J. Seyi-Olajide, Oti N. Aria, Nkeiruka Obi, Paul Lobi, E. A. Ameh
Global health advocacy plays a crucial role in addressing emerging health challenges, including the provision of surgical healthcare care in low- and middle-income countries (LMICs). Nigeria launched its national surgical, obstetrics, anaesthesia, and nursing plan (NSOANP) in 2019 to improve access to surgical services, including cleft lip and palate. This report examines the potential of media engagement as a catalyst for advocacy initiatives to strengthen surgical systems. # Methods The study conducted media and advocacy workshops targeting journalists from various media outlets across Nigeria. Workshops included didactic lectures, presentations, role plays, and group discussions. Participants were evaluated through pre- and post-tests. Follow-up activities tracked participants’ reporting and awarded prizes for outstanding reporting on cleft and surgical care. # Results One hundred and three journalists, including 61 (59.2%) males and 42 (39.8%) females participated, showing significant improvement in knowledge about cleft lip and palate anomalies and access to surgical care (p = 0.03). Post-workshop outputs included public enlightenment programmes, radio dramas, and published reports. The initiative awarded prizes to 9 journalists for quality reporting. # Conclusions Media engagement is a potent tool for advocating for surgical care access. The success of this initiative underscores the importance of collaboration between stakeholders and the need for sustained efforts to support advocacy for access to surgical healthcare.
{"title":"Implementation of Nigeria’s surgical plan: leveraging media engagement for cleft lip and palate to drive advocacy for access to surgical healthcare","authors":"J. Seyi-Olajide, Oti N. Aria, Nkeiruka Obi, Paul Lobi, E. A. Ameh","doi":"10.29392/001c.120239","DOIUrl":"https://doi.org/10.29392/001c.120239","url":null,"abstract":"Global health advocacy plays a crucial role in addressing emerging health challenges, including the provision of surgical healthcare care in low- and middle-income countries (LMICs). Nigeria launched its national surgical, obstetrics, anaesthesia, and nursing plan (NSOANP) in 2019 to improve access to surgical services, including cleft lip and palate. This report examines the potential of media engagement as a catalyst for advocacy initiatives to strengthen surgical systems. # Methods The study conducted media and advocacy workshops targeting journalists from various media outlets across Nigeria. Workshops included didactic lectures, presentations, role plays, and group discussions. Participants were evaluated through pre- and post-tests. Follow-up activities tracked participants’ reporting and awarded prizes for outstanding reporting on cleft and surgical care. # Results One hundred and three journalists, including 61 (59.2%) males and 42 (39.8%) females participated, showing significant improvement in knowledge about cleft lip and palate anomalies and access to surgical care (p = 0.03). Post-workshop outputs included public enlightenment programmes, radio dramas, and published reports. The initiative awarded prizes to 9 journalists for quality reporting. # Conclusions Media engagement is a potent tool for advocating for surgical care access. The success of this initiative underscores the importance of collaboration between stakeholders and the need for sustained efforts to support advocacy for access to surgical healthcare.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141702071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jayakayatri Jeevajothi Nathan, Dhiraj Agarwal, I. T. Peres, L. S. Bastos, N. Resende, Silvo Hamacher, Ashleigh Cheyne, Nina Jamieson, Anand Kawade, Ee Ming Khoo, F. A. Bozza
The integration of digital health (eHealth) interventions into primary healthcare systems has gained recognition lately in Low- and Middle-Income Countries (LMICs) to enhance healthcare quality, accessibility, and efficiency. These interventions may offer effective strategies in mitigating the burden of chronic diseases by facilitating access to remote healthcare and optimising its processes. This scoping review aims to identify and assess eHealth interventions implemented in primary care settings in LMICs for further development and adaptation. We will search two electronic databases, such as Scopus and Embase, to identify peer-reviewed studies reporting on eHealth interventions implemented in primary care settings within LMICs. This review will encompass evidence published in the English language without a time frame restriction. We will remove duplicates from the search, and two reviewers will independently assess all articles for eligibility by first screening the title and abstract, followed by a full-text review. Eligible articles will be extracted, and data will be charted according to types of intervention and settings using a standardised form. There is no ethical review required for this scoping review. We plan to disseminate the findings by presentations at conferences and publishing in open-access journal.
{"title":"Digital health interventions in primary care in low- and middle-income countries: a systematic scoping review protocol","authors":"Jayakayatri Jeevajothi Nathan, Dhiraj Agarwal, I. T. Peres, L. S. Bastos, N. Resende, Silvo Hamacher, Ashleigh Cheyne, Nina Jamieson, Anand Kawade, Ee Ming Khoo, F. A. Bozza","doi":"10.29392/001c.120508","DOIUrl":"https://doi.org/10.29392/001c.120508","url":null,"abstract":"The integration of digital health (eHealth) interventions into primary healthcare systems has gained recognition lately in Low- and Middle-Income Countries (LMICs) to enhance healthcare quality, accessibility, and efficiency. These interventions may offer effective strategies in mitigating the burden of chronic diseases by facilitating access to remote healthcare and optimising its processes. This scoping review aims to identify and assess eHealth interventions implemented in primary care settings in LMICs for further development and adaptation. We will search two electronic databases, such as Scopus and Embase, to identify peer-reviewed studies reporting on eHealth interventions implemented in primary care settings within LMICs. This review will encompass evidence published in the English language without a time frame restriction. We will remove duplicates from the search, and two reviewers will independently assess all articles for eligibility by first screening the title and abstract, followed by a full-text review. Eligible articles will be extracted, and data will be charted according to types of intervention and settings using a standardised form. There is no ethical review required for this scoping review. We plan to disseminate the findings by presentations at conferences and publishing in open-access journal.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141705511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Birabwa, Banke-Thomas Aduragbemi, P. Waiswa, A. Semaan, R. M. Kananura, J. van Olmen, L. Beňová
Recent estimates have shown a stagnation in maternal mortality reduction globally. Levels and trends in maternal mortality in urban settings in Africa are of interest due to health system challenges posed by rapid urbanisation. Given the high percentage of births occurring in city health facilities, tracking the institutional maternal mortality ratio (IMMR) can reveal key performance issues. We described the trends in IMMR between 2016 and 2021, and the causes and characteristics of maternal deaths in Kampala, Uganda. This retrospective study utilised routine data from all facilities in Kampala that provided childbirth services from 2016 to 2021. Three key variables were used: number of deliveries, live births, and maternal deaths. Additionally, from medical records in three purposively selected hospitals, we extracted information on characteristics of women recorded as maternal deaths and their causes for the period 2016-2021 from death notification and review forms. We conducted descriptive analysis and assessed time trends in IMMR. For the six-year period, the Kampala-level IMMR was 189/100,000 deliveries (194/100,000 livebirths). The IMMR declined from 213 (2016) to 109/100,000 deliveries in 2019 (p=0.04) and then increased to 258 in 2021 (p=0.12). A review of 358 maternal death records showed that 65% of deaths were women referred from other health facilities, and 47% lived in the surrounding district (Wakiso). Obstetric haemorrhage (44%) and hypertensive disorders in pregnancy (28%) were the most commonly recorded causes of death. Health system factors such as lack of blood and other supplies contributed to 65% of the deaths reviewed. IMMR in Kampala increased from 2019-2021. Health infrastructure changes and maternal health initiatives potentially accounted for the observed trend by affecting data quality. Referral and facility readiness were underlying reasons for maternal deaths. Addressing bottlenecks in emergency referral processes may contribute to mortality reduction. Further research should determine the relative contribution of key influences on mortality levels and examine the dynamics between women’s care-seeking pathways and service delivery arrangements for emergency obstetric care in urban settings.
{"title":"Maternal health in cities: analysis of institutional maternal mortality and health system bottlenecks in Kampala City Uganda, 2016-2021","authors":"C. Birabwa, Banke-Thomas Aduragbemi, P. Waiswa, A. Semaan, R. M. Kananura, J. van Olmen, L. Beňová","doi":"10.29392/001c.116248","DOIUrl":"https://doi.org/10.29392/001c.116248","url":null,"abstract":"Recent estimates have shown a stagnation in maternal mortality reduction globally. Levels and trends in maternal mortality in urban settings in Africa are of interest due to health system challenges posed by rapid urbanisation. Given the high percentage of births occurring in city health facilities, tracking the institutional maternal mortality ratio (IMMR) can reveal key performance issues. We described the trends in IMMR between 2016 and 2021, and the causes and characteristics of maternal deaths in Kampala, Uganda. This retrospective study utilised routine data from all facilities in Kampala that provided childbirth services from 2016 to 2021. Three key variables were used: number of deliveries, live births, and maternal deaths. Additionally, from medical records in three purposively selected hospitals, we extracted information on characteristics of women recorded as maternal deaths and their causes for the period 2016-2021 from death notification and review forms. We conducted descriptive analysis and assessed time trends in IMMR. For the six-year period, the Kampala-level IMMR was 189/100,000 deliveries (194/100,000 livebirths). The IMMR declined from 213 (2016) to 109/100,000 deliveries in 2019 (p=0.04) and then increased to 258 in 2021 (p=0.12). A review of 358 maternal death records showed that 65% of deaths were women referred from other health facilities, and 47% lived in the surrounding district (Wakiso). Obstetric haemorrhage (44%) and hypertensive disorders in pregnancy (28%) were the most commonly recorded causes of death. Health system factors such as lack of blood and other supplies contributed to 65% of the deaths reviewed. IMMR in Kampala increased from 2019-2021. Health infrastructure changes and maternal health initiatives potentially accounted for the observed trend by affecting data quality. Referral and facility readiness were underlying reasons for maternal deaths. Addressing bottlenecks in emergency referral processes may contribute to mortality reduction. Further research should determine the relative contribution of key influences on mortality levels and examine the dynamics between women’s care-seeking pathways and service delivery arrangements for emergency obstetric care in urban settings.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141016437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chronic respiratory diseases (CRDs) such as Chronic obstructive pulmonary disease (COPD), Asthma and post-tuberculosis lung disease (PTLD) are a growing public health concern in India. Early diagnosis and management of CRDs require a good quality spirometry test, a technician to conduct spirometry and a chest physician to interpret the results. In India, these are not available at the primary care level. This study reports the feasibility of a large-scale CRD diagnosis and management program in primary care using a unique point-of-care spirometry solution, Briota PFT in a Box™. # Methods A community-based cross-sectional study was conducted among 15,602 adults in Dindori Taluka (subdivision), Nashik, Maharashtra state. This study was part of a holistic CRD diagnosis and management program SAVE™ (Spirometry Assisted Virtually Early). Make In India point of care solution Briota PFT in a Box™ was used. A House‐to‐house community-based assessment checklist (CBAC) survey, 4-parameter spirometry test, 15-parameter pre and post-bronchodilator spirometry test and a software-assisted medical examination by the medical officer at primary care were conducted. Software was used to generate CRD diagnosis and lung health score (LHS™). The diagnosis was verified by the chest physician. Confirmed diagnosed patients were provided treatment and offered a patient support program. Interviews were conducted with the patients, nurses, doctors and public health officials for understanding feasibility and documenting learning from program SAVE™. # Results Out of 15,602 adults surveyed, total 4,937 (31.6%) were identified as “CRD high risk”. 1231 participants based on medical examination, spirometry tests and software analysis were identified as CRD candidates by medical officers at primary care. 1154 participants out of 15,602 (7.4%) were confirmed diagnosed as CRD patients post independent evaluation by chest physicians. At the time of follow-up, 537 patients (75% of 712 patients enrolled in patient support program) reported improvement in symptoms and high satisfaction with the program. District health officer, Medical officers, nurses, Accredited Social Health Activist (ASHA) from the primary health care centers confirmed ease of use and feasibility of using Briota PFT in a Box™ in program SAVE™. Outcome and learning from program SAVE™ was documented and submitted to Ministry of Health and Family Welfare Government of India. # Conclusions CRD diagnosis and management in large scale settings in primary healthcare level using a point of care spirometry solution Briota PFT in a Box™ is highly feasible.
慢性阻塞性肺病（COPD）、哮喘和肺结核后肺病（PTLD）等慢性呼吸系统疾病（CRDs）是印度日益严重的公共卫生问题。慢性阻塞性肺疾病的早期诊断和管理需要高质量的肺活量测试、进行肺活量测试的技术人员和解释测试结果的胸科医生。在印度，基层医疗机构并不具备这些条件。本研究报告了在基层医疗机构使用独特的床旁肺活量测定解决方案 Briota PFT in a Box™ 开展大规模 CRD 诊断和管理项目的可行性。# 方法 在马哈拉施特拉邦纳希克市 Dindori Taluka（分区）的 15602 名成年人中开展了一项社区横断面研究。该研究是整体 CRD 诊断和管理计划 SAVE™（早期肺活量测定辅助）的一部分。该项目采用了印度制造的 Briota PFT in a Box™ 医疗点解决方案。进行了逐户社区评估清单（CBAC）调查、4 参数肺活量测试、支气管扩张剂前后 15 参数肺活量测试以及初级保健医疗人员的软件辅助体检。软件用于生成 CRD 诊断和肺健康评分 (LHS™)。诊断结果由胸科医生核实。确诊患者将接受治疗并获得患者支持计划。对患者、护士、医生和公共卫生官员进行了访谈，以了解 SAVE™ 计划的可行性，并记录从该计划中学到的知识。# 结果 在接受调查的 15602 名成年人中，共有 4937 人（31.6%）被确定为 "CRD 高危人群"。根据体检、肺活量测试和软件分析，1231 名参与者被基层医疗机构的医务人员确定为 CRD 候选者。在 15602 名参与者中，有 1154 人（7.4%）经胸科医生独立评估后确诊为 CRD 患者。在随访时，537 名患者（占参加患者支持计划的 712 名患者的 75%）表示症状有所改善，并对该计划非常满意。来自初级卫生保健中心的地区卫生官员、医务人员、护士和经认可的社会健康活动家 (ASHA) 均证实，在 SAVE™ 项目中使用 Briota PFT in a Box™ 非常简单可行。SAVE™ 计划的成果和经验已记录在案并提交给印度政府卫生和家庭福利部。# 结论 在基层医疗机构大规模开展 CRD 诊断和管理，使用 Briota PFT in a Box™ 医疗点肺活量测量解决方案是非常可行的。
{"title":"Using spirometry for screening and diagnosis of chronic respiratory diseases in primary health care: findings from a community health project in rural India","authors":"Gajanan Sakhare, Yogesh Chitte, Radha Munje, Shardul Joshi, Meenakshi Bhakare","doi":"10.29392/001c.116246","DOIUrl":"https://doi.org/10.29392/001c.116246","url":null,"abstract":"Chronic respiratory diseases (CRDs) such as Chronic obstructive pulmonary disease (COPD), Asthma and post-tuberculosis lung disease (PTLD) are a growing public health concern in India. Early diagnosis and management of CRDs require a good quality spirometry test, a technician to conduct spirometry and a chest physician to interpret the results. In India, these are not available at the primary care level. This study reports the feasibility of a large-scale CRD diagnosis and management program in primary care using a unique point-of-care spirometry solution, Briota PFT in a Box™. # Methods A community-based cross-sectional study was conducted among 15,602 adults in Dindori Taluka (subdivision), Nashik, Maharashtra state. This study was part of a holistic CRD diagnosis and management program SAVE™ (Spirometry Assisted Virtually Early). Make In India point of care solution Briota PFT in a Box™ was used. A House‐to‐house community-based assessment checklist (CBAC) survey, 4-parameter spirometry test, 15-parameter pre and post-bronchodilator spirometry test and a software-assisted medical examination by the medical officer at primary care were conducted. Software was used to generate CRD diagnosis and lung health score (LHS™). The diagnosis was verified by the chest physician. Confirmed diagnosed patients were provided treatment and offered a patient support program. Interviews were conducted with the patients, nurses, doctors and public health officials for understanding feasibility and documenting learning from program SAVE™. # Results Out of 15,602 adults surveyed, total 4,937 (31.6%) were identified as “CRD high risk”. 1231 participants based on medical examination, spirometry tests and software analysis were identified as CRD candidates by medical officers at primary care. 1154 participants out of 15,602 (7.4%) were confirmed diagnosed as CRD patients post independent evaluation by chest physicians. At the time of follow-up, 537 patients (75% of 712 patients enrolled in patient support program) reported improvement in symptoms and high satisfaction with the program. District health officer, Medical officers, nurses, Accredited Social Health Activist (ASHA) from the primary health care centers confirmed ease of use and feasibility of using Briota PFT in a Box™ in program SAVE™. Outcome and learning from program SAVE™ was documented and submitted to Ministry of Health and Family Welfare Government of India. # Conclusions CRD diagnosis and management in large scale settings in primary healthcare level using a point of care spirometry solution Briota PFT in a Box™ is highly feasible.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141016221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neha Dumka, Aayushi Gurung, Erin Hannah, Sonu Goel, A. Kotwal
Nepal’s health policy environment and health-care delivery system has changed over the last 25 years, during which it witnessed a significant progress in improving citizens’ access to healthcare services. However, a combination of factors intrinsic to the nation continue to influence health service delivery producing variable health outcomes. Given the nation’s target towards achieving universal health coverage and sustainable development targets, there is a need to review and understand the functioning of Nepal’s health system, its strengths, challenges, and opportunities. The review aims to explore the key health system factors influencing health services and healthcare needs, and forge actionable recommendations for the future. # Methods The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for identifying the relevant literature between 2001 and 2023. A total of 300 articles were obtained from the initial search, out of which 42 full text articles were selected for an in-depth review. The literature was analysed to identify the broad themes relevant to Nepal’s health system, and the findings were synthesized narratively under each theme. # Results The review highlights various factors influencing health services and healthcare needs by describing the historical development of Nepal’s healthcare delivery system, its current scenario, health expenditure, health system challenges and opportunities ahead. The evolution of Nepal’s health system has been both significant and responsive. # Conclusions The change in the governance structure and adoption of primary healthcare approach present the nation with ample opportunities to further the scope of the nation’s existing health sector initiatives and outcomes.
{"title":"Understanding key factors for strengthening Nepal’s healthcare needs: health systems perspectives","authors":"Neha Dumka, Aayushi Gurung, Erin Hannah, Sonu Goel, A. Kotwal","doi":"10.29392/001c.94931","DOIUrl":"https://doi.org/10.29392/001c.94931","url":null,"abstract":"Nepal’s health policy environment and health-care delivery system has changed over the last 25 years, during which it witnessed a significant progress in improving citizens’ access to healthcare services. However, a combination of factors intrinsic to the nation continue to influence health service delivery producing variable health outcomes. Given the nation’s target towards achieving universal health coverage and sustainable development targets, there is a need to review and understand the functioning of Nepal’s health system, its strengths, challenges, and opportunities. The review aims to explore the key health system factors influencing health services and healthcare needs, and forge actionable recommendations for the future. # Methods The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for identifying the relevant literature between 2001 and 2023. A total of 300 articles were obtained from the initial search, out of which 42 full text articles were selected for an in-depth review. The literature was analysed to identify the broad themes relevant to Nepal’s health system, and the findings were synthesized narratively under each theme. # Results The review highlights various factors influencing health services and healthcare needs by describing the historical development of Nepal’s healthcare delivery system, its current scenario, health expenditure, health system challenges and opportunities ahead. The evolution of Nepal’s health system has been both significant and responsive. # Conclusions The change in the governance structure and adoption of primary healthcare approach present the nation with ample opportunities to further the scope of the nation’s existing health sector initiatives and outcomes.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140736724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Lemma, Anene Tesfa, Fikreselassie Getachew, Hiwot Achamyeleh, Bantalem Yeshanew, T. Getachew, Tanya Marchant
Efforts to improve the quality of maternal, neonatal and child health services have intensified in Ethiopia. Consistent with global recommendations, measuring only coverage of these health services is no longer sufficient to assess their impact on population health. As a result, interest has grown in effective coverage measures that combine service access and service quality into one metric. However, operationalising effective coverage measurement in settings like Ethiopia requires understanding the context and feasibility with available data and resources. Thus, this study aimed to explore the demand for effective coverage measurement among Ethiopian key stakeholders and identify the actions needed to enhance its implementation in Ethiopia’s healthcare system. An explorative, qualitative study design was employed, and data was collected through semi-structured interviews. Nineteen key informants from national level, three regions (Amhara, Oromia and Gambela), and one administrative city (Addis Ababa) in Ethiopia, participated in the study from March to April 2023. Key informants were identified using a snowballing approach. This study received ethical approval from the London School of Hygiene and Tropical Medicine and the Ethiopian Public Health Institute ethical review boards. There is a strong demand for effective coverage measurement for decision making on health care quality in the Ethiopian health sector. The demand is characterised either for individual patient care or for tracking health system performance; currently, there is limited clarity on the distinction between these two needs. A strong sentiment exists for the use of routine health information system data for this purpose, although stakeholders acknowledge the limitations of this data source. To advance the effective coverage measurement agenda in Ethiopia, respondents recommend building confidence in the quality of data sources, the need for more guidance on how to generate effective coverage measures, and the need for government leadership to coordinate these efforts. The strong demand for effective coverage measures and the positive policy environment encourages further testing of effective coverage measurement in Ethiopia.
{"title":"Operationalising effective coverage measurement in Ethiopia: a qualitative study","authors":"S. Lemma, Anene Tesfa, Fikreselassie Getachew, Hiwot Achamyeleh, Bantalem Yeshanew, T. Getachew, Tanya Marchant","doi":"10.29392/001c.94935","DOIUrl":"https://doi.org/10.29392/001c.94935","url":null,"abstract":"Efforts to improve the quality of maternal, neonatal and child health services have intensified in Ethiopia. Consistent with global recommendations, measuring only coverage of these health services is no longer sufficient to assess their impact on population health. As a result, interest has grown in effective coverage measures that combine service access and service quality into one metric. However, operationalising effective coverage measurement in settings like Ethiopia requires understanding the context and feasibility with available data and resources. Thus, this study aimed to explore the demand for effective coverage measurement among Ethiopian key stakeholders and identify the actions needed to enhance its implementation in Ethiopia’s healthcare system. An explorative, qualitative study design was employed, and data was collected through semi-structured interviews. Nineteen key informants from national level, three regions (Amhara, Oromia and Gambela), and one administrative city (Addis Ababa) in Ethiopia, participated in the study from March to April 2023. Key informants were identified using a snowballing approach. This study received ethical approval from the London School of Hygiene and Tropical Medicine and the Ethiopian Public Health Institute ethical review boards. There is a strong demand for effective coverage measurement for decision making on health care quality in the Ethiopian health sector. The demand is characterised either for individual patient care or for tracking health system performance; currently, there is limited clarity on the distinction between these two needs. A strong sentiment exists for the use of routine health information system data for this purpose, although stakeholders acknowledge the limitations of this data source. To advance the effective coverage measurement agenda in Ethiopia, respondents recommend building confidence in the quality of data sources, the need for more guidance on how to generate effective coverage measures, and the need for government leadership to coordinate these efforts. The strong demand for effective coverage measures and the positive policy environment encourages further testing of effective coverage measurement in Ethiopia.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140739861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Ramaiya, K. Mmari, Ana Luiza Borges, Christiane Cabral, E. Mafuta, Aimee Lulebo, Chunyan Yu, A. W. Pinandari, S. Wilopo, E. Chipeta, Kara Hunersen
The number of studies examining family, community, institutional and policy factors on COVID-19 vaccine perceptions is limited, with most concentrating on high-income countries and using predominantly quantitative methods. To address this gap, the goal of this manuscript is to qualitatively explore these factors and how they shape adolescents’ perspectives on COVID-19 vaccines across diverse contexts. Focus group discussions were conducted among adolescent populations (13 - 18 years) across seven countries: Ghent, Belgium; Sao Paulo, Brazil, Shanghai; China, Kinshasa, Democratic Republic of Congo (DRC); Semarang and Denpasar, Indonesia; Blantyre, Malawi and New Orleans, United States of America (USA). An inductive thematic analytical approach was used to understand the emerging themes across the different countries based on the study’s objectives. The study found that all influences were inter-connected and contributed towards vaccine perceptions among adolescents, which were largely positive except in the two African countries and to an extent in the USA. Family and community influences played a large role in vaccine perceptions, however, this differed by context. Our findings suggest adolescents’ perceptions about vaccines were more positive in countries with higher vaccination rates, i.e. China and Indonesia versus countries with lower vaccination rates i.e. Malawi and DRC. Vaccine mandates within schools, offices, and public places were also discussed with varying perceptions based on government trust. Adolescents’ perceptions of the Covid-19 vaccine are based on a variety of elements, such as families, community, institutions, and policies. Prioritizing one or another path may not be sufficient to improve vaccine adherence during future pandemics, as we experienced with Covid-19. Strategies to make vaccine perceptions more positive among urban poor adolescents should address both family and community perceptions. However, policies and robust programs around immunization are still needed.
{"title":"Understanding how socioecological factors affect COVID-19 vaccine perceptions among adolescents: qualitative evidence from seven high-, middle- and low-income countries","authors":"A. Ramaiya, K. Mmari, Ana Luiza Borges, Christiane Cabral, E. Mafuta, Aimee Lulebo, Chunyan Yu, A. W. Pinandari, S. Wilopo, E. Chipeta, Kara Hunersen","doi":"10.29392/001c.94937","DOIUrl":"https://doi.org/10.29392/001c.94937","url":null,"abstract":"The number of studies examining family, community, institutional and policy factors on COVID-19 vaccine perceptions is limited, with most concentrating on high-income countries and using predominantly quantitative methods. To address this gap, the goal of this manuscript is to qualitatively explore these factors and how they shape adolescents’ perspectives on COVID-19 vaccines across diverse contexts. Focus group discussions were conducted among adolescent populations (13 - 18 years) across seven countries: Ghent, Belgium; Sao Paulo, Brazil, Shanghai; China, Kinshasa, Democratic Republic of Congo (DRC); Semarang and Denpasar, Indonesia; Blantyre, Malawi and New Orleans, United States of America (USA). An inductive thematic analytical approach was used to understand the emerging themes across the different countries based on the study’s objectives. The study found that all influences were inter-connected and contributed towards vaccine perceptions among adolescents, which were largely positive except in the two African countries and to an extent in the USA. Family and community influences played a large role in vaccine perceptions, however, this differed by context. Our findings suggest adolescents’ perceptions about vaccines were more positive in countries with higher vaccination rates, i.e. China and Indonesia versus countries with lower vaccination rates i.e. Malawi and DRC. Vaccine mandates within schools, offices, and public places were also discussed with varying perceptions based on government trust. Adolescents’ perceptions of the Covid-19 vaccine are based on a variety of elements, such as families, community, institutions, and policies. Prioritizing one or another path may not be sufficient to improve vaccine adherence during future pandemics, as we experienced with Covid-19. Strategies to make vaccine perceptions more positive among urban poor adolescents should address both family and community perceptions. However, policies and robust programs around immunization are still needed.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140735826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Einar B Thorsteinsson, Suzanne M Cosh, Natasha M. Loi
In response to the COVID-19 pandemic, nations around the world introduced a range of behavioural interventions and restrictions in order to manage the spread of the virus. These included social distancing, lockdowns, and use of personal protective equipment, amongst others. The aim of the present paper is to examine some of the effects of these interventions on the psychological wellbeing and mental health of older adults, especially those with hearing loss. The present review focused on published peer reviewed studies focusing on older adults. Search engines included Google Scholar, SpringerLink Journals, ProQuest Central, and PubMed employing different combinations of search terms such as “COVID-19”, “older adults”, and “isolation”. Older adults were at risk of experiencing increased anxiety and depression and poorer wellbeing during lockdowns across nations, with those self-reporting loneliness reporting more severe symptomatology. Reductions in wellbeing were observed both amongst community-dwelling older adults and those living in residential care facilities. Use of personal protective equipment, especially masks, and social distancing requirements impacted communication amongst older adults with hearing loss, with this subgroup reporting increased depression, anxiety, and stress, with symptoms increasing with the severity of the hearing loss. While technology can help to mitigate the impacts of lockdowns and restrictions, limited access to devices and a range of challenges in upskilling older adults has impacted the utility of these technologies for promoting wellbeing. Education and training in the use of technologies and digital devices for both older adults and families might assist in promoting wellbeing, with increased accessibility needed in aged care facilities to further support the wellbeing of residents.
为应对 COVID-19 大流行，世界各国采取了一系列行为干预和限制措施，以控制病毒的传播。这些措施包括社会隔离、封锁和使用个人防护设备等。本文旨在研究这些干预措施对老年人，尤其是听力受损的老年人的心理健康和精神健康的一些影响。本综述侧重于已发表的、经同行评审的、以老年人为重点的研究。搜索引擎包括 Google Scholar、SpringerLink Journals、ProQuest Central 和 PubMed，并使用了不同的搜索词组合，如 "COVID-19"、"老年人 "和 "隔离"。在各国的封锁期间，老年人的焦虑和抑郁情绪有可能加重，幸福感也会降低，而那些自我报告有孤独感的老年人的症状会更严重。在社区居住的老年人和居住在养老院的老年人中都观察到了幸福感下降的情况。个人防护设备（尤其是口罩）的使用和社交距离的要求影响了有听力损失的老年人之间的交流，这部分人的抑郁、焦虑和压力都有所增加，症状随着听力损失的严重程度而加重。虽然技术可以帮助减轻封锁和限制的影响，但由于获取设备的途径有限，以及在提高老年人技能方面的一系列挑战，这些技术在促进福祉方面的效用受到了影响。对老年人和家庭进行使用技术和数字设备的教育和培训可能有助于促进福祉，同时需要增加老年护理设施的无障碍性，以进一步支持居民的福祉。
{"title":"Older individuals and preventative behavioural interventions for COVID-19: a scoping review and perspective on wellbeing","authors":"Einar B Thorsteinsson, Suzanne M Cosh, Natasha M. Loi","doi":"10.29392/001c.94210","DOIUrl":"https://doi.org/10.29392/001c.94210","url":null,"abstract":"In response to the COVID-19 pandemic, nations around the world introduced a range of behavioural interventions and restrictions in order to manage the spread of the virus. These included social distancing, lockdowns, and use of personal protective equipment, amongst others. The aim of the present paper is to examine some of the effects of these interventions on the psychological wellbeing and mental health of older adults, especially those with hearing loss. The present review focused on published peer reviewed studies focusing on older adults. Search engines included Google Scholar, SpringerLink Journals, ProQuest Central, and PubMed employing different combinations of search terms such as “COVID-19”, “older adults”, and “isolation”. Older adults were at risk of experiencing increased anxiety and depression and poorer wellbeing during lockdowns across nations, with those self-reporting loneliness reporting more severe symptomatology. Reductions in wellbeing were observed both amongst community-dwelling older adults and those living in residential care facilities. Use of personal protective equipment, especially masks, and social distancing requirements impacted communication amongst older adults with hearing loss, with this subgroup reporting increased depression, anxiety, and stress, with symptoms increasing with the severity of the hearing loss. While technology can help to mitigate the impacts of lockdowns and restrictions, limited access to devices and a range of challenges in upskilling older adults has impacted the utility of these technologies for promoting wellbeing. Education and training in the use of technologies and digital devices for both older adults and families might assist in promoting wellbeing, with increased accessibility needed in aged care facilities to further support the wellbeing of residents.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140256717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Water is one of the social determinants of health and a key factor towards improving health outcomes and inequalities. Access to safe and adequate water has been identified as an essential component for protecting, maintaining and promoting public health and reducing the total burden of diseases. Though India has made substantial progress in increasing access to safe drinking water in rural areas through household tap connections, there is a lack of contemporary evidence reflecting the progress achieved so far. A desk review of India’s schemes, programmes, and policies on access to drinking water was undertaken for review. Programme and policy documents from various central government websites such as the Ministry of Jal Shakti, Department of Drinking Water and Sanitation, Jal Jeevan Mission, and Central Water Commission websites were reviewed. The paper focuses on the recently launched Jal Jeevan Mission (JJM) in addressing the identified gaps of the former initiatives in rural areas. The broad vision of JJM also aims to reduce the incidence of acute diarrhoeal diseases. It was found that with the launch of JJM in 2019, tap water connections in rural households have increased from 16.69% (2019) to 62.79% (2023). The Government of India (GoI)’s commitment and citizen-centric approach to decentralised governance in providing safe drinking water to all is reflected in the financial allocations made under the JJM to states and fifteen finance commission (FC-XV) grants. The review highlights the need for intersectoral coordination across the levels to realise better results and health outcomes.
{"title":"Water as a social determinant of health: bringing policies into action","authors":"Vikas Sheel, A. Kotwal, Neha Dumka, Vineeta Sharma, Rajnesh Kumar, Vidhi Tyagi","doi":"10.29392/001c.92160","DOIUrl":"https://doi.org/10.29392/001c.92160","url":null,"abstract":"Water is one of the social determinants of health and a key factor towards improving health outcomes and inequalities. Access to safe and adequate water has been identified as an essential component for protecting, maintaining and promoting public health and reducing the total burden of diseases. Though India has made substantial progress in increasing access to safe drinking water in rural areas through household tap connections, there is a lack of contemporary evidence reflecting the progress achieved so far. A desk review of India’s schemes, programmes, and policies on access to drinking water was undertaken for review. Programme and policy documents from various central government websites such as the Ministry of Jal Shakti, Department of Drinking Water and Sanitation, Jal Jeevan Mission, and Central Water Commission websites were reviewed. The paper focuses on the recently launched Jal Jeevan Mission (JJM) in addressing the identified gaps of the former initiatives in rural areas. The broad vision of JJM also aims to reduce the incidence of acute diarrhoeal diseases. It was found that with the launch of JJM in 2019, tap water connections in rural households have increased from 16.69% (2019) to 62.79% (2023). The Government of India (GoI)’s commitment and citizen-centric approach to decentralised governance in providing safe drinking water to all is reflected in the financial allocations made under the JJM to states and fifteen finance commission (FC-XV) grants. The review highlights the need for intersectoral coordination across the levels to realise better results and health outcomes.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140256731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Natalie Anumolu, Matida Bojang, Pius Mulamira, C. Jankowski, Kia Lechleitner, Sarah Abunike, Simon Kasasa, R. Lukande, N. Niyonzima, K. Beyer
Cancer is increasingly diagnosed in Africa, with more than one million new diagnoses annually. In Uganda, the Uganda Cancer Institute (UCI) is the primary cancer care facility, with patients travelling long distances to this facility to receive care. During the COVID-19 pandemic, cancer care was disrupted on several levels, including prevention, screening, diagnosis, treatment, and follow-up. National lockdowns impeded patient access to UCI and halted cancer screening. This study used qualitative interviews to obtain primary data from professionals working at UCI. Interviews were conducted from April 2022 to January 2023. KI (key informants) ’s were purposively selected, identified by colleagues at UCI and recruited through email and WhatsApp messaging. Verbal consent was obtained. Thirty to 60-minute open-ended interviews conducted virtually and in person were audio recorded and transcribed verbatim. Transcripts were coded via MAXQDA software and analyzed to identify themes. Thematic analysis revealed three major challenges to cancer care during COVID-19. First, UCI experienced logistical barriers such as travel restrictions, staff shortages, and insufficient protective gear. Second, staff adapted to the inflexible national lockdown policy for chronic health care with modifications to treatment regimens. Third, KI reported a significant mental health burden and reflected on how care should be improved. As colleagues got infected, UCI staff organized their training, discussed treatment plans with colleagues, and continued to care for patients at personal risk. Resilience characterized UCI’s response to COVID-19. They adapted treatment protocols to their setting, many of which remain the standard of care today. At the same time, there is a need for capacity building tailored to the Ugandan context to provide cancer care effectively in case of another pandemic.
{"title":"The double burden of COVID-19 and cancer at the Uganda Cancer Institute","authors":"Natalie Anumolu, Matida Bojang, Pius Mulamira, C. Jankowski, Kia Lechleitner, Sarah Abunike, Simon Kasasa, R. Lukande, N. Niyonzima, K. Beyer","doi":"10.29392/001c.92052","DOIUrl":"https://doi.org/10.29392/001c.92052","url":null,"abstract":"Cancer is increasingly diagnosed in Africa, with more than one million new diagnoses annually. In Uganda, the Uganda Cancer Institute (UCI) is the primary cancer care facility, with patients travelling long distances to this facility to receive care. During the COVID-19 pandemic, cancer care was disrupted on several levels, including prevention, screening, diagnosis, treatment, and follow-up. National lockdowns impeded patient access to UCI and halted cancer screening. This study used qualitative interviews to obtain primary data from professionals working at UCI. Interviews were conducted from April 2022 to January 2023. KI (key informants) ’s were purposively selected, identified by colleagues at UCI and recruited through email and WhatsApp messaging. Verbal consent was obtained. Thirty to 60-minute open-ended interviews conducted virtually and in person were audio recorded and transcribed verbatim. Transcripts were coded via MAXQDA software and analyzed to identify themes. Thematic analysis revealed three major challenges to cancer care during COVID-19. First, UCI experienced logistical barriers such as travel restrictions, staff shortages, and insufficient protective gear. Second, staff adapted to the inflexible national lockdown policy for chronic health care with modifications to treatment regimens. Third, KI reported a significant mental health burden and reflected on how care should be improved. As colleagues got infected, UCI staff organized their training, discussed treatment plans with colleagues, and continued to care for patients at personal risk. Resilience characterized UCI’s response to COVID-19. They adapted treatment protocols to their setting, many of which remain the standard of care today. At the same time, there is a need for capacity building tailored to the Ugandan context to provide cancer care effectively in case of another pandemic.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139528612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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