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":"102 4","pages":""},"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":"20 1","pages":""},"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}
This article describes the conceptual and methodological foundation of community-supported chronic disease management. A community-supported approach recognizes the diversity of community residents’ participation outcomes and attempts to maximize self-mobilization to manage chronic diseases in community settings. This paper argues that incorporating ethnographic research to understand a community holistically and promoting an inclusive community organization through a systematic approach has the potential to facilitate community support and improve sustainability in chronic disease management in resource-limited settings.
{"title":"Developing conceptual framework and methodological considerations in community-supported chronic disease management","authors":"Abdullah Noor","doi":"10.29392/001c.117342","DOIUrl":"https://doi.org/10.29392/001c.117342","url":null,"abstract":"This article describes the conceptual and methodological foundation of community-supported chronic disease management. A community-supported approach recognizes the diversity of community residents’ participation outcomes and attempts to maximize self-mobilization to manage chronic diseases in community settings. This paper argues that incorporating ethnographic research to understand a community holistically and promoting an inclusive community organization through a systematic approach has the potential to facilitate community support and improve sustainability in chronic disease management in resource-limited settings.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":"34 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140979213","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":"49 215","pages":""},"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":"102 s4","pages":""},"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}
Abdulrahman H Balkhoyor, M. Algamdi, Mahmoud S Alyamany, Norah S Bin Saad, Hani Lababidi, Mohammed A Hussein, Ayman M Kharaba, M. Almaani
COVID-19 pandemic curfew made it difficult for families to communicate with their loved ones while hospitalized in the intensive care unit (ICU). A hybrid telephone and video conferencing model (VC) was created as a method of communication. This study aims to assess the satisfaction of critically ill non-COVID-19 patients and their families with VC as a mean of communication during the curfew. A prospective observational study was conducted in two academic hospitals. Family visits were replaced by VC during the curfew and visitation restriction. To assess the satisfaction with VC, families were surveyed twice while patients were surveyed once during the ICU admission. Among 81 family representatives initially surveyed, 26 (32.1%) underwent a follow-up survey. On a scale of 1-10, high general satisfaction was reported by family representatives in the initial and follow-up surveys (8.68 ± 1.66 and 8.31 ± 1.89, respectively). General satisfaction of 9.64 ± 0.67 was reported by the patients who were surveyed during their ICU admission (n=11). Higher patient’s Glasgow Coma Scale at the time of VC and increased number of VC sessions were associated with higher family satisfaction (P=0.001 and P=0.019, respectively). Among family representatives, more than 70% preferred video conferencing over traditional means of communication during the curfew. Family representatives and their critically ill non-COVID-19 patients were highly satisfied with video conferencing as a mean of communication during the curfew and visiting restriction. Video conferencing offers a great way of communication during pandemics, such as COVID-19.
{"title":"Utilizing video conferencing with families of critically ill non-COVID-19 patients during the pandemic curfew","authors":"Abdulrahman H Balkhoyor, M. Algamdi, Mahmoud S Alyamany, Norah S Bin Saad, Hani Lababidi, Mohammed A Hussein, Ayman M Kharaba, M. Almaani","doi":"10.29392/001c.94933","DOIUrl":"https://doi.org/10.29392/001c.94933","url":null,"abstract":"COVID-19 pandemic curfew made it difficult for families to communicate with their loved ones while hospitalized in the intensive care unit (ICU). A hybrid telephone and video conferencing model (VC) was created as a method of communication. This study aims to assess the satisfaction of critically ill non-COVID-19 patients and their families with VC as a mean of communication during the curfew. A prospective observational study was conducted in two academic hospitals. Family visits were replaced by VC during the curfew and visitation restriction. To assess the satisfaction with VC, families were surveyed twice while patients were surveyed once during the ICU admission. Among 81 family representatives initially surveyed, 26 (32.1%) underwent a follow-up survey. On a scale of 1-10, high general satisfaction was reported by family representatives in the initial and follow-up surveys (8.68 ± 1.66 and 8.31 ± 1.89, respectively). General satisfaction of 9.64 ± 0.67 was reported by the patients who were surveyed during their ICU admission (n=11). Higher patient’s Glasgow Coma Scale at the time of VC and increased number of VC sessions were associated with higher family satisfaction (P=0.001 and P=0.019, respectively). Among family representatives, more than 70% preferred video conferencing over traditional means of communication during the curfew. Family representatives and their critically ill non-COVID-19 patients were highly satisfied with video conferencing as a mean of communication during the curfew and visiting restriction. Video conferencing offers a great way of communication during pandemics, such as COVID-19.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":"9 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140735816","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":"31 10","pages":""},"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":"34 1","pages":""},"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":"104 3","pages":""},"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}
D. Zaake, D. Amongin, L. Beňová, S. Kiwanuka, C. Nalwadda, Mary Nakafeero, Sara Riese, Anthony Kayiira, A. Asefa
Low- and middle-income countries, particularly in the African region in-country distribution and determinants of infertility are understudied. In this study, we aimed to estimate the prevalence, regional distribution, and determinants of infertility in Uganda to inform programming. We estimated the prevalence of primary and secondary infertility among women aged 20-49 years using data from the three rounds of the Uganda Demographic and Health Survey 2006, 2011, and 2016, and compared the differences across geographic regions. We pooled data sets for all three years and conducted logistic regression to identify factors associated with infertility. We included 16,537 women aged 20-49 years for analysis of primary infertility and 12,628 for secondary infertility. The overall prevalence of infertility (pooled across the three surveys was 6.4%. The prevalence of primary infertility was 1.4% (95% Confidence interval, CI=1.0-1.8), 0.7% (95% CI=0.5-1.0) and 0.8% (95% CI=0.6-1.0) in 2006, 2011 and 2016, respectively. The prevalence of secondary infertility was 7.4% (95% CI=6.5-8.4), 6.9% (95% CI=5.9-8.0) and 7.1% (95% CI=6.4-7.9) in 2006, 2011, and 2016 respectively. The prevalence of primary infertility was similar across regions. Secondary infertility was highest in the Central (7.9%, 95% CI= 6.1-10.3, in 2016) and Northern regions (7.4%, 95% CI=6.1-8.9, in 2016). In all survey years, women with higher education had lower odds of secondary infertility compared to women with no education (adjusted odds ratio, aOR=0.54, 95% CI=0.35-0.83; P < 0.001). Our results suggest that the prevalence of primary infertility is similar across regions, whereas secondary infertility varies by region, with higher prevalence in Central and Northern regions. More research is required to understand the drivers behind the variation of secondary infertility across regions to inform policy and decision making.
{"title":"Prevalence, regional distribution, and determinants of infertility in Uganda between 2006 and 2016: analysis of three Demographic and Health Surveys","authors":"D. Zaake, D. Amongin, L. Beňová, S. Kiwanuka, C. Nalwadda, Mary Nakafeero, Sara Riese, Anthony Kayiira, A. Asefa","doi":"10.29392/001c.94212","DOIUrl":"https://doi.org/10.29392/001c.94212","url":null,"abstract":"Low- and middle-income countries, particularly in the African region in-country distribution and determinants of infertility are understudied. In this study, we aimed to estimate the prevalence, regional distribution, and determinants of infertility in Uganda to inform programming. We estimated the prevalence of primary and secondary infertility among women aged 20-49 years using data from the three rounds of the Uganda Demographic and Health Survey 2006, 2011, and 2016, and compared the differences across geographic regions. We pooled data sets for all three years and conducted logistic regression to identify factors associated with infertility. We included 16,537 women aged 20-49 years for analysis of primary infertility and 12,628 for secondary infertility. The overall prevalence of infertility (pooled across the three surveys was 6.4%. The prevalence of primary infertility was 1.4% (95% Confidence interval, CI=1.0-1.8), 0.7% (95% CI=0.5-1.0) and 0.8% (95% CI=0.6-1.0) in 2006, 2011 and 2016, respectively. The prevalence of secondary infertility was 7.4% (95% CI=6.5-8.4), 6.9% (95% CI=5.9-8.0) and 7.1% (95% CI=6.4-7.9) in 2006, 2011, and 2016 respectively. The prevalence of primary infertility was similar across regions. Secondary infertility was highest in the Central (7.9%, 95% CI= 6.1-10.3, in 2016) and Northern regions (7.4%, 95% CI=6.1-8.9, in 2016). In all survey years, women with higher education had lower odds of secondary infertility compared to women with no education (adjusted odds ratio, aOR=0.54, 95% CI=0.35-0.83; P < 0.001). Our results suggest that the prevalence of primary infertility is similar across regions, whereas secondary infertility varies by region, with higher prevalence in Central and Northern regions. More research is required to understand the drivers behind the variation of secondary infertility across regions to inform policy and decision making.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":"149 S294","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140256629","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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