流程效率并优化医疗资源。通过评估报告的临床和患者报告的结果，我们可以澄清临床护理中CAHT的益处、局限性和实际考虑。本系统综述综合了CAHT在急性和择期护理方面的文献。方法本系统评价遵循PRISMA指南。对MEDLINE， Embase， CINAHL和Web of Science进行全面搜索，确定了2014年1月至2024年12月之间发表的研究。两位审稿人独立筛选文章，评估研究质量，并以叙述方式提取数据。结果共纳入19项研究，涉及11,885名特殊患者和151名医护人员。caht问卷完成率在较大样本中较高（75-95%），而在较小样本中较低（51-67%）。在不同的交付方式和设备中，满意度始终很高。患者参与的积极结果，如积极参与和加强沟通，被证明。在简化工作流程和资源利用方面，临床效率确实有所提高。关于咨询时间的报告结果好坏参半。最后，通过全面的数据采集和更好地符合临床标准，提高了诊断的准确性。结论caht提供了促进患者参与、工作流程和诊断准确性的机会，并具有高完成率。我们需要进行合理的实施研究，以探索caht系统如何简化流程并最大限度地减少所需资源。未来的实施应确保整合到电子健康记录中，并解决跨年龄组和地区的数字包容问题，以实现CAHT在以患者为中心的常规护理中的潜力。
{"title":"Computer assisted history taking in elective and acute care: Systematic review","authors":"Casper Craamer , Thomas Timmers , Walter van der Weegen , Rudolf B Kool","doi":"10.1016/j.hlpt.2025.101108","DOIUrl":"10.1016/j.hlpt.2025.101108","url":null,"abstract":"<div><h3>Background</h3><div>Computer-assisted history taking (CAHT) could increase patient flow efficiency and healthcare resources optimization. By assessing reported clinical and patient-reported outcomes, we can clarify the benefits, limitations, and practical considerations of CAHT in clinical care. This systematic review synthesizes literature on CAHT in acute and elective care.</div></div><div><h3>Methods</h3><div>This systematic review followed PRISMA guidelines. A comprehensive search of MEDLINE, Embase, CINAHL, and Web of Science identified studies published between January 2014 and December 2024. Two reviewers independently screened articles, assessed study quality, and extracted data narratively.</div></div><div><h3>Results</h3><div>In total, 19 studies (involving 11,885 unique patients and 151 healthcare providers) were included. CAHT-questionnaire completion rates were high (75–95%) in larger samples but lower (51–67%) in smaller ones. Satisfaction was consistently high across different delivery methods and devices. Positive outcomes on patient engagement, such as active involvement and enhanced communication, were demonstrated. Clinical efficiency did improve in terms of streamlined workflows and resource utilization. Mixed results were reported on consultation duration. Finally, improved diagnostic accuracy was reported through comprehensive data capture and better alignment with clinical standards.</div></div><div><h3>Conclusion</h3><div>CAHT offers opportunities to contribute to patient engagement, workflows, and diagnostic accuracy, with high completion rates. We need sound implementation studies to explore how CAHT-systems can streamline processes and minimize needed resources. Future implementations should ensure integration into electronic health records and address digital inclusion across age groups and regions to realize CAHT’s potential in routine, patient-centered care.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101108"},"PeriodicalIF":3.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-23DOI: 10.1016/j.hlpt.2025.101107
Yuwen Liu, Zheng Zhang, Yige Chen, Kexin Du, Weiguang Ma
Objective
To review wearable protective devices for individuals at high risk of falling and to analyze the feasibility of these wearable protective tools in reducing fall-related harm.
Design
A systematic search was conducted across 7 databases to identify studies that met the inclusion criteria for analysis.
Results
A total of 31 studies were included. 28 studies involved the design of pre-impact fall protective devices, while 3 studies utilized commercially available products. The primary target population was the elderly, with some designed for children, blind person, and patients with craniocerebral disease. The wearing methods mainly included clothing, accessories, and protective gears. The protective areas primarily focused on the hip or head. The core components of these tools were airbags triggered by falls or protective layers made of special materials. 11 devices included emergency call systems. 7 studies conducted clinical trials for empirical, showing protective tools had certain effectiveness in mitigating injuries caused by falls, but some of these devices exhibit poor wearing comfort and compliance among users.
Conclusions
The targeted design of the application population and the design of wearable pre-impact fall protection system need to be further improved. The effectiveness of these devices in practical application needs to be verified by more clinical studies.
{"title":"Wearable pre-impact fall protection system: a scoping review","authors":"Yuwen Liu, Zheng Zhang, Yige Chen, Kexin Du, Weiguang Ma","doi":"10.1016/j.hlpt.2025.101107","DOIUrl":"10.1016/j.hlpt.2025.101107","url":null,"abstract":"<div><h3>Objective</h3><div>To review wearable protective devices for individuals at high risk of falling and to analyze the feasibility of these wearable protective tools in reducing fall-related harm.</div></div><div><h3>Design</h3><div>A systematic search was conducted across 7 databases to identify studies that met the inclusion criteria for analysis.</div></div><div><h3>Results</h3><div>A total of 31 studies were included. 28 studies involved the design of pre-impact fall protective devices, while 3 studies utilized commercially available products. The primary target population was the elderly, with some designed for children, blind person, and patients with craniocerebral disease. The wearing methods mainly included clothing, accessories, and protective gears. The protective areas primarily focused on the hip or head. The core components of these tools were airbags triggered by falls or protective layers made of special materials. 11 devices included emergency call systems. 7 studies conducted clinical trials for empirical, showing protective tools had certain effectiveness in mitigating injuries caused by falls, but some of these devices exhibit poor wearing comfort and compliance among users.</div></div><div><h3>Conclusions</h3><div>The targeted design of the application population and the design of wearable pre-impact fall protection system need to be further improved. The effectiveness of these devices in practical application needs to be verified by more clinical studies.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101107"},"PeriodicalIF":3.7,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-18DOI: 10.1016/j.hlpt.2025.101106
Natasha A. Bujang , Chandrani Ghosh , Kavitha Palaniappan , Silke Vogel , John C.W. Lim , Wei Wei Tiong , Adrian Sim , Beatrice Lee
Introduction
Direct-to-Consumer Genetic Testing (DTC-GT) provides consumers access to genetic tests without the mediation of healthcare professionals. This raises regulatory and ethical concerns including potential misinformation from company claims, especially in Singapore where DTC-GT is limited to non-clinical applications and is presently not regulated under health products regulations.
Objective
This scoping review aims to map non-clinical DTC-GT regulatory guidelines and compare data protection laws for genetic data to understand the regulatory landscape.
Methods
Online databases (PubMed, EBSCO, Springer, ScienceDirect, Embase, Web of Science, and SCOPUS) were used to identify papers published from 2000 onwards along with grey literature like websites and reports from Google searches.
Results
Based on the scoping review, 35 publications were identified, comprising 19 regulations and guidelines, and 16 relevant articles. Our findings indicate that the regulatory landscape of DTC-GT lacks uniformity, with most jurisdictions without specific regulations for non-clinical DTC-GT. 7 jurisdictions were identified to have data protection laws concerning genetic data privacy.
Conclusions
The review concluded that non-clinical DTC-GT is generally perceived as low-risk, resulting in minimal regulatory scrutiny across the surveyed regions. Despite the fundamental roles of informed consent and anonymisation of genetic data within existing frameworks for genetic data privacy, the regulation of non-clinical DTC-GT remains either limited or entirely absent due to its low-risk classification. Consequently, there is a significant need to enhance consumer health literacy, ensuring individuals are well-informed about GT services and are aware of the limitations and implications of data privacy risks. This approach is essential for safeguarding consumer interests in the evolving genetic testing landscape, as accuracy and reliability of these tests can be questionable, often leading to misinformation.
Public Interest Summary
This scoping review highlights that non-clinical DTC-GT often have minimal regulations because they are seen as low risk. However, the lack of specific regulations for how genetic data is collected, used, and shared poses privacy concerns. As genetic research technology advances, regulations should be adaptable and based on fundamental principles to keep up with these changes. It is also crucial to protect individuals from discrimination based on their genetic information. While there is no urgent need to regulate non-clinical DTC-GT that do not impact medical diagnoses, there is a growing concern about companies suggesting these tests have clinical importance without clear evidence. The best way forward is to implement strong consumer education programmes to help people understand
直接面向消费者的基因检测（DTC-GT）为消费者提供了无需医疗保健专业人员调解的基因检测途径。这引起了监管和道德方面的担忧，包括公司声明中可能存在的错误信息，特别是在新加坡，DTC-GT仅限于非临床应用，目前不受健康产品法规的监管。目的：本综述旨在绘制非临床DTC-GT监管指南，并比较遗传数据的数据保护法律，以了解监管格局。方法利用在线数据库（PubMed、EBSCO、谷歌、ScienceDirect、Embase、Web of Science和SCOPUS）识别2000年以来发表的论文以及谷歌搜索的网站和报告等灰色文献。结果根据范围审查，确定了35篇出版物，包括19篇法规和指南以及16篇相关文章。我们的研究结果表明，DTC-GT的监管格局缺乏统一性，大多数司法管辖区没有针对非临床DTC-GT的具体法规。确定有7个司法管辖区制定了有关遗传数据隐私的数据保护法。该综述的结论是，非临床DTC-GT通常被认为是低风险的，因此在调查地区的监管审查很少。尽管知情同意和遗传数据匿名化在现有遗传数据隐私框架中发挥着重要作用，但由于其低风险分类，对非临床DTC-GT的监管仍然有限或完全缺失。因此，非常需要提高消费者的健康知识，确保个人充分了解GT服务，并意识到数据隐私风险的局限性和影响。这种方法对于在不断发展的基因检测领域维护消费者利益至关重要，因为这些检测的准确性和可靠性可能受到质疑，经常导致错误信息。该范围审查强调，非临床DTC-GT通常具有最小的法规，因为它们被视为低风险。然而，缺乏关于如何收集、使用和共享基因数据的具体规定，引发了隐私问题。随着基因研究技术的进步，法规应该具有适应性，并以基本原则为基础，以跟上这些变化。保护个人免受基于其遗传信息的歧视也至关重要。虽然没有迫切需要对不影响医学诊断的非临床DTC-GT进行监管，但越来越多的公司在没有明确证据的情况下暗示这些测试具有临床重要性。最好的方法是实施强有力的消费者教育计划，帮助人们了解非临床DTC-GT的风险和益处，确保他们能够做出明智的选择。
{"title":"Non-clinical direct-to-consumer genetic testing: a scoping review of regulatory frameworks and issues","authors":"Natasha A. Bujang , Chandrani Ghosh , Kavitha Palaniappan , Silke Vogel , John C.W. Lim , Wei Wei Tiong , Adrian Sim , Beatrice Lee","doi":"10.1016/j.hlpt.2025.101106","DOIUrl":"10.1016/j.hlpt.2025.101106","url":null,"abstract":"<div><h3>Introduction</h3><div>Direct-to-Consumer Genetic Testing (DTC-GT) provides consumers access to genetic tests without the mediation of healthcare professionals. This raises regulatory and ethical concerns including potential misinformation from company claims, especially in Singapore where DTC-GT is limited to non-clinical applications and is presently not regulated under health products regulations.</div></div><div><h3>Objective</h3><div>This scoping review aims to map non-clinical DTC-GT regulatory guidelines and compare data protection laws for genetic data to understand the regulatory landscape.</div></div><div><h3>Methods</h3><div>Online databases (PubMed, EBSCO, Springer, ScienceDirect, Embase, Web of Science, and SCOPUS) were used to identify papers published from 2000 onwards along with grey literature like websites and reports from Google searches.</div></div><div><h3>Results</h3><div>Based on the scoping review, 35 publications were identified, comprising 19 regulations and guidelines, and 16 relevant articles. Our findings indicate that the regulatory landscape of DTC-GT lacks uniformity, with most jurisdictions without specific regulations for non-clinical DTC-GT. 7 jurisdictions were identified to have data protection laws concerning genetic data privacy.</div></div><div><h3>Conclusions</h3><div>The review concluded that non-clinical DTC-GT is generally perceived as low-risk, resulting in minimal regulatory scrutiny across the surveyed regions. Despite the fundamental roles of informed consent and anonymisation of genetic data within existing frameworks for genetic data privacy, the regulation of non-clinical DTC-GT remains either limited or entirely absent due to its low-risk classification. Consequently, there is a significant need to enhance consumer health literacy, ensuring individuals are well-informed about GT services and are aware of the limitations and implications of data privacy risks. This approach is essential for safeguarding consumer interests in the evolving genetic testing landscape, as accuracy and reliability of these tests can be questionable, often leading to misinformation.</div></div><div><h3>Public Interest Summary</h3><div>This scoping review highlights that non-clinical DTC-GT often have minimal regulations because they are seen as low risk. However, the lack of specific regulations for how genetic data is collected, used, and shared poses privacy concerns. As genetic research technology advances, regulations should be adaptable and based on fundamental principles to keep up with these changes. It is also crucial to protect individuals from discrimination based on their genetic information. While there is no urgent need to regulate non-clinical DTC-GT that do not impact medical diagnoses, there is a growing concern about companies suggesting these tests have clinical importance without clear evidence. The best way forward is to implement strong consumer education programmes to help people understand","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101106"},"PeriodicalIF":3.7,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-08DOI: 10.1016/j.hlpt.2025.101105
Tom Brandsma , Rogier van de Wetering , Jol Stoffers
Objectives
Increasing healthcare organizations’ digital innovation readiness is crucial to ensuring future availability, accessibility, affordability, and quality of healthcare. This study identifies themes that contribute to the digital innovation readiness of healthcare organizations.
Methods
A qualitative study was conducted using 17 semi-structured interviews among multiple stakeholders, clustered into 5 groups—academics, consultants, (top) managers (e.g., CIO/CEO), digital innovation managers, and primary care workers with digital innovation as a field of interest. Thematic analysis was used to analyze data.
Results
Five themes that contribute to digital innovation readiness of healthcare organizations were identified—strategic guidance, organization, adaptive climate, leading digital innovation, and digital foundation.
Conclusions
This study identifies themes that contribute to digital innovation readiness of healthcare organizations, helping such organizations prepare to innovate using digital technologies. Future research should validate these themes and explore interrelationships among them.
{"title":"Digital innovation readiness of Dutch healthcare organizations: an interview study with multiple stakeholders","authors":"Tom Brandsma , Rogier van de Wetering , Jol Stoffers","doi":"10.1016/j.hlpt.2025.101105","DOIUrl":"10.1016/j.hlpt.2025.101105","url":null,"abstract":"<div><h3>Objectives</h3><div>Increasing healthcare organizations’ digital innovation readiness is crucial to ensuring future availability, accessibility, affordability, and quality of healthcare. This study identifies themes that contribute to the digital innovation readiness of healthcare organizations.</div></div><div><h3>Methods</h3><div>A qualitative study was conducted using 17 semi-structured interviews among multiple stakeholders, clustered into 5 groups—academics, consultants, (top) managers (e.g., CIO/CEO), digital innovation managers, and primary care workers with digital innovation as a field of interest. Thematic analysis was used to analyze data.</div></div><div><h3>Results</h3><div>Five themes that contribute to digital innovation readiness of healthcare organizations were identified—strategic guidance, organization, adaptive climate, leading digital innovation, and digital foundation.</div></div><div><h3>Conclusions</h3><div>This study identifies themes that contribute to digital innovation readiness of healthcare organizations, helping such organizations prepare to innovate using digital technologies. Future research should validate these themes and explore interrelationships among them.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101105"},"PeriodicalIF":3.7,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-01DOI: 10.1016/j.hlpt.2022.100715
Md. Abu Bakar Siddique Jami , Kushal Biswas
Background
Self-medication is the use of medicinal products by the consumer which is not prescribed by a doctor. Self-medication practice (SMP) is widely adopted by the common people of developing countries like Bangladesh.
Methods
It was a cross-sectional study. Primary data were collected by conducting an online survey. Data collection was carried out from April 2021 to September 2021. The subjects were a minimum of 15 years of age. From 35 districts of Bangladesh, a total of 322 people of different age groups, education levels, and economic classes participated in the survey.
Result
71% (229) of the respondents were 21-25 years of age. 66% were undergraduate students. Most of them were from middle class society and well-educated. 80% of the population said that they had purchased or taken medicines without any prescription. 57% of them said they do not consider self-medication a very safe practice although, 87% of the population had practiced self-medication at least once in the preceding year. Antipyretics (212), Analgesics (165), Drugs for Cold/Cough (197) and Anti-ulcer/Antacids (140) were the majority categories of medicines that were used mostly for self-medication. Nearly all (311) of them collect SMP medicine from pharmacy shops. Previous prescriptions (146), advice from family or friends (165) and Internet or other media (113) were common sources of information for their self-medication practice.
Conclusion
Self-medication practice is highly prevalent in Bangladesh. People are not aware enough about the possible negative outcomes of it. Therefore, regulatory laws should be implemented more strictly regarding buying and selling medicines.
Lay Summary
The rate of self-medication practice appears to be increasing in Bangladesh, due to a number of socioeconomic and lifestyle factors that include ready access to drugs, increased potential to manage certain illnesses through self- care, and greater availability of medicinal products. Self-medication is not only prevalent in Bangladesh, it is present at a catastrophic rate. This article shows the overall awareness level of people regarding SMP and other health issues, which medicines are commonly being bought by people and their sources of information.
{"title":"A cross-sectional study regarding the knowledge, attitude and awareness about self-medication among Bangladeshi people","authors":"Md. Abu Bakar Siddique Jami , Kushal Biswas","doi":"10.1016/j.hlpt.2022.100715","DOIUrl":"10.1016/j.hlpt.2022.100715","url":null,"abstract":"<div><h3>Background</h3><div>Self-medication is the use of medicinal products by the consumer which is not prescribed by a doctor. Self-medication practice (SMP) is widely adopted by the common people of developing countries like Bangladesh.</div></div><div><h3>Methods</h3><div>It was a cross-sectional study. Primary data were collected by conducting an online survey. Data collection was carried out from April 2021 to September 2021. The subjects were a minimum of 15 years of age. From 35 districts of Bangladesh, a total of 322 people of different age groups, education levels, and economic classes participated in the survey.</div></div><div><h3>Result</h3><div>71% (229) of the respondents were 21-25 years of age. 66% were undergraduate students. Most of them were from middle class society and well-educated. 80% of the population said that they had purchased or taken medicines without any prescription. 57% of them said they do not consider self-medication a very safe practice although, 87% of the population had practiced self-medication at least once in the preceding year. Antipyretics (212), Analgesics (165), Drugs for Cold/Cough (197) and Anti-ulcer/Antacids (140) were the majority categories of medicines that were used mostly for self-medication. Nearly all (311) of them collect SMP medicine from pharmacy shops. Previous prescriptions (146), advice from family or friends (165) and Internet or other media (113) were common sources of information for their self-medication practice.</div></div><div><h3>Conclusion</h3><div>Self-medication practice is highly prevalent in Bangladesh. People are not aware enough about the possible negative outcomes of it. Therefore, regulatory laws should be implemented more strictly regarding buying and selling medicines.</div></div><div><h3>Lay Summary</h3><div>The rate of self-medication practice appears to be increasing in Bangladesh, due to a number of socioeconomic and lifestyle factors that include ready access to drugs, increased potential to manage certain illnesses through self- care, and greater availability of medicinal products. Self-medication is not only prevalent in Bangladesh, it is present at a catastrophic rate. This article shows the overall awareness level of people regarding SMP and other health issues, which medicines are commonly being bought by people and their sources of information.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 4","pages":"Article 100715"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The study investigates the key issues influencing different barriers resulting in user resistance toward adopting contact tracing smartphone apps launched to track COVID-19 infections.
Methods
Indian users’ experiences regarding the Aarogya Setu app for preventing the spread of COVID-19 were examined in two phases. In Phase I, online users’ comments available at the Google Play Store were qualitatively analyzed using open and axial coding. These codes were then used to create an implication matrix and hierarchical value maps to illustrate and interpret the relationships between issues, barriers, and user behavior. In Phase II, a supplementary empirical study, data was collected from users and non-users of the app through semi-structured telephone interviews and then qualitatively analyzed.
Results
By drawing on innovation resistance theory, the current study mapped a set of adoption barriers with three types of user resistance, i.e., postponement, opposition, and rejection. Rejection emerged as the most prominent consumer resistance behavior; usage barriers, functional risk, and value barriers related to the app's usage were the key drivers of this behavior. Postponement was the second most observed consumer resistance behavior. If usage barriers, functional risk, and value barriers of the app resulted in functional barriers toward adoption of the app, then image barrier was the key reason behind the psychological barrier.
Conclusion
Administrators and developers of future interventions need to be conscious of usage barriers, functional risks, and value barriers related to the app's usage through stakeholder engagement to secure broader and faster adoption of such apps to improve health information systems.
本研究调查了影响用户采用为追踪 COVID-19 感染而推出的接触追踪智能手机应用程序的不同障碍的关键问题。研究分两个阶段考察了印度用户对用于预防 COVID-19 传播的 Aarogya Setu 应用程序的体验。在第一阶段，我们使用开放式和轴向编码对 Google Play 商店中的在线用户评论进行了定性分析。然后，利用这些编码创建了影响矩阵和分层价值图，以说明和解释问题、障碍和用户行为之间的关系。第二阶段是补充性实证研究，通过半结构化电话访谈从应用程序的用户和非用户那里收集数据，然后进行定性分析。通过借鉴创新阻力理论，本研究将一系列采用障碍与三种类型的用户阻力（即推迟、反对和拒绝）进行了映射。拒绝是最突出的消费者抵制行为；与应用程序使用相关的使用障碍、功能风险和价值障碍是这一行为的主要驱动因素。推迟是第二大消费者抵制行为。如果说应用程序的使用障碍、功能风险和价值障碍导致了采用应用程序的功能障碍，那么形象障碍则是心理障碍背后的关键原因。未来干预措施的管理者和开发者需要通过利益相关者的参与，意识到与应用程序使用相关的使用障碍、功能风险和价值障碍，以确保更广泛、更快速地采用此类应用程序来改善医疗信息系统。
{"title":"Adoption of contact tracing app during pandemic: Users’ resistance behavior","authors":"Yogesh Bhatt , Karminder Ghuman , Safiya Mukhtar Alshibani , Usama Awan","doi":"10.1016/j.hlpt.2024.100901","DOIUrl":"10.1016/j.hlpt.2024.100901","url":null,"abstract":"<div><h3>Objectives</h3><div>The study investigates the key issues influencing different barriers resulting in user resistance toward adopting contact tracing smartphone apps launched to track COVID-19 infections.</div></div><div><h3>Methods</h3><div>Indian users’ experiences regarding the Aarogya Setu app for preventing the spread of COVID-19 were examined in two phases. In Phase I, online users’ comments available at the Google Play Store were qualitatively analyzed using open and axial coding. These codes were then used to create an implication matrix and hierarchical value maps to illustrate and interpret the relationships between issues, barriers, and user behavior. In Phase II, a supplementary empirical study, data was collected from users and non-users of the app through semi-structured telephone interviews and then qualitatively analyzed.</div></div><div><h3>Results</h3><div>By drawing on innovation resistance theory, the current study mapped a set of adoption barriers with three types of user resistance, i.e., postponement, opposition, and rejection. Rejection emerged as the most prominent consumer resistance behavior; usage barriers, functional risk, and value barriers related to the app's usage were the key drivers of this behavior. Postponement was the second most observed consumer resistance behavior. If usage barriers, functional risk, and value barriers of the app resulted in functional barriers toward adoption of the app, then image barrier was the key reason behind the psychological barrier.</div></div><div><h3>Conclusion</h3><div>Administrators and developers of future interventions need to be conscious of usage barriers, functional risks, and value barriers related to the app's usage through stakeholder engagement to secure broader and faster adoption of such apps to improve health information systems.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 4","pages":"Article 100901"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142215669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-01DOI: 10.1016/j.hlpt.2025.101024
Oscar Chidiebere Ukaegbu, Mingyue Fan
Objectives
Mobile health applications (MHAs) play a key role in modern healthcare delivery, yet understanding the factors influencing users' continuance intention towards these platforms remains a critical area of inquiry. This study investigates the influence of perceived e-Health literacy (PEHL) on users' trust, perceived usefulness, and perceived ease of use of MHAs, employing the Technology Acceptance Model (TAM) as a theoretical framework.
Methods
Structural equation modeling was employed to evaluate data collected from 430 participants in Nigeria. This approach facilitated a thorough assessment of the complex interconnections among Perceived e-health literacy, Perceived usefulness, perceived ease of use, trust, and Continuance intention of MHAs. Through the application of statistical analyses within this framework, the study aimed to offer a rigorous examination of the data and extract significant findings.
Results
Through this survey of MHAs users, path analysis reveals significant positive associations between PEHL and trust, perceived usefulness, and perceived ease of use, underscoring importance regarding individual competencies with shaping views of digital health resources. Moreover, trust emerges as a key mediator in the relationship between PEHL and users' continuance intention to use MHAs, highlighting its pivotal role in fostering sustained engagement with these platforms.
Discussion
The findings highlight the pivotal role of trust in fostering sustained engagement with MHAs. The results suggest that enhancing users' eHealth literacy can positively influence their trust and perceptions of usefulness and ease of use, which in turn can drive their intention to continue using these applications.
Conclusions
The study contributes to theoretical advancements in eHealth literature and offers practical insights for the design and implementation of MHAs to enhance user acceptance and engagement in digital healthcare ecosystems. The positive associations identified between PEHL, trust, and continuance intention underscore the need for strategies that enhance users' competencies and trust to ensure sustained use of MHAs.
{"title":"Examining the influence of personal eHealth literacy on continuance intention towards mobile health applications: A TAM-based approach","authors":"Oscar Chidiebere Ukaegbu, Mingyue Fan","doi":"10.1016/j.hlpt.2025.101024","DOIUrl":"10.1016/j.hlpt.2025.101024","url":null,"abstract":"<div><h3>Objectives</h3><div>Mobile health applications (MHAs) play a key role in modern healthcare delivery, yet understanding the factors influencing users' continuance intention towards these platforms remains a critical area of inquiry. This study investigates the influence of perceived e-Health literacy (PEHL) on users' trust, perceived usefulness, and perceived ease of use of MHAs, employing the Technology Acceptance Model (TAM) as a theoretical framework.</div></div><div><h3>Methods</h3><div>Structural equation modeling was employed to evaluate data collected from 430 participants in Nigeria. This approach facilitated a thorough assessment of the complex interconnections among Perceived e-health literacy, Perceived usefulness, perceived ease of use, trust, and Continuance intention of MHAs. Through the application of statistical analyses within this framework, the study aimed to offer a rigorous examination of the data and extract significant findings.</div></div><div><h3>Results</h3><div>Through this survey of MHAs users, path analysis reveals significant positive associations between PEHL and trust, perceived usefulness, and perceived ease of use, underscoring importance regarding individual competencies with shaping views of digital health resources. Moreover, trust emerges as a key mediator in the relationship between PEHL and users' continuance intention to use MHAs, highlighting its pivotal role in fostering sustained engagement with these platforms.</div></div><div><h3>Discussion</h3><div>The findings highlight the pivotal role of trust in fostering sustained engagement with MHAs. The results suggest that enhancing users' eHealth literacy can positively influence their trust and perceptions of usefulness and ease of use, which in turn can drive their intention to continue using these applications.</div></div><div><h3>Conclusions</h3><div>The study contributes to theoretical advancements in eHealth literature and offers practical insights for the design and implementation of MHAs to enhance user acceptance and engagement in digital healthcare ecosystems. The positive associations identified between PEHL, trust, and continuance intention underscore the need for strategies that enhance users' competencies and trust to ensure sustained use of MHAs.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 4","pages":"Article 101024"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-01DOI: 10.1016/j.hlpt.2024.100970
Diana Frost , Mufti Mahmud , M.Shamim Kaiser , David Musoke , Paulette Henry , Shariful Islam
None.
没有。
{"title":"Innovative approaches to strengthening health systems in LMIC's","authors":"Diana Frost , Mufti Mahmud , M.Shamim Kaiser , David Musoke , Paulette Henry , Shariful Islam","doi":"10.1016/j.hlpt.2024.100970","DOIUrl":"10.1016/j.hlpt.2024.100970","url":null,"abstract":"<div><div>None.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 4","pages":"Article 100970"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-01DOI: 10.1016/j.hlpt.2023.100731
Moinul H. Chowdhury , Rony Chowdhury Ripan , A.K.M. Nazmul Islam , Rubaiyat Alim Hridhee , Farhana Sarker , Sheikh Mohammed Shariful Islam , Khondaker A. Mamun
Objective
Bangladesh's health care system, particularly in rural areas, experiences enormous obstacles in providing complete preventive and primary healthcare services due to the lack of adequate healthcare facilities, resource constraints, and a non-functional referral system. To alleviate these problems, in this study, we introduce the digital general practitioner (GP) model for rural Bangladesh, digital platforms and present a statistical analysis of the data that was gathered from the pilot project.
Methods
A total of 12,746 people were provided regular health services during the pilot project, from all genders and age groups, and provided their socio-demographic and healthcare-related data. We analyzed healthcare-related data by carrying out both descriptive and inferential statistics.
Results
By utilizing this digital GP model, rural residents can receive routine health screenings at their homes, identify health risks early, receive consultation and health education, and be referred to GP and upper-level health facilities as needed. We found that hypertension was more prevalent (4.84% of the served population), and cancer was the least prevalent of all the NCDs in the studied population (0.05% of the served population). The population for stroke, hypertension, diabetes increased until the 50–59 age range as age increased, following which the population proportion declined as age increased. Additionally, 3.96% of young females were severely malnourished, comparably higher proportion than young males (2.34%).
Conclusion
NCDs such as hypertension, diabetes was prevalent among rural people. Necessary steps should be taken to raise preventive and primary healthcare awareness among rural people.
Public interest summary
The absence of proper healthcare facilities, resource constraints, and a non-functional referral system hamper Bangladesh's health care system's ability to provide comprehensive preventive and primary healthcare services in rural area. As a result, patients develop advanced ailments, including non-communicable diseases (NCDs), and must seek treatment at an expensive specialty hospital. To resolve this issue, we introduce a digital GP model for rural Bangladesh, then show digital platforms that use the concept, and lastly summarize significant findings from the piloted digital GP model. By utilizing this digital GP model, rural residents can receive routine health screenings at their homes, identify health risks early, receive consultation and health education, and be referred to GP and upper-level health facilities as need. From our data analysis, we discovered high burden of NCDs such as hypertension and diabetes in the piloted area. Necessary steps should be taken to raise preventive and primary healthcare awareness among rural people.
{"title":"Digital health inclusion towards achieving universal health coverage for Bangladesh utilizing general practitioner model","authors":"Moinul H. Chowdhury , Rony Chowdhury Ripan , A.K.M. Nazmul Islam , Rubaiyat Alim Hridhee , Farhana Sarker , Sheikh Mohammed Shariful Islam , Khondaker A. Mamun","doi":"10.1016/j.hlpt.2023.100731","DOIUrl":"10.1016/j.hlpt.2023.100731","url":null,"abstract":"<div><h3>Objective</h3><div>Bangladesh's health care system, particularly in rural areas, experiences enormous obstacles in providing complete preventive and primary healthcare services due to the lack of adequate healthcare facilities, resource constraints, and a non-functional referral system. To alleviate these problems, in this study, we introduce the digital general practitioner (GP) model for rural Bangladesh, digital platforms and present a statistical analysis of the data that was gathered from the pilot project.</div></div><div><h3>Methods</h3><div>A total of 12,746 people were provided regular health services during the pilot project, from all genders and age groups, and provided their socio-demographic and healthcare-related data. We analyzed healthcare-related data by carrying out both descriptive and inferential statistics.</div></div><div><h3>Results</h3><div>By utilizing this digital GP model, rural residents can receive routine health screenings at their homes, identify health risks early, receive consultation and health education, and be referred to GP and upper-level health facilities as needed. We found that hypertension was more prevalent (4.84% of the served population), and cancer was the least prevalent of all the NCDs in the studied population (0.05% of the served population). The population for stroke, hypertension, diabetes increased until the 50–59 age range as age increased, following which the population proportion declined as age increased. Additionally, 3.96% of young females were severely malnourished, comparably higher proportion than young males (2.34%).</div></div><div><h3>Conclusion</h3><div>NCDs such as hypertension, diabetes was prevalent among rural people. Necessary steps should be taken to raise preventive and primary healthcare awareness among rural people.</div></div><div><h3>Public interest summary</h3><div>The absence of proper healthcare facilities, resource constraints, and a non-functional referral system hamper Bangladesh's health care system's ability to provide comprehensive preventive and primary healthcare services in rural area. As a result, patients develop advanced ailments, including non-communicable diseases (NCDs), and must seek treatment at an expensive specialty hospital. To resolve this issue, we introduce a digital GP model for rural Bangladesh, then show digital platforms that use the concept, and lastly summarize significant findings from the piloted digital GP model. By utilizing this digital GP model, rural residents can receive routine health screenings at their homes, identify health risks early, receive consultation and health education, and be referred to GP and upper-level health facilities as need. From our data analysis, we discovered high burden of NCDs such as hypertension and diabetes in the piloted area. Necessary steps should be taken to raise preventive and primary healthcare awareness among rural people.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 4","pages":"Article 100731"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48926968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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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