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Sample records for health related facilities

  1. Health seeking behaviour and utilization of health facilities for schistosomiasis-related symptoms in ghana.

    Directory of Open Access Journals (Sweden)

    Anthony Danso-Appiah

    Full Text Available BACKGROUND: Schistosomiasis causes long-term illness and significant economic burden. Morbidity control through integration within existing health care delivery systems is considered a potentially sustainable and cost-effective approach, but there is paucity of information about health-seeking behaviour. METHODS: A questionnaire-based study involving 2,002 subjects was conducted in three regions of Ghana to investigate health-seeking behaviour and utilization of health facilities for symptoms related to urinary (blood in urine and painful urination and intestinal schistosomiasis (diarrhea, blood in stool, swollen abdomen and abdominal pain. Fever (for malaria was included for comparison. RESULTS: Only 40% of patients with urinary symptoms sought care compared to >70% with intestinal symptoms and >90% with fever. Overall, about 20% of schistosomiasis-related symptoms were reported to a health facility (hospital or clinic, compared to about 30% for fever. Allopathic self-medication was commonly practiced as alternative action. Health-care seeking was relatively lower for patients with chronic symptoms, but if they took action, they were more likely to visit a health facility. In a multivariate logistic regression analysis, perceived severity was the main predictor for seeking health care or visiting a health facility. Age, socio-economic status, somebody else paying for health care, and time for hospital visit occasionally showed a significant impact, but no clear trend. The effect of geographic location was less marked, although people in the central region, and to a lesser extent the north, were usually less inclined to seek health care than people in the south. Perceived quality of health facility did not demonstrate impact. CONCLUSION: Perceived severity of the disease is the most important determinant of seeking health care or visiting a health facility in Ghana. Schistosomiasis control by passive case-finding within the regular health care

  2. Health Facilities

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    Health facilities are places that provide health care. They include hospitals, clinics, outpatient care centers, and specialized care centers, such as birthing centers and psychiatric care centers. When you ...

  3. Determining health-care facility catchment areas in Uganda using data on malaria-related visits.

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    Zinszer, Kate; Charland, Katia; Kigozi, Ruth; Dorsey, Grant; Kamya, Moses R; Buckeridge, David L

    2014-03-01

    To illustrate the use of a new method for defining the catchment areas of health-care facilities based on their utilization. The catchment areas of six health-care facilities in Uganda were determined using the cumulative case ratio: the ratio of the observed to expected utilization of a facility for a particular condition by patients from small administrative areas. The cumulative case ratio for malaria-related visits to these facilities was determined using data from the Uganda Malaria Surveillance Project. Catchment areas were also derived using various straight line and road network distances from the facility. Subsequently, the 1-year cumulative malaria case rate was calculated for each catchment area, as determined using the three methods. The 1-year cumulative malaria case rate varied considerably with the method used to define the catchment areas. With the cumulative case ratio approach, the catchment area could include noncontiguous areas. With the distance approaches, the denominator increased substantially with distance, whereas the numerator increased only slightly. The largest cumulative case rate per 1000 population was for the Kamwezi facility: 234.9 (95% confidence interval, CI: 226.2-243.8) for a straight-line distance of 5 km, 193.1 (95% CI: 186.8-199.6) for the cumulative case ratio approach and 156.1 (95% CI: 150.9-161.4) for a road network distance of 5 km. Use of the cumulative case ratio for malaria-related visits to determine health-care facility catchment areas was feasible. Moreover, this approach took into account patients' actual addresses, whereas using distance from the facility did not.

  4. Perception and prevalence of work-related health hazards among health care workers in public health facilities in southern India

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    Senthil, Arasi; Anandh, Balasubramanian; Jayachandran, Palsamy; Thangavel, Gurusamy; Josephin, Diana; Yamini, Ravindran; Kalpana, Balakrishnan

    2015-01-01

    Background: Health care workers (HCWs) are exposed to occupational related health hazards. Measuring worker perception and the prevalence of these hazards can help facilitate better risk management for HCWs, as these workers are envisaged to be the first point of contact, especially in resource poor settings. Objective: To describe the perception of occupational health hazards and self-reported exposure prevalence among HCWs in Southern India. Methods: We used cross sectional design with stratified random sampling of HCWs from different levels of health facilities and categories in a randomly selected district in Southern India. Data on perception and exposure prevalence were collected using a structured interview schedule developed by occupational health experts and administered by trained investigators. Results: A total of 482 HCWs participated. Thirty nine percent did not recognize work-related health hazards, but reported exposure to at least one hazard upon further probing. Among the 81·5% who reported exposure to biological hazard, 93·9% had direct skin contact with infectious materials. Among HCWs reporting needle stick injury, 70·5% had at least one in the previous three months. Ergonomic hazards included lifting heavy objects (42%) and standing for long hours (37%). Psychological hazards included negative feelings (20·3%) and verbal or physical abuse during work (20·5%). Conclusion: More than a third of HCWs failed to recognize work-related health hazards. Despite training in handling infectious materials, HCWs reported direct skin contact with infectious materials and needle stick injuries. Results indicate the need for training oriented toward behavioral change and provision of occupational health services. PMID:25482656

  5. Health seeking behaviour and utilization of health facilities for schistosomiasis-related symptoms in ghana

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    D. Danso-Appiah (Anthony); W.A. Stolk (Wilma); K.M. Bosompem (Kwabena); J. Otchere (Joseph); C.W.N. Looman (Caspar); J.D.F. Habbema (Dik); S.J. de Vlas (Sake)

    2010-01-01

    textabstractBackground: Schistosomiasis causes long-term illness and significant economic burden. Morbidity control through integration within existing health care delivery systems is considered a potentially sustainable and cost-effective approach, but there is paucity of information about health-s

  6. Assessment of the degree of adherence to health facility indicators related to rational drug use in Selected Health Facilities of Amhara Region, Northwest Ethiopia

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    Wubante Demilew Nigussie

    2014-04-01

    Full Text Available Purpose: The purpose of this study was to assess the degree of adherence of health care facility to World Health Organization health facility indicators in selected health care facilities of Amhara Region, Northwest Ethiopia. Methods: A cross sectional study was conducted among randomly selected health care facilities of Amhara region from March 01 to 15, 2014. Data was collected by interview and observation using structured questionnaire and check list respectively. Ethical clearance was obtained from the ethics review committee of Amhara regional state health bureau. The data was checked for completeness and consistency, cleared, coded, and entry and analysis was done by using SPSS (version 16. Results: The percentage availability of key essential drugs was found to be 73.05%, availability of Essential Drug List (EDL, Standard Treatment Guidelines (STG, drug formulary and average stock out duration were 75%, 87.5% 75% and 34 days respectively. Conclusion: The study revealed that evaluation of the patterns of drug use based on World Health Organization (WHO facility indicators was not satisfactory. So there is a need for managerial and educational intervention to improve rational drug use and thereby need to improve’ availability of essential drug list, standard treatment guidelines, drug formulary in order to access unbiased information for health care providers and also to prevent stock out of key essential drugs.

  7. Exposures and health outcomes in relation to bioaerosol emissions from composting facilities: a systematic review of occupational and community studies.

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    Pearson, Clare; Littlewood, Emma; Douglas, Philippa; Robertson, Sarah; Gant, Timothy W; Hansell, Anna L

    2015-01-01

    The number of composting sites in Europe is rapidly increasing, due to efforts to reduce the fraction of waste destined for landfill, but evidence on possible health impacts is limited. This article systematically reviews studies related to bioaerosol exposures within and near composting facilities and associated health effects in both community and occupational health settings. Six electronic databases and bibliographies from January 1960 to July 2014 were searched for studies reporting on health outcomes and/or bioaerosol emissions related to composting sites. Risk of bias was assessed using a customized score. Five hundred and thirty-six papers were identified and reviewed, and 66 articles met the inclusion criteria (48 exposure studies, 9 health studies, 9 health and exposure studies). Exposure information was limited, with most measurements taken in occupational settings and for limited time periods. Bioaerosol concentrations were highest on-site during agitation activities (turning, shredding, and screening). Six studies detected concentrations of either Aspergillus fumigatus or total bacteria above the English Environment Agency's recommended threshold levels beyond 250 m from the site. Occupational studies of compost workers suggested elevated risks of respiratory illnesses with higher bioaerosol exposures. Elevated airway irritation was reported in residents near composting sites, but this may have been affected by reporting bias. The evidence base on health effects of bioaerosol emissions from composting facilities is still limited, although there is sufficient evidence to support a precautionary approach for regulatory purposes. While data to date are suggestive of possible respiratory effects, further study is needed to confirm this and to explore other health outcomes.

  8. Mental Health Treatement Facilities Locator

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    U.S. Department of Health & Human Services — An online resource for locating mental health treatment facilities and programs supported by the Substance Abuse and Mental Health Services Administration (SAMHSA)....

  9. Teale Health Facilities

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    California Department of Resources — California Spatial Information System (CaSIL) is a project designed to improve access to geo-spatial and geo-spatial related data information throughout the state of...

  10. Perceived mental health related stigma, gender, and depressive symptom severity in a psychiatric facility in South India.

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    Kulesza, Magdalena; Raguram, R; Rao, Deepa

    2014-06-01

    Few studies exist on the topic of gender associated with depression and mental health-related stigma coming out of non-Western countries such as India. We aimed to add to the literature by assessing these relationships among adults seeking psychiatric services in India. Participants were 60 individuals seeking care at a psychiatric clinic in Bangalore, India. The majority of participants were female with a mean age of 36 years (SD=9.75). Contrary to our prediction, there were no significant differences between men (M=28.96; SD=9.85) and women (M=33.03; SD=12.08) on depression severity, t(58)=1.42, p=.16. Yet, women (M=10.09, SD=8.23) reported significantly more perceived stigma than men (M=5.79, SD=5.86), t(58)=2.30, p=.02. While men and women seeking psychiatric services at the psychiatric clinic in India report similar levels of depression severity, women reported more perceived mental illness stigma. Having experienced regular forms of discrimination associated with female status in India, it may be the case that women are more attuned to other forms of stigma, such as mental health stigma investigated in the present study. Given the detrimental impact of stigma on treatment adherence and engagement in care, additional research is needed support this work, including research on interventions to reduce stigma and improve engagement in care. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Environmental assessment for the decommissioning and decontamination of contaminated facilities at the Laboratory for Energy-Related Health Research University of California, Davis

    Energy Technology Data Exchange (ETDEWEB)

    1992-09-01

    The Laboratory for Energy-Related Health Research (LEHR) was established in 1958 at its present location by the Atomic Energy Commission. Research at LEHR originally focused on the health effects from chronic exposures to radionuclides, primarily strontium 90 and radium 226, using beagles to simulate radiation effects on humans. In 1988, pursuant to a memorandum of agreement between the US Department of Energy (DOE) and the University of California, DOE`s Office of Energy Research decided to close out the research program, shut down LEHR, and turn the facilities and site over to the University of California, Davis (UCD) after remediation. The decontamination and decommissioning (D&D) of LEHR will be managed by the San Francisco Operations Office (SF) under DOE`s Environmental Restoration Program. This environmental assessment (EA) addresses the D&D of four site buildings and a tank trailer, and the removal of the on-site cobalt 60 (Co-60) source. Future activities at the site will include D&D of the Imhoff building and the outdoor dog pens, and may include remediation of underground tanks, and the landfill and radioactive disposal trenches. The remaining buildings on the LEHR site are not contaminated. The environmental impacts of the future activities cannot be determined at this time because the extent of contamination has not yet been ascertained. The impacts of these future activities (including the cumulative impacts of the future activities and those addressed in this EA) will be addressed in future National Environmental Policy Act (NEPA) documentation.

  12. A brief, standardized tool for measuring HIV-related stigma among health facility staff: results of field testing in China, Dominica, Egypt, Kenya, Puerto Rico and St. Christopher & Nevis.

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    Nyblade, Laura; Jain, Aparna; Benkirane, Manal; Li, Li; Lohiniva, Anna-Leena; McLean, Roger; Turan, Janet M; Varas-Díaz, Nelson; Cintrón-Bou, Francheska; Guan, Jihui; Kwena, Zachary; Thomas, Wendell

    2013-11-13

    Within healthcare settings, HIV-related stigma is a recognized barrier to access of HIV prevention and treatment services and yet, few efforts have been made to scale-up stigma reduction programs in service delivery. This is in part due to the lack of a brief, simple, standardized tool for measuring stigma among all levels of health facility staff that works across diverse HIV prevalence, language and healthcare settings. In response, an international consortium led by the Health Policy Project, has developed and field tested a stigma measurement tool for use with health facility staff. Experts participated in a content-development workshop to review an item pool of existing measures, identify gaps and prioritize questions. The resulting questionnaire was field tested in six diverse sites (China, Dominica, Egypt, Kenya, Puerto Rico and St. Christopher & Nevis). Respondents included clinical and non-clinical staff. Questionnaires were self- or interviewer-administered. Analysis of item performance across sites examined both psychometric properties and contextual issues. The key outcome of the process was a substantially reduced questionnaire. Eighteen core questions measure three programmatically actionable drivers of stigma within health facilities (worry about HIV transmission, attitudes towards people living with HIV (PLHIV), and health facility environment, including policies), and enacted stigma. The questionnaire also includes one short scale for attitudes towards PLHIV (5-item scale, α=0.78). Stigma-reduction programmes in healthcare facilities are urgently needed to improve the quality of care provided, uphold the human right to healthcare, increase access to health services, and maximize investments in HIV prevention and treatment. This brief, standardized tool will facilitate inclusion of stigma measurement in research studies and in routine facility data collection, allowing for the monitoring of stigma within healthcare facilities and evaluation of

  13. A brief, standardized tool for measuring HIV-related stigma among health facility staff: results of field testing in China, Dominica, Egypt, Kenya, Puerto Rico and St. Christopher & Nevis

    Directory of Open Access Journals (Sweden)

    Laura Nyblade

    2013-11-01

    Full Text Available Introduction: Within healthcare settings, HIV-related stigma is a recognized barrier to access of HIV prevention and treatment services and yet, few efforts have been made to scale-up stigma reduction programs in service delivery. This is in part due to the lack of a brief, simple, standardized tool for measuring stigma among all levels of health facility staff that works across diverse HIV prevalence, language and healthcare settings. In response, an international consortium led by the Health Policy Project, has developed and field tested a stigma measurement tool for use with health facility staff. Methods: Experts participated in a content-development workshop to review an item pool of existing measures, identify gaps and prioritize questions. The resulting questionnaire was field tested in six diverse sites (China, Dominica, Egypt, Kenya, Puerto Rico and St. Christopher & Nevis. Respondents included clinical and non-clinical staff. Questionnaires were self- or interviewer-administered. Analysis of item performance across sites examined both psychometric properties and contextual issues. Results: The key outcome of the process was a substantially reduced questionnaire. Eighteen core questions measure three programmatically actionable drivers of stigma within health facilities (worry about HIV transmission, attitudes towards people living with HIV (PLHIV, and health facility environment, including policies, and enacted stigma. The questionnaire also includes one short scale for attitudes towards PLHIV (5-item scale, α = 0.78. Conclusions: Stigma-reduction programmes in healthcare facilities are urgently needed to improve the quality of care provided, uphold the human right to healthcare, increase access to health services, and maximize investments in HIV prevention and treatment. This brief, standardized tool will facilitate inclusion of stigma measurement in research studies and in routine facility data collection, allowing for the

  14. Optimization of preventive health care facility locations

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    McGregor S

    2010-03-01

    Full Text Available Abstract Background Preventive health care programs can save lives and contribute to a better quality of life by diagnosing serious medical conditions early. The Preventive Health Care Facility Location (PHCFL problem is to identify optimal locations for preventive health care facilities so as to maximize participation. When identifying locations for preventive health care facilities, we need to consider the characteristics of the preventive health care services. First, people should have more flexibility to select service locations. Second, each preventive health care facility needs to have a minimum number of clients in order to retain accreditation. Results This paper presents a new methodology for solving the PHCFL problem. In order to capture the characteristics of preventive health care services, we define a new accessibility measurement that combines the two-step floating catchment area method, distance factor, and the Huff-based competitive model. We assume that the accessibility of preventive health care services is a major determinant for participation in the service. Based on the new accessibility measurement, the PHCFL problem is formalized as a bi-objective model based on efficiency and coverage. The bi-objective model is solved using the Interchange algorithm. In order to accelerate the solving process, we implement the Interchange algorithm by building two new data structures, which captures the spatial structure of the PHCFL problem. In addition, in order to measure the spatial barrier between clients and preventive health care facilities accurately and dynamically, this paper estimates travelling distance and travelling time by calling the Google Maps Application Programming Interface (API. Conclusions Experiments based on a real application for the Alberta breast cancer screening program show that our work can increase the accessibility of breast cancer screening services in the province.

  15. Attributes and perspectives of public providers related to provision of medical abortion at public health facilities in Vietnam: a cross-sectional study in three provinces

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    Ngo TD

    2014-08-01

    Full Text Available Thoai D Ngo,1,2 Caroline Free,1 Hoan T Le,3 Phil Edwards,1 Kiet HT Pham,4 Yen BT Nguyen,4 Thang H Nguyen5 1Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK; 2Research, Monitoring and Evaluation Team, Health System Department, Marie Stopes International, London, UK; 3Department of Environmental Health, 4Department of Health Economics, Hanoi Medical University, 5Research and Metrics Team, Marie Stopes International Vietnam, Hanoi, Vietnam Background: The purpose of this study was to investigate attributes of public service providers associated with the provision of medical abortion in Vietnam. Methods: We conducted a cross-sectional study via interviewer-administered questionnaire among abortion providers from public health facilities in Hanoi, Khanh Hoa, and Ho Chi Minh City in Vietnam between August 2011 and January 2012. We recruited abortion providers at all levels of Vietnam's public health service delivery system. Participants were questioned about their medical abortion provision practices and perspectives regarding abortion methods. Results: A total of 905 providers from 62 health facilities were included, comprising 525 (58.0% from Hanoi, 122 (13.5% from Khanh Hoa, and 258 (28.5% from Ho Chi Minh City. The majority of providers were female (96.7%, aged ≥25 years (94%, married (84.4%, and had at least one child (89%; 68.9% of providers offered only manual vacuum aspiration and 31.1% performed both medical abortion and manual vacuum aspiration. Those performing both methods included physicians (74.5%, midwives (21.7%, and nurses (3.9%. Unadjusted analyses showed that female providers (odds ratio 0.1; 95% confidence interval 0.01–0.30 and providers in rural settings (odds ratio 0.3; 95% confidence interval 0.08–0.79 were less likely to provide medical abortion than their counterparts. Obstetricians and gynecologists were more likely to provide medical abortion than providers with

  16. TB in Correctional Facilities Is a Public Health Concern

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    ... this? Submit Button Past Emails CDC Features TB in Correctional Facilities is a Public Health Concern Recommend ... health concern. Figure 1 (larger view). TB Control in Correctional Facilities Diagnosing and treating TB in correctional ...

  17. Health facility committees and facility management - exploring the nature and depth of their roles in Coast Province, Kenya.

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    Goodman, Catherine; Opwora, Antony; Kabare, Margaret; Molyneux, Sassy

    2011-09-22

    Community participation has been emphasized internationally as a way of enhancing accountability, as well as a means to enhance health goals in terms of coverage, access and effective utilization. In rural health facilities in Kenya, initiatives to increase community accountability have focused on Health Facility Committees (HFCs). In Coast Province the role of HFCs has been expanded with the introduction of direct funding of rural facilities. We explored the nature and depth of managerial engagement of HFCs at the facility level in two rural districts in this Coastal setting, and how this has contributed to community accountability We conducted structured interviews with the health worker in-charge and with patients in 30 health centres and dispensaries. These data were supplemented with in-depth interviews with district managers, and with health workers and HFC members in 12 health centres and dispensaries. In-depth interviews with health workers and HFC members included a participatory exercise to stimulate discussion of the nature and depth of their roles in facility management. HFCs were generally functioning well and played an important role in facility operations. The breadth and depth of engagement had reportedly increased after the introduction of direct funding of health facilities which allowed HFCs to manage their own budgets. Although relations with facility staff were generally good, some mistrust was expressed between HFC members and health workers, and between HFC members and the broader community, partially reflecting a lack of clarity in HFC roles. Moreover, over half of exit interviewees were not aware of the HFC's existence. Women and less well-educated respondents were particularly unlikely to know about the HFC. There is potential for HFCs to play an active and important role in health facility management, particularly where they have control over some facility level resources. However, to optimise their contribution, efforts are needed to

  18. Health facility committees and facility management - exploring the nature and depth of their roles in Coast Province, Kenya

    Directory of Open Access Journals (Sweden)

    Kabare Margaret

    2011-09-01

    Full Text Available Abstract Background Community participation has been emphasized internationally as a way of enhancing accountability, as well as a means to enhance health goals in terms of coverage, access and effective utilization. In rural health facilities in Kenya, initiatives to increase community accountability have focused on Health Facility Committees (HFCs. In Coast Province the role of HFCs has been expanded with the introduction of direct funding of rural facilities. We explored the nature and depth of managerial engagement of HFCs at the facility level in two rural districts in this Coastal setting, and how this has contributed to community accountability Methods We conducted structured interviews with the health worker in-charge and with patients in 30 health centres and dispensaries. These data were supplemented with in-depth interviews with district managers, and with health workers and HFC members in 12 health centres and dispensaries. In-depth interviews with health workers and HFC members included a participatory exercise to stimulate discussion of the nature and depth of their roles in facility management. Results HFCs were generally functioning well and played an important role in facility operations. The breadth and depth of engagement had reportedly increased after the introduction of direct funding of health facilities which allowed HFCs to manage their own budgets. Although relations with facility staff were generally good, some mistrust was expressed between HFC members and health workers, and between HFC members and the broader community, partially reflecting a lack of clarity in HFC roles. Moreover, over half of exit interviewees were not aware of the HFC's existence. Women and less well-educated respondents were particularly unlikely to know about the HFC. Conclusions There is potential for HFCs to play an active and important role in health facility management, particularly where they have control over some facility level resources

  19. Health-related quality of life in HIV/AIDS patients on antiretroviral therapy at a tertiary care facility in Zimbabwe

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    Mafirakureva, N.; Dzingirai, B.; Postma, M. J.; van Hulst, M.; Khoza, S.

    2016-01-01

    Health-related quality of life (HRQoL) is a broad concept reflecting a patient's general subjective perception of the effect of an illness or intervention on physical, psychological and social aspects of their daily life. HRQoL among patients infected with HIV has become an important indicator of im

  20. Health maintenance facility: Dental equipment requirements

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    Young, John; Gosbee, John; Billica, Roger

    1991-01-01

    The objectives were to test the effectiveness of the Health Maintenance Facility (HMF) dental suction/particle containment system, which controls fluids and debris generated during simulated dental treatment, in microgravity; to test the effectiveness of fiber optic intraoral lighting systems in microgravity, while simulating dental treatment; and to evaluate the operation and function of off-the-shelf dental handheld instruments, namely a portable dental hand drill and temporary filling material, in microgravity. A description of test procedures, including test set-up, flight equipment, and the data acquisition system, is given.

  1. Western Canada study of animal health effects associated with exposure to emissions from oil and natural gas field facilities. Study design and data collection II. Location of study herds relative to the oil and gas industry in Western Canada.

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    Waldner, Cheryl L

    2008-01-01

    During the late part of 2000 and early months of 2001, project veterinarians recruited 205 beef herds to participate in a study of the effects of emissions from the upstream oil and gas industry on cattle reproduction and health. Researchers developed herd-selection criteria to optimize the range of exposure to facilities, including oil and gas wells, battery sites, and gas-gathering and gas-processing facilities across the major cattle-producing areas of Western Canada. Herds were initially selected on the basis of a ranking system of exposure potential on the basis of herd-owner reports of the locations of their operations in relation to oil and gas industry facilities. At the end of the study, researchers summarized data obtained from provincial regulatory agencies on facility location and reported flaring and venting volumes for each herd and compared these data to the original rankings of herd-exposure potential. Through this selection process, the researchers were successful in obtaining statistically significant differences in exposure to various types of oil and gas facility types and reported emissions among herds recruited for the study.

  2. Legionnaires' Disease: a Problem for Health Care Facilities

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    ... Clips Legionnaires’ Disease A problem for health care facilities Language: English (US) Español (Spanish) Recommend on ... drinking. Many people being treated at health care facilities, including long-term care facilities and hospitals, have ...

  3. Psychiatric and Medical Health Care Policies in Juvenile Detention Facilities

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    Pajer, Kathleen A.; Kelleher, Kelly; Gupta, Ravindra A.; Rolls, Jennifer; Gardner, William

    2007-01-01

    A study aims to examine the existing health care policies in U.S. juvenile detention centres. The results conclude that juvenile detention facilities have many shortfalls in providing care for adolescents, particularly mental health care.

  4. Oral health champions in long-term care facilities-a pilot study.

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    Amerine, Carol; Boyd, Linda; Bowen, Denise M; Neill, Karen; Johnson, Tara; Peterson, Teri

    2014-01-01

    This preintervention/postintervention pilot study examined impact of onsite support by a dental hygiene champion (DHC) on oral health and quality of life (QOL) of elderly residents in three long-term care facilities (LTCFs) in Arkansas. Oral health and oral health-related QOL were operationalized using the Oral Health Assessment Tool (OHAT) and Geriatric Oral Health Assessment Index (GOHAI), respectively. CNAs in Facility A received standardized oral health education/materials with onsite DHC support. Facility B received education/materials only. Facility C served as control. Data analyses included Wilcoxon-signed rank tests (OHAT) and repeated measures ANOVA (GOHAI) (p ≤ .05). OHAT postintervention data in Facility A showed significant improvements in three measured areas (tongue health, denture status, and oral cleanliness); in Facility B, one area (tongue health); and none in Facility C. No significant differences were found in GOHAI scores across facilities. Findings suggest that the presence of DHCs in LTCFs may positively impact the oral health of CNA-assisted residents.

  5. A qualitative study of patients' knowledge and views of about oral health and acceptability of related intervention in an Australian inpatient alcohol and drug treatment facility.

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    Cheah, Alison Li Sun; Pandey, Ram; Daglish, Mark; Ford, Pauline J; Patterson, Sue

    2017-01-20

    Social factors, health behaviours and the direct effects of substances contribute to the poor oral health and restricted access to dental services experienced by people who are dependent on drugs and/or alcohol. Admission for inpatient withdrawal management provides an opportunity for intervention to promote oral health but to be effective it must be acceptable to patients. To support intervention design, we examined patients' views about oral health, practices and treatment access, and appropriateness of health-promoting intervention in this context. Given paucity of knowledge in the area we employed a qualitative approach, data were collected in semi-structured interviews with inpatients of a public specialist alcohol and drug unit in Australia in September 2014. Analysis employed the framework approach. All 14 participants wanted 'good teeth' but few diligently attended to oral healthcare; most sought assistance only in emergencies. Participants' knowledge of services was limited and practical and affective barriers hindered access. With none recalling attention to oral health during admission, support was strong for incorporation of oral health in inpatient assessments. Participants wanted information about the impact of substances on oral health and oral hygiene practices provided in various formats, and facilitated referral to non-judgemental, affordable treatment. Patients regarded promotion of oral health in the inpatient context as important, relevant and acceptable. Support should respect the different knowledge, practices and motivations for oral health and recovery, of patients. Addressing practical and affective barriers to dental services will require collaboration between drug and alcohol and dental services, and this should be the focus of further research.

  6. Health Care Facilities Resilient to Climate Change Impacts

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    Jaclyn Paterson

    2014-12-01

    Full Text Available Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact health care facilities. Health care facilities will need to assess climate change risks and adopt adaptive management strategies to be resilient, but guidance tools are lacking. In this study, a toolkit was developed for health care facility officials to assess the resiliency of their facility to climate change impacts. A mixed methods approach was used to develop climate change resiliency indicators to inform the development of the toolkit. The toolkit consists of a checklist for officials who work in areas of emergency management, facilities management and health care services and supply chain management, a facilitator’s guide for administering the checklist, and a resource guidebook to inform adaptation. Six health care facilities representing three provinces in Canada piloted the checklist. Senior level officials with expertise in the aforementioned areas were invited to review the checklist, provide feedback during qualitative interviews and review the final toolkit at a stakeholder workshop. The toolkit helps health care facility officials identify gaps in climate change preparedness, direct allocation of adaptation resources and inform strategic planning to increase resiliency to climate change.

  7. Bypassing health facilities for childbirth: a multilevel study in three districts of Gujarat, India.

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    Salazar, Mariano; Vora, Kranti; Costa, Ayesha De

    2016-01-01

    Bypassing available facilities for childbirth has important implications for maternal health service delivery and human resources within a health system. The results are the additional expenses imposed on the woman and her family, as well as the inefficient use of health system resources. Bypassing often indicates a lack of confidence in the care provided by the facility nearest to the mother, which implies a level of dysfunctionality that the health system needs to address. Over the past decade, India has experienced a steep rise in the proportion of facility births. The initiation of programs promoting facility births resulted in a rise from 39% in 2005 to 85% in 2014. There have been no reports on bypassing facilities for childbirth from India. In the context of steeply rising facility births, it is important to quantify the occurrence of and study the relative contributions of maternal characteristics and facility functionality to bypassing. 1) To determine the extent of bypassing health facilities for childbirth among rural mothers in three districts of Gujarat, India, 2) to identify associations between the functionality of an obstetric care (OC) facility and it being bypassed, and 3) to assess the relative contribution of maternal and facility characteristics to bypassing. A cross-sectional survey of 166 public and private OC facilities reporting ≥30 births in the 3 months before the survey was conducted in three purposively selected districts (Dahod, Sabarkantha, and Surendranagar) in the state of Gujarat, India. Besides information on each facility, data from 946 women giving birth at these facilities were also gathered. Data were analyzed using a multilevel mixed-effects logistic regression model. Off all mothers, 37.7% bypassed their nearest facility for childbirth. After adjusting for maternal characteristics, for every one-unit increase in the facility's emergency obstetric care (EmOC) signal functions, the odds of bypassing a facility for childbirth

  8. Bypassing health facilities for childbirth: a multilevel study in three districts of Gujarat, India.

    Science.gov (United States)

    Salazar, Mariano; Vora, Kranti; De Costa, Ayesha

    2016-01-01

    Background Bypassing available facilities for childbirth has important implications for maternal health service delivery and human resources within a health system. The results are the additional expenses imposed on the woman and her family, as well as the inefficient use of health system resources. Bypassing often indicates a lack of confidence in the care provided by the facility nearest to the mother, which implies a level of dysfunctionality that the health system needs to address. Over the past decade, India has experienced a steep rise in the proportion of facility births. The initiation of programs promoting facility births resulted in a rise from 39% in 2005 to 85% in 2014. There have been no reports on bypassing facilities for childbirth from India. In the context of steeply rising facility births, it is important to quantify the occurrence of and study the relative contributions of maternal characteristics and facility functionality to bypassing. Objectives 1) To determine the extent of bypassing health facilities for childbirth among rural mothers in three districts of Gujarat, India, 2) to identify associations between the functionality of an obstetric care (OC) facility and it being bypassed, and 3) to assess the relative contribution of maternal and facility characteristics to bypassing. Design A cross-sectional survey of 166 public and private OC facilities reporting ≥30 births in the 3 months before the survey was conducted in three purposively selected districts (Dahod, Sabarkantha, and Surendranagar) in the state of Gujarat, India. Besides information on each facility, data from 946 women giving birth at these facilities were also gathered. Data were analyzed using a multilevel mixed-effects logistic regression model. Results Off all mothers, 37.7% bypassed their nearest facility for childbirth. After adjusting for maternal characteristics, for every one-unit increase in the facility's emergency obstetric care (EmOC) signal functions, the odds

  9. Bypassing health facilities for childbirth: a multilevel study in three districts of Gujarat, India

    Directory of Open Access Journals (Sweden)

    Mariano Salazar

    2016-08-01

    Full Text Available Background: Bypassing available facilities for childbirth has important implications for maternal health service delivery and human resources within a health system. The results are the additional expenses imposed on the woman and her family, as well as the inefficient use of health system resources. Bypassing often indicates a lack of confidence in the care provided by the facility nearest to the mother, which implies a level of dysfunctionality that the health system needs to address. Over the past decade, India has experienced a steep rise in the proportion of facility births. The initiation of programs promoting facility births resulted in a rise from 39% in 2005 to 85% in 2014. There have been no reports on bypassing facilities for childbirth from India. In the context of steeply rising facility births, it is important to quantify the occurrence of and study the relative contributions of maternal characteristics and facility functionality to bypassing. Objectives: 1 To determine the extent of bypassing health facilities for childbirth among rural mothers in three districts of Gujarat, India, 2 to identify associations between the functionality of an obstetric care (OC facility and it being bypassed, and 3 to assess the relative contribution of maternal and facility characteristics to bypassing. Design: A cross-sectional survey of 166 public and private OC facilities reporting ≥30 births in the 3 months before the survey was conducted in three purposively selected districts (Dahod, Sabarkantha, and Surendranagar in the state of Gujarat, India. Besides information on each facility, data from 946 women giving birth at these facilities were also gathered. Data were analyzed using a multilevel mixed-effects logistic regression model. Results: Off all mothers, 37.7% bypassed their nearest facility for childbirth. After adjusting for maternal characteristics, for every one-unit increase in the facility's emergency obstetric care (EmOC signal

  10. Prospective encounter study of the degree of adherence to patient care indicators related to drug dispensing in Health Care facilities: A Sri Lankan perspective

    OpenAIRE

    Lukshmy Menik Hettihewa; Amarasinghe Isuru; Jayarathna Kalana

    2011-01-01

    The World Health Organization-recommended patient care indicators in Government Hospitals were assessed in 422 patients attending the Outpatient Department in selected hospitals of the Galle district in Southern Province. The average dispensing time (ADT), percentage of drugs actually dispensed (PDAD), percentage of drugs adequately labeled (PDAL) and patient′s knowledge on correct dosage (PKCD) were compared in these selected teaching hospitals (TH), general hospitals (GHs) and district hosp...

  11. NIF conventional facilities construction health and safety plan

    Energy Technology Data Exchange (ETDEWEB)

    Benjamin, D W

    1998-05-14

    The purpose of this Plan is to outline the minimum health and safety requirements to which all participating Lawrence Livermore National Laboratory (LLNL) and non-LLNL employees (excluding National Ignition Facility [NIF] specific contractors and subcontractors covered under the construction subcontract packages (e.g., CSP-9)-see Construction Safety Program for the National Ignition Facility [CSP] Section I.B. ''NIF Construction Contractors and Subcontractors'' for specifics) shall adhere to for preventing job-related injuries and illnesses during Conventional Facilities construction activities at the NIF Project. For the purpose of this Plan, the term ''LLNL and non-LLNL employees'' includes LLNL employees, LLNL Plant Operations staff and their contractors, supplemental labor, contract labor, labor-only contractors, vendors, DOE representatives, personnel matrixed/assigned from other National Laboratories, participating guests, and others such as visitors, students, consultants etc., performing on-site work or services in support of the NIF Project. Based upon an activity level determination explained in Section 1.2.18, in this document, these organizations or individuals may be required by site management to prepare their own NIF site-specific safety plan. LLNL employees will normally not be expected to prepare a site-specific safety plan. This Plan also outlines job-specific exposures and construction site safety activities with which LLNL and non-LLNL employees shall comply.

  12. Quality of drug prescription in primary health care facilities in ...

    African Journals Online (AJOL)

    DR Marwa

    1Ilemela District Hospital, P.O. Box 735, Mwanza, Tanzania. 2Catholic ... prolonged hospital stay and consequently an increased cost of disease management in patients ... WHO/INRUD primary health facility prescribing indicators that monitor ...

  13. An audit of some health facilities and equipment for neonatal ...

    African Journals Online (AJOL)

    2016-04-19

    Apr 19, 2016 ... The child survival indices of 2012 especially the under-5 mortality rate has ... This audit of neonatal resuscitation equipments in health facilities in the state was, ..... sensus on Cardiopulmonary Resuscita- tion and Emergency ...

  14. Satisfaction with health facility delivery care services and ssociated ...

    African Journals Online (AJOL)

    Satisfaction with health facility delivery care services and ssociated factors: The ... of care ranging from 30% reporting to be satisfied with management of labour pains ... women comfortable and satisfied with the process of delivery elsewhere.

  15. Guidelines for Management Information Systems in Canadian Health Care Facilities

    OpenAIRE

    Thompson, Larry E.

    1987-01-01

    The MIS Guidelines are a comprehensive set of standards for health care facilities for the recording of staffing, financial, workload, patient care and other management information. The Guidelines enable health care facilities to develop management information systems which identify resources, costs and products to more effectively forecast and control costs and utilize resources to their maximum potential as well as provide improved comparability of operations.

  16. Survival from sports-related sudden cardiac arrest: In sports facilities versus outside of sports facilities.

    Science.gov (United States)

    Marijon, Eloi; Bougouin, Wulfran; Karam, Nicole; Beganton, Frankie; Lamhaut, Lionel; Perier, Marie-Cécile; Benameur, Nordine; Tafflet, Muriel; Beal, Guillaume; Hagege, Albert; Le Heuzey, Jean-Yves; Desnos, Michel; Spaulding, Christian; Carré, Francois; Dumas, Florence; Celermajer, David S; Cariou, Alain; Jouven, Xavier

    2015-08-01

    We sought to evaluate frequency, characteristics, and outcomes of sudden cardiac arrest (SCA) during sports activities according to the location of occurrence (in sports facilities vs those occurring outside of sports facilities). This is an observational 5-year prospective national French survey of subjects 10 to 75 years old presenting with SCA during sports (2005-2010), in 60 French administrative regions (covering a population of 35 million people). Of the 820 SCA during sports, 426 SCAs (52%) occurred in sports facilities. Overall, a substantially higher survival rate at hospital discharge was observed among SCA in sports facilities (22.8%, 95% CI 18.8-26.8) compared to those occurring outside (8.0%, 95% CI 5.3-10.7) (P facilities were younger (42.1 vs 51.3 years, P facilities (9.3 vs 13.6, P=0.03), and the proportion of initially shockable rhythm was higher (58.8% vs 33.1%, P facilities was mainly explained by concomitant circumstances of occurrence (adjusted odds ratio 1.48, 95% CI 0.88-2.49, P = .134). Sports-related SCA is not a homogeneous entity. The 3-fold higher survival rate reported among sports-related SCA is mainly due to cases that occur in sports facilities, whereas SCA during sports occurring outside of sports facilities has the usual very low rate of survival. Copyright © 2015. Published by Elsevier Inc.

  17. Facilities Management and Health Care at Home

    OpenAIRE

    Lundberg, Stefan

    2007-01-01

    The topic of this thesis is the new requirements that will be put upon the facilities management when the elderly are living longer in their own homes, in spite of illness, impairment and old age. For many reasons, especially demographic ones, this issue has come to the fore and since it has substantial political impact and considerably affects our living conditions, it will most certainly appear on the agenda of most Swedish housing companies in the near future. The growing number of inhabit...

  18. The Relative Importance of Health

    Science.gov (United States)

    Hsieh, Chang-Ming

    2008-01-01

    This article seeks to extend Michalos' [Social indicators research and health-related quality of life (QoL) research. "Social Indicators Research," 65, 27-72, 2004] discussion on bridging social indicators research and health-related QoL (HRQoL) research through an examination of (1) the relative importance of satisfaction with one's own health to…

  19. The Relative Importance of Health

    Science.gov (United States)

    Hsieh, Chang-Ming

    2008-01-01

    This article seeks to extend Michalos' [Social indicators research and health-related quality of life (QoL) research. "Social Indicators Research," 65, 27-72, 2004] discussion on bridging social indicators research and health-related QoL (HRQoL) research through an examination of (1) the relative importance of satisfaction with one's own health to…

  20. Prospective encounter study of the degree of adherence to patient care indicators related to drug dispensing in Health Care facilities: A Sri Lankan perspective.

    Science.gov (United States)

    Hettihewa, Lukshmy Menik; Isuru, Amarasinghe; Kalana, Jayarathna

    2011-04-01

    The World Health Organization-recommended patient care indicators in Government Hospitals were assessed in 422 patients attending the Outpatient Department in selected hospitals of the Galle district in Southern Province. The average dispensing time (ADT), percentage of drugs actually dispensed (PDAD), percentage of drugs adequately labeled (PDAL) and patient's knowledge on correct dosage (PKCD) were compared in these selected teaching hospitals (TH), general hospitals (GHs) and district hospitals (DHs) in Galle. ADT in DH (1.16 min) and GH (1.07 min) were high when compared with ADT in TH (0.81 min). PDAD was 100% in DH, 97.79% in GH and lowest in TH (94.64%). PDAL was highest (22.66%) in TH, 17.57% in GH and lowest in DH (1.57%). PKCD was 100% in GH and lowest in DH (0%) and only 50% in TH in Galle district. We noted that there was a significant difference in ADT in all three categories (P PKCD was 0% due to negligence in dispensing practices. We also noted a 100% PKCD only in GH due to the practice of a well-prepared correct labeling system in GH. We noticed that these patients were provided drugs with inadequate labeling and that patients had only a poor knowledge about the drug administration schedule. We conclude that there was a low dispenser-patient ratio in all three hospitals and that there was a need for an implementation plan for proper dispensing techniques by introducing a well-prepared drug labeling system in a printed format.

  1. Prospective encounter study of the degree of adherence to patient care indicators related to drug dispensing in Health Care facilities: A Sri Lankan perspective

    Directory of Open Access Journals (Sweden)

    Lukshmy Menik Hettihewa

    2011-01-01

    Full Text Available The World Health Organization-recommended patient care indicators in Government Hospitals were assessed in 422 patients attending the Outpatient Department in selected hospitals of the Galle district in Southern Province. The average dispensing time (ADT, percentage of drugs actually dispensed (PDAD, percentage of drugs adequately labeled (PDAL and patient′s knowledge on correct dosage (PKCD were compared in these selected teaching hospitals (TH, general hospitals (GHs and district hospitals (DHs in Galle. ADT in DH (1.16 min and GH (1.07 min were high when compared with ADT in TH (0.81 min. PDAD was 100% in DH, 97.79% in GH and lowest in TH (94.64%. PDAL was highest (22.66% in TH, 17.57% in GH and lowest in DH (1.57%. PKCD was 100% in GH and lowest in DH (0% and only 50% in TH in Galle district. We noted that there was a significant difference in ADT in all three categories (P < 0.05. We noted that dispensers spend only a short dispensing time and showed a tendency for dispensing errors. We found that PDAL was very low in all hospitals but PDAD was significantly high. Even though the ADT was high in DH, PKCD was 0% due to negligence in dispensing practices. We also noted a 100% PKCD only in GH due to the practice of a well-prepared correct labeling system in GH. We noticed that these patients were provided drugs with inadequate labeling and that patients had only a poor knowledge about the drug administration schedule. We conclude that there was a low dispenser-patient ratio in all three hospitals and that there was a need for an implementation plan for proper dispensing techniques by introducing a well-prepared drug labeling system in a printed format.

  2. Human health risk characterization of petroleum coke calcining facility emissions.

    Science.gov (United States)

    Singh, Davinderjit; Johnson, Giffe T; Harbison, Raymond D

    2015-12-01

    Calcining processes including handling and storage of raw petroleum coke may result in Particulate Matter (PM) and gaseous emissions. Concerns have been raised over the potential association between particulate and aerosol pollution and adverse respiratory health effects including decrements in lung function. This risk characterization evaluated the exposure concentrations of ambient air pollutants including PM10 and gaseous pollutants from a petroleum coke calciner facility. The ambient air pollutant levels were collected through monitors installed at multiple locations in the vicinity of the facility. The measured and modeled particulate levels in ambient air from the calciner facility were compared to standards protective of public health. The results indicated that exposure levels were, on occasions at sites farther from the facility, higher than the public health limit of 150 μg/m(3) 24-h average for PM10. However, the carbon fraction demonstrated that the contribution from the calciner facility was de minimis. Exposure levels of the modeled SO2, CO, NOx and PM10 concentrations were also below public health air quality standards. These results demonstrate that emissions from calcining processes involving petroleum coke, at facilities that are well controlled, are below regulatory standards and are not expected to produce a public health risk.

  3. ACSM's Health/Fitness Facility Standards and Guidelines. Second Edition.

    Science.gov (United States)

    Peterson, James A., Ed; Tharrett, Stephen J., Ed.

    The American College of Sports Medicine (ACSM) sets the industry standard for certifying professionals involved in health and fitness and their clinical applications. This 5-part publication provides a revised edition of six standards representing the industry's consensus on design and operation of a safe and high-quality health/fitness facility.…

  4. Recommendations for Health Monitoring and Reporting for Zebrafish Research Facilities.

    Science.gov (United States)

    Collymore, Chereen; Crim, Marcus J; Lieggi, Christine

    2016-07-01

    The presence of subclinical infection or clinical disease in laboratory zebrafish may have a significant impact on research results, animal health and welfare, and transfer of animals between institutions. As use of zebrafish as a model of disease increases, a harmonized method for monitoring and reporting the health status of animals will facilitate the transfer of animals, allow institutions to exclude diseases that may negatively impact their research programs, and improve animal health and welfare. All zebrafish facilities should implement a health monitoring program. In this study, we review important aspects of a health monitoring program, including choice of agents, samples for testing, available testing methodologies, housing and husbandry, cost, test subjects, and a harmonized method for reporting results. Facilities may use these recommendations to implement their own health monitoring program.

  5. Sound & Vibration 20 Design Guidelines for Health Care Facilities

    CERN Document Server

    Tocci, Gregory; Cavanaugh, William

    2013-01-01

    Sound, vibration, noise and privacy have significant impacts on health and performance. As a result, they are recognized as essential components of effective health care environments. However, acoustics has only recently become a prominent consideration in the design, construction, and operation of healthcare facilities owing to the absence, prior to 2010, of clear and objective guidance based on research and best practices. Sound & Vibration 2.0 is the first publication to comprehensively address this need. Sound & Vibration 2.0 is the sole reference standard for acoustics in health care facilities and is recognized by: the 2010 FGI Guidelines for the Design and Construction of Health Care Facilities (used in 60 countries); the US Green Building Council’s LEED for Health Care (used in 87 countries); The Green Guide for Health Care V2.2; and the International Code Council (2011). Sound & Vibration 2.0 was commissioned by the Facility Guidelines Institute in 2005, written by the Health Care Acous...

  6. Assisted Living Facilities, Licensed Health Care Facilities - assisted living facility type identified in attributes, Published in 2007, Iowa Dept. of Public Health.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Assisted Living Facilities dataset, was produced all or in part from Published Reports/Deeds information as of 2007. It is described as 'Licensed Health Care...

  7. Assisted Living Facilities, Licensed Health Care Facilities - long term care facility type identified in attributes, Published in 2007, Iowa Dept. of Public Health.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Assisted Living Facilities dataset, was produced all or in part from Published Reports/Deeds information as of 2007. It is described as 'Licensed Health Care...

  8. Strategic Facilities Planning: A Focus On Health Care

    Directory of Open Access Journals (Sweden)

    Ellen D. Hoadley

    2011-01-01

    Full Text Available Turbulent market conditions have forced the health care sector to re-examine its business and operational practices.  Health care has become increasingly complex as decisions and planning are reframed in light of the current lagging economy, an increased demand for services, new global competition, and impending legislation reform.  The stress is felt most keenly within the nation’s hospitals and consortia of health care facilitiesFacility planning decisions are no exception.  Hospital administrators are abandoning the once commonplace rules governing aging infrastructure renovations.  Instead, administrators are basing decisions within their respective strategic context and are attempting to align buildings, services, personnel, and technology to an overall plan that looks at markets, operations, and finances as resources for competitive advantage.  This paper reviews the strategic facilities planning literature and applies those best practices which support this organizational alignment for health care.  An application in the mid-Atlantic demonstrates that hospital facilities, by design, need to support the current and future needs of health care delivery systems, while dated structures impede industry advances.  Health care infrastructure improvements must proactively address technological, regulatory, and financial changes facing the sector.

  9. 42 CFR 71.47 - Special provisions relating to airports: Office and isolation facilities.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Special provisions relating to airports: Office and.... Ports: Sanitary Inspection § 71.47 Special provisions relating to airports: Office and isolation facilities. Each U.S. airport which receives international traffic shall provide without cost to...

  10. Domain : Health and health-related behaviour

    NARCIS (Netherlands)

    Heuvel, S. van den; Wind, A. de

    2015-01-01

    In general, the relation between health and employment participation has been studied extensively. The predominant conclusion is that poor health is one of the most predictive determinant for exit from work. Partially, this conclusion is obvious as one of the main exit routes is disability pension

  11. Global income related health inequalities

    Directory of Open Access Journals (Sweden)

    Jalil Safaei

    2007-01-01

    Full Text Available Income related health inequalities have been estimated for various groups of individuals at local, state, or national levels. Almost all of theses estimates are based on individual data from sample surveys. Lack of consistent individual data worldwide has prevented estimates of international income related health inequalities. This paper uses the (population weighted aggregate data available from many countries around the world to estimate worldwide income related health inequalities. Since the intra-country inequalities are subdued by the aggregate nature of the data, the estimates would be those of the inter-country or international health inequalities. As well, the study estimates the contribution of major socioeconomic variables to the overall health inequalities. The findings of the study strongly support the existence of worldwide income related health inequalities that favor the higher income countries. Decompositions of health inequalities identify inequalities in both the level and distribution of income as the main source of health inequality along with inequalities in education and degree of urbanization as other contributing determinants. Since income related health inequalities are preventable, policies to reduce the income gaps between the poor and rich nations could greatly improve the health of hundreds of millions of people and promote global justice. Keywords: global, income, health inequality, socioeconomic determinants of health

  12. Enhancing the sustainability and climate resiliency of health care facilities: a comparison of initiatives and toolkits.

    Science.gov (United States)

    Balbus, John; Berry, Peter; Brettle, Meagan; Jagnarine-Azan, Shalini; Soares, Agnes; Ugarte, Ciro; Varangu, Linda; Prats, Elena Villalobos

    2016-09-01

    Extreme weather events have revealed the vulnerability of health care facilities and the extent of devastation to the community when they fail. With climate change anticipated to increase extreme weather and its impacts worldwide-severe droughts, floods, heat waves, and related vector-borne diseases-health care officials need to understand and address the vulnerabilities of their health care systems and take action to improve resiliency in ways that also meet sustainability goals. Generally, the health sector is among a country's largest consumers of energy and a significant source of greenhouse gas emissions. Now it has the opportunity lead climate mitigation, while reducing energy, water, and other costs. This Special Report summarizes several initiatives and compares three toolkits for implementing sustainability and resiliency measures for health care facilities: the Canadian Health Care Facility Climate Change Resiliency Toolkit, the U.S. Sustainable and Climate Resilient Health Care Facilities Toolkit, and the PAHO SMART Hospitals Toolkit of the World Health Organization/Pan American Health Organization. These tools and the lessons learned can provide a critical starting point for any health system in the Americas.

  13. An Application of Business Process Management to Health Care Facilities.

    Science.gov (United States)

    Hassan, Mohsen M D

    The purpose of this article is to help health care facility managers and personnel identify significant elements of their facilities to address, and steps and actions to follow, when applying business process management to them. The ABPMP (Association of Business Process Management Professionals) life-cycle model of business process management is adopted, and steps from Lean, business process reengineering, and Six Sigma, and actions from operations management are presented to implement it. Managers of health care facilities can find in business process management a more comprehensive approach to improving their facilities than Lean, Six Sigma, business process reengineering, and ad hoc approaches that does not conflict with them because many of their elements can be included under its umbrella. Furthermore, the suggested application of business process management can guide and relieve them from selecting among these approaches, as well as provide them with specific steps and actions that they can follow. This article fills a gap in the literature by presenting a much needed comprehensive application of business process management to health care facilities that has specific steps and actions for implementation.

  14. Current trends in health facility planning, design, and construction.

    Science.gov (United States)

    Beale, Craig; Kittredge, Frank D

    2014-01-01

    It is critical now more than ever for today's healthcare facilities to serve as more than just a backdrop to the care provided--they can, and should, be an integral part of that care. In addition to promoting efficacy, delighting the senses, and placing patients and families at ease, facilities need to be high-performing, sustainable, and healthy environments. Creating today's healthcare facilities requires breaking through barriers in unexpected ways, and it often requires looking outside the healthcare profession for guidance. In this article, we explore current trends in health facility planning, design, and construction. Our focus is on the buildings that serve as venues for the provision of healthcare services across the full continuum, from prevention to critical care. In particular, we discuss four current broad trends and conclude with thoughts on future developments.

  15. Availability of emergency obstetric care (EmOC) among public and private health facilities in rural northwest Bangladesh

    OpenAIRE

    Sikder, Shegufta S; Labrique, Alain B.; Ali, Hasmot; Hanif, Abu AM; Klemm, Rolf DW; Mehra, Sucheta; Keith P. West; Christian, Parul

    2015-01-01

    Background Although safe motherhood strategies recommend that women seek timely care from health facilities for obstetric complications, few studies have described facility availability of emergency obstetric care (EmOC). We sought to describe and compare availability and readiness to provide EmOC among public and private health facilities commonly visited for pregnancy-related complications in two districts of northwest Bangladesh. We also described aspects of financial and geographic access...

  16. Availability of emergency obstetric care (EmOC) among public and private health facilities in rural northwest Bangladesh

    OpenAIRE

    Sikder, Shegufta S.; Labrique, Alain B; Ali, Hasmot; Hanif, Abu AM; Klemm, Rolf DW; Mehra, Sucheta; West, Keith P; Christian, Parul

    2015-01-01

    Background Although safe motherhood strategies recommend that women seek timely care from health facilities for obstetric complications, few studies have described facility availability of emergency obstetric care (EmOC). We sought to describe and compare availability and readiness to provide EmOC among public and private health facilities commonly visited for pregnancy-related complications in two districts of northwest Bangladesh. We also described aspects of financial and geographic access...

  17. Frontline staff motivation levels and health care quality in rural and urban primary health facilities: a baseline study in the Greater Accra and Western regions of Ghana.

    Science.gov (United States)

    Alhassan, Robert Kaba; Nketiah-Amponsah, Edward

    2016-12-01

    The population of Ghana is increasingly becoming urbanized with about 70 % of the estimated 26.9 million people living in urban and peri-urban areas. Nonetheless, eight out of the ten regions in Ghana remain predominantly rural where only 32.1 % of the national health sector workforce works. Doctor-patient ratio in a predominantly rural region is about 1:18,257 compared to 1:4,099 in an urban region. These rural-urban inequities significantly account for the inability of Ghana to attain the health related Millennium Development Goals (MDGs) before the end of 2015. To ascertain whether or not rural-urban differences exist in health worker motivation levels and quality of health care in health facilities accredited by the National Health Insurance Authority in Ghana. This is a baseline quantitative study conducted in 2012 among 324 health workers in 64 accredited clinics located in 9 rural and 7 urban districts in Ghana. Ordered logistic regression was performed to determine the relationship between facility geographic location (rural/urban) and staff motivation levels, and quality health care standards. Quality health care and patient safety standards were averagely low in the sampled health facilities. Even though health workers in rural facilities were more de-motivated by poor availability of resources and drugs than their counterparts in urban facilities (p facilities. For Ghana to attain the newly formulated sustainable development goals on health, there is the need for health authorities to address the existing rural-urban imbalances in health worker motivation and quality health care standards in primary healthcare facilities. Future studies should compare staff motivation levels and quality standards in accredited and non-accredited health facilities since the current study was limited to health facilities accredited by the National Health Insurance Authority.

  18. Uses of inorganic hypochlorite (bleach) in health-care facilities.

    Science.gov (United States)

    Rutala, W A; Weber, D J

    1997-01-01

    Hypochlorite has been used as a disinfectant for more than 100 years. It has many of the properties of an ideal disinfectant, including a broad antimicrobial activity, rapid bactericidal action, reasonable persistence in treated potable water, ease of use, solubility in water, relative stability, relative nontoxicity at use concentrations, no poisonous residuals, no color, no staining, and low cost. The active species is undissociated hypochlorous acid (HOCl). Hypochlorites are lethal to most microbes, although viruses and vegetative bacteria are more susceptible than endospore-forming bacteria, fungi, and protozoa. Activity is reduced by the presence of heavy metal ions, a biofilm, organic material, low temperature, low pH, or UV radiation. Clinical uses in health-care facilities include hyperchlorination of potable water to prevent Legionella colonization, chlorination of water distribution systems used in hemodialysis centers, cleaning of environmental surfaces, disinfection of laundry, local use to decontaminate blood spills, disinfection of equipment, decontamination of medical waste prior to disposal, and dental therapy. Despite the increasing availability of other disinfectants, hypochlorites continue to find wide use in hospitals. PMID:9336664

  19. Factors associated with health facility childbirth in districts of Kenya, Tanzania and Zambia

    DEFF Research Database (Denmark)

    Phiri, Selia Ng'anjo; Kiserud, Torvid; Kvåle, Gunnar

    2014-01-01

    to ANC services and HIV related counselling and testing were positively associated with health facility deliveries. Perceived distance was negatively associated with facility childbirth in rural areas of Malindi and urban areas of Kapiri Mposhi. CONCLUSION: Strong socio-economic inequities...... in the likelihood of facility childbirths were revealed in all the districts added to geographic inequities in two of the three districts. This strongly suggests an urgent need to strengthen services targeting disadvantaged and remote populations. The finding of a positive association between HIV counselling...

  20. Cost recovery of NGO primary health care facilities: a case study in Bangladesh

    Directory of Open Access Journals (Sweden)

    Alam Khurshid

    2010-06-01

    Full Text Available Abstract Background Little is known about the cost recovery of primary health care facilities in Bangladesh. This study estimated the cost recovery of a primary health care facility run by Building Resources Across Community (BRAC, a large NGO in Bangladesh, for the period of July 2004 - June 2005. This health facility is one of the seven upgraded BRAC facilities providing emergency obstetric care and is typical of the government and private primary health care facilities in Bangladesh. Given the current maternal and child mortality in Bangladesh and the challenges to addressing health-related Millennium Development Goal (MDG targets the financial sustainability of such facilities is crucial. Methods The study was designed as a case study covering a single facility. The methodology was based on the 'ingredient approach' using the allocation techniques by inpatient and outpatient services. Cost recovery of the facility was estimated from the provider's perspective. The value of capital items was annualized using 5% discount rate and its market price of 2004 (replacement value. Sensitivity analysis was done using 3% discount rate. Results The cost recovery ratio of the BRAC primary care facility was 59%, and if excluding all capital costs, it increased to 72%. Of the total costs, 32% was for personnel while drugs absorbed 18%. Capital items were17% of total costs while operational cost absorbed 12%. Three-quarters of the total cost was variable costs. Inpatient services contributed 74% of total revenue in exchange of 10% of total utilization. An average cost per patient was US$ 10 while it was US$ 67 for inpatient and US$ 4 for outpatient. Conclusion The cost recovery of this NGO primary care facility is important for increasing its financial sustainability and decreasing donor dependency, and achieving universal health coverage in a developing country setting. However, for improving the cost recovery of the health facility, it needs to increase

  1. Health facilities humanisation: design guidelines supported by statistical evidence.

    Science.gov (United States)

    Bosia, Daniela; Marino, Donatella; Peretti, Gabriella

    2016-01-01

    Healthcare building humanisation is currently a widely debated issue and the development of patient centered and evidence based design is growing worldwide. Many international health organizations and researchers understand the importance of Patient Centred Design and leading architects incorporate it into the design process. In Italy this design approach is still at an early stage. The article refers to research commissioned by the Italian Health Ministry and carried out by R. Del Nord (Università degli Studi di Firenze) and G. Peretti (Politecnico di Torino) with their collaborators. The scope of the research was the definition of design guidelines for healthcare facilities humanisation. The methodology framework adopted is the well established need and performance approach in architectural design. The article deals with the results of statistical investigations for the definition and ranking of users' needs and the consistent expression of their requirements. The investigations were carried out with the cooperation of psychologists of the Università degli Studi di Torino and researchers of the Università degli Studi di Cagliari. The proposed evaluation system allows ranking of health facilities according to the level of humanisation achieved. The statistical investigation evidence collected allowed the definition of humanisation design guidelines for health-care facilities and for the assessment of their specific level of humanisation.

  2. Community health facility preparedness for a cholera surge in Haiti.

    Science.gov (United States)

    Mobula, Linda Meta; Jacquet, Gabrielle A; Weinhauer, Kristin; Alcidas, Gladys; Thomas, Hans-Muller; Burnham, Gilbert

    2013-01-01

    With increasing population displacement and worsening water insecurity after the 2010 earthquake, Haiti experienced a large cholera outbreak. Our goal was to evaluate the strengths and weaknesses of seven community health facilities' ability to respond to a surge in cholera cases. Since 2010, Catholic Relief Services (CRS) with a number of public and private donors has been working with seven health facilities in an effort to reduce morbidity and mortality from cholera infection. In November 2012, CRS through the Centers for Disease Control and Prevention (CDC)'s support, asked the Johns Hopkins Center for Refugee and Disaster Response to conduct a cholera surge simulation tabletop exercise at these health facilities to improve each facility's response in the event of a cholera surge. Using simulation development guidelines from the Pan American Health Organization and others, a simulation scenario script was produced that included situations of differing severity, supply chain, as well as a surge of patients. A total of 119 hospital staff from seven sites participated in the simulation exercise including community health workers, clinicians, managers, pharmacists, cleaners, and security guards. Clinics that had challenges during the simulated clinical care of patients were those that did not appropriately treat all cholera patients according to protocol, particularly those that were vulnerable, those that would need additional staff to properly treat patients during a surge of cholera, and those that required a better inventory of supplies. Simulation-based activities have the potential to identify healthcare delivery system vulnerabilities that are amenable to intervention prior to a cholera surge.

  3. Comparison of patient referral processes between rural and urban health facilities in Liberia

    Directory of Open Access Journals (Sweden)

    J. Kim*

    2013-12-01

    Conclusions: Patient referral systems in Liberia are relatively unsystematic. While formal and informal mechanisms for referrals exist at both rural and urban health facilities, establishing guidelines for referral care practices and transportation strategies tailored to each of these settings will help to strengthen the healthcare system as a whole.

  4. Factors associated with skilled attendance at delivery in Uganda: results from a national health facility survey.

    Science.gov (United States)

    Mbonye, Anthony K; Asimwe, John Bosco

    2010-01-01

    Uganda has high maternal mortality ratio of 435/100,000 live births. In order to address this, Uganda has developed a strategy and has prioritized skilled attendance at delivery as a key intervention. A survey covering 54 districts and 553 health facilities was conducted to determine availability and access to essential maternity care and health system factors related to maternal health. The survey specifically assessed availability of emergency obstetric care (EmOC) signal functions, the state of health infrastructure and availability of basic drugs and supplies. A total of 194,029 deliveries were recorded in the year preceding the survey. Majority, 117,761 (60.7%) occurred in hospitals, while 76,268 (39.3%) occurred in health centers. The following factors were associated with increased deliveries at health facilities; running water, (RR 1.5, P EmOC had the highest chances of attracting women to deliver there, (RR 4.0, P EmOC, (RR 3.1, P EmOC, 349 (97.2%) were not offering the service. This is the likely explanation for the high health facility-based maternal ratio of 671/100,000 live births in Uganda. Improving availability and quality of care especially EmOC; and ensuring that health units have electricity, running water and accommodation for staff could increase skilled attendance at delivery and help achieve the Millennium Development Goals (MDG) target on maternal health in Uganda.

  5. Human resource development in rural health care facilities.

    Science.gov (United States)

    Johnson, L

    1991-01-01

    In this paper, human resource development problems facing rural health care facilities are identified and it is recognised that, particularly in the face of escalating demands for training arising from environmental pressures such as implementation of the structural efficiency principle, a coordinated approach to meet these problems is desirable. Such coordination is often sought via a regional staff development service. Accordingly, using the organisational life cycle as a conceptual framework, staff development services in five NSW health regions are examined. Ranging from a cafeteria style to a results-orientation, a diversity of strategic approaches to staff development is reflected.

  6. The effect of health facility delivery on neonatal mortality: systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Tura Gurmesa

    2013-01-01

    Full Text Available Abstract Background Though promising progress has been made towards achieving the Millennium Development Goal four through substantial reduction in under-five mortality, the decline in neonatal mortality remains stagnant, mainly in the middle and low-income countries. As an option, health facility delivery is assumed to reduce this problem significantly. However, the existing evidences show contradicting conclusions about this fact, particularly in areas where enabling environments are constraint. Thus, this review was conducted with the aim of determining the pooled effect of health facility delivery on neonatal mortality. Methods The reviewed studies were accessed through electronic web-based search strategy from PUBMED, Cochrane Library and Advanced Google Scholar by using combination key terms. The analysis was done by using STATA-11. I2 test statistic was used to assess heterogeneity. Funnel plot, Begg’s test and Egger’s test were used to check for publication bias. Pooled effect size was determined in the form of relative risk in the random-effects model using DerSimonian and Laird's estimator. Results A total of 2,216 studies conducted on the review topic were identified. During screening, 37 studies found to be relevant for data abstraction. From these, only 19 studies fulfilled the preset criteria and included in the analysis. In 10 of the 19 studies included in the analysis, facility delivery had significant association with neonatal mortality; while in 9 studies the association was not significant. Based on the random effects model, the final pooled effect size in the form of relative risk was 0.71 (95% CI: 0.54, 0.87 for health facility delivery as compared to home delivery. Conclusion Health facility delivery is found to reduce the risk of neonatal mortality by 29% in low and middle income countries. Expansion of health facilities, fulfilling the enabling environments and promoting their utilization during childbirth are

  7. Airborne infection control in India: Baseline assessment of health facilities

    Science.gov (United States)

    Parmar, Malik M.; Sachdeva, K.S.; Rade, Kiran; Ghedia, Mayank; Bansal, Avi; Nagaraja, Sharath Burugina; Willis, Matthew D.; Misquitta, Dyson P.; Nair, Sreenivas A.; Moonan, Patrick K.; Dewan, Puneet K.

    2016-01-01

    Background Tuberculosis transmission in health care settings represents a major public health problem. In 2010, national airborne infection control (AIC) guidelines were adopted in India. These guidelines included specific policies for TB prevention and control in health care settings. However, the feasibility and effectiveness of these guidelines have not been assessed in routine practice. This study aimed to conduct baseline assessments of AIC policies and practices within a convenience sample of 35 health care settings across 3 states in India and to assess the level of implementation at each facility after one year. Method A multi-agency, multidisciplinary panel of experts performed site visits using a standardized risk assessment tool to document current practices and review resource capacity. At the conclusion of each assessment, facility-specific recommendations were provided to improve AIC performance to align with national guidelines. Result Upon initial assessment, AIC systems were found to be poorly developed and implemented. Administrative controls were not commonly practiced and many departments needed renovation to achieve minimum environmental standards. One year after the baseline assessments, there were substantial improvements in both policy and practice. Conclusion A package of capacity building and systems development that followed national guidelines substantially improved implementation of AIC policies and practice. PMID:26970461

  8. Mental and behavioral health environments: critical considerations for facility design.

    Science.gov (United States)

    Shepley, Mardelle McCuskey; Watson, Angela; Pitts, Francis; Garrity, Anne; Spelman, Elizabeth; Kelkar, Janhawi; Fronsman, Andrea

    2016-01-01

    The purpose of the study was to identify features in the physical environment that are believed to positively impact staff and patients in psychiatric environments and use these features as the foundation for future research regarding the design of mental and behavioral health facilities. Pursuant to a broad literature review that produced an interview script, researchers conducted 19 interviews of psychiatric staff, facility administrators and architects. Interview data were analyzed using the highly structured qualitative data analysis process authored by Lincoln and Guba (1985). Seventeen topics were addressed ranging from the importance of a deinstitutionalized environment to social interaction and autonomy. The interviewees reinforced the controversy that exists around the implications of a deinstitutionalized environment, when the resulting setting diminishes patient and staff safety. Respondents tended to support open nurse stations vs. enclosed stations. Support for access to nature and the provision of an aesthetic environment was strong. Most interviewees asserted that private rooms were highly desirable because lower room density reduces the institutional character of a unit. However, a few interviewees adamantly opposed private rooms because they considered the increased supervision of one patient by another to be a deterrent to self-harm. The need to address smoking rooms in future research received the least support of all topics. Responses of interviews illustrate current opinion regarding best practice in the design of psychiatric facilities. The findings emphasize the need for more substantive research on appropriate physical environments in mental and behavioral health settings. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Health problems from radiation of high-voltage facilities

    Directory of Open Access Journals (Sweden)

    Hossein Ali Yousefi Rizi

    2013-01-01

    Full Text Available Aims: The aim of this study was to survey the health problems caused by exposure to high-voltage facility radiation. Materials and Methods: Sampling included workers exposed to electromagnetic fields at high-voltage facilities. The strength of the electric and magnetic fields was determined by a field meter. A questionnaire was used to evaluate the prevalence of subjective and psychological symptoms. Statistical descriptive used and data analyzed by a Student′s t-tests. Results: This study indicates that increased symptoms among the exposed workers including depression, anxiety, hostility, paranoia, inter-sensitivity, and obsession-compulsion. Some of the self-reported symptoms were, headache (53.5%, fatigue (35.6%, difficulties in concentration (32.5%, vertigo/dizziness (30.4%, attention disorders (28.8%, nervousness (28.1%, and palpitations (14.7%. A significant relationship was observed between the exposure to the electromagnetic field and psychological symptoms (P < 0.05. Conclusion: Radiation of high-voltage facilities probably increased the risk of mental disorders and intensified them in susceptible workers, especially depression. This finding confirmed the results obtained in provocative studies that indicated an increase in the risk of psychological symptoms, which was put forth by several investigators Observation of occupational health and other control measures play an important role in decreasing the symptoms.

  10. Measuring three aspects of motivation among health workers at primary level health facilities in rural Tanzania.

    Science.gov (United States)

    Sato, Miho; Maufi, Deogratias; Mwingira, Upendo John; Leshabari, Melkidezek T; Ohnishi, Mayumi; Honda, Sumihisa

    2017-01-01

    The threshold of 2.3 skilled health workers per 1,000 population, published in the World Health Report in 2006, has galvanized resources and efforts to attain high coverage of skilled birth attendance. With the inception of the Sustainable Development Goals (SDGs), a new threshold of 4.45 doctors, nurses, and midwives per 1,000 population has been identified. This SDG index threshold indicates the minimum density to respond to the needs of health workers to deliver a much broader range of health services, such as management of non-communicable diseases to meet the targets under Goal 3: Ensure healthy lives and promote well-being for all people of all ages. In the United Republic of Tanzania, the density of skilled health workers in 2012 was 0.5 per 1,000 population, which more than doubled from 0.2 per 1,000 in 2002. However, this showed that Tanzania still faced a critical shortage of skilled health workers. While training, deployment, and retention are important, motivation is also necessary for all health workers, particularly those who serve in rural areas. This study measured the motivation of health workers who were posted at government-run rural primary health facilities. We sought to measure three aspects of motivation-Management, Performance, and Individual Aspects-among health workers deployed in rural primary level government health facilities. In addition, we also sought to identify the job-related attributes associated with each of these three aspects. Two regions in Tanzania were selected for our research. In each region, we further selected two districts in which we carried out our investigation. The two regions were Lindi, where we carried out our study in the Nachingwea District and the Ruangwa District, and Mbeya, within which the Mbarali and Rungwe Districts were selected for research. All four districts are considered rural. This cross-sectional study was conducted by administering a two-part questionnaire in the Kiswahili language. The first

  11. The Epidaurus Project: holism in Department of Defense health facilities.

    Science.gov (United States)

    Foote, Frederick

    2012-01-01

    The Epidaurus Project, an advanced initiative in holistic (or whole-person) medicine, has operated in the Military Health System (MHS) since 2001. Its purpose has been to engage prominent civilian authorities on evidence-based building design, family-centered approaches, interdisciplinary care integration, and wellness, to optimize outcomes in the MHS. Over the past decade, many of the Epidaurus idea sets have been incorporated into MHS facility designs and therapeutic programs. The MHS owes a debt of gratitude to the numerous civilian thought leaders who participated in this project.

  12. Public Health Risks from Mismanagement of Healthcare Wastes in Shinyanga Municipality Health Facilities, Tanzania

    OpenAIRE

    Kizito Kuchibanda; Mayo, Aloyce W.

    2015-01-01

    The increase of healthcare facilities in Shinyanga municipality has resulted in an increase of healthcare wastes, which poses serious threats to the environment, health workers, and the general public. This research was conducted to investigate management practices of healthcare wastes in Shinyanga municipality with a view of assessing health risks to health workers and the general public. The study, which was carried out in three hospitals, involved the use of questionnaires, in-depth interv...

  13. Environmental Assessment for the Health Protection Instrument Calibration Facility at the Savannah River Site

    Energy Technology Data Exchange (ETDEWEB)

    1993-08-01

    The purpose of this Environmental Assessment (EA) is to review the possible environmental consequences associated with the construction and operation of a Health Protection Instrument Calibration Facility on the Savannah River Site (SRS). The proposed replacement calibration facility would be located in B Area of SRS and would replace an inadequate existing facility currently located within A Area of SRS (Building 736-A). The new facility would provide laboratories, offices, test equipment and the support space necessary for the SRS Radiation Monitoring Instrument Calibration Program to comply with DOE Orders 5480.4 (Environmental Protection, Safety and Health Protection Standards) and 5480.11 (Radiation Protection for Occupational Workers). The proposed facility would serve as the central site source for the evaluation, selection, inspection, testing, calibration, and maintenance of all SRS radiation monitoring instrumentation. The proposed facility would be constructed on a currently undeveloped portion in B Area of SRS. The exact plot associated with the proposed action is a 1.2 hectare (3 acre) tract of land located on the west side of SRS Road No. 2. The proposed facility would lie approximately 4.4 km (2.75 mi) from the nearest SRS site boundary. The proposed facility would also lie within the confines of the existing B Area, and SRS safeguards and security systems. Archaeological, ecological, and land use reviews have been conducted in connection with the use of this proposed plot of land, and a detailed discussion of these reviews is contained herein. Socioeconomic, operational, and accident analyses were also examined in relation to the proposed project and the findings from these reviews are also contained in this EA.

  14. Referral of children seeking care at private health facilities in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony K.; Buregyeya, Esther; Rutebemberwa, Elizeus

    2017-01-01

    Background In Uganda, referral of sick children seeking care at public health facilities is poor and widely reported. However, studies focusing on the private health sector are scanty. The main objective of this study was to assess referral practices for sick children seeking care at private health...... children to higher levels of care in the two weeks prior to the survey. The main constraints to follow referral advice as perceived by caretakers were: not appreciating the importance of referral, gender-related decision-making and negotiations at household level, poor quality of care at referral...

  15. Health providers' perception of quality of care for neonates in health facilities in a municipality in Southern Ghana.

    Science.gov (United States)

    Elikplim Pomevor, Kokui; Adomah-Afari, Augustine

    2016-10-10

    Purpose The purpose of this paper is to assess available human resources for neonatal care and their skills, in order to explore health providers' perceptions of quality of neonatal care in health facilities in Ghana. Design/methodology/approach Data were gathered using qualitative interviews with health providers working in the maternity and paediatric wards and midwives; direct observation; and documentary review at a regional hospital, a municipal hospital and four health centres in a municipality in a region in Southern Ghana. Data were analysed using thematic framework through the process of coding in six phases to create and establish meaningful patterns. Findings The study revealed that health providers were concerned about the number of staff available, their competence and also equipment available for them to work more efficiently. Some essential equipment for neonatal care was either not available or was non-functional where it was available, while aseptic procedures were not adhered to. Moreover, personal protective equipment such as facemask, caps, aprons were not used except in the labour wards where staff had to change their footwear before entering. Research limitations/implications Limited number of health providers and facilities used, lack of exploration of parents of neonates' perspective of quality of neonatal care in this study and other settings, including the teaching hospitals. The authors did not examine issues related to the ineffective use of IV cannulation for neonates by nurses as well as referral of neonates. Additionally, the authors did not explore the perspectives of management of the municipal and regional health directorates or policy makers of the Ministry of Health and Ghana Health Service regarding the shortage of staff, inadequate provision of medical equipment and infrastructure. Practical implications This paper suggests the need for policy makers to redirect their attention to the issues that would improve the quality of

  16. Potential community and public health impacts of medically supervised safer smoking facilities for crack cocaine users

    Directory of Open Access Journals (Sweden)

    Oleson Megan

    2006-01-01

    Full Text Available Abstract There is growing evidence of the public health and community harms associated with crack cocaine smoking, particularly the risk of blood-borne transmission through non-parenteral routes. In response, community advocates and policy makers in Vancouver, Canada are calling for an exemption from Health Canada to pilot a medically supervised safer smoking facility (SSF for non-injection drug users (NIDU. Current reluctance on the part of health authorities is likely due to the lack of existing evidence surrounding the extent of related harm and potential uptake of such a facility among NIDUs in this setting. In November 2004, a feasibility study was conducted among 437 crack cocaine smokers. Univariate analyses were conducted to determine associations with willingness to use a SSF and logistic regression was used to adjust for potentially confounding variables (p

  17. Liberia_WADC00004_OHDR_Health_Facilities2010

    Data.gov (United States)

    United Nations Cartographic Section — This data is based on the survey questionnaire, which are included in the table belowWhat county is this facility in?What is the facility name?Is this facility a...

  18. Mental Health Facilities, This file contains the name, address, contact and some licensing information for the Mental Health facilities in Maryland., Published in 2010, Smaller than 1:100000 scale, Maryland Department of Health and Mental Hygiene.

    Data.gov (United States)

    NSGIC State | GIS Inventory — Mental Health Facilities dataset current as of 2010. This file contains the name, address, contact and some licensing information for the Mental Health facilities in...

  19. Assessing the quality of care in a new nation: South Sudan's first national health facility assessment.

    Science.gov (United States)

    Berendes, Sima; Lako, Richard L; Whitson, Donald; Gould, Simon; Valadez, Joseph J

    2014-10-01

    We adapted a rapid quality of care monitoring method to a fragile state with two aims: to assess the delivery of child health services in South Sudan at the time of independence and to strengthen local capacity to perform regular rapid health facility assessments. Using a two-stage lot quality assurance sampling (LQAS) design, we conducted a national cross-sectional survey among 156 randomly selected health facilities in 10 states. In each of these facilities, we obtained information on a range of access, input, process and performance indicators during structured interviews and observations. Quality of care was poor with all states failing to achieve the 80% target for 14 of 19 indicators. For example, only 12% of facilities were classified as acceptable for their adequate utilisation by the population for sick-child consultations, 16% for staffing, 3% for having infection control supplies available and 0% for having all child care guidelines. Health worker performance was categorised as acceptable in only 6% of cases related to sick-child assessments, 38% related to medical treatment for the given diagnosis and 33% related to patient counselling on how to administer the prescribed drugs. Best performance was recorded for availability of in-service training and supervision, for seven and ten states, respectively. Despite ongoing instability, the Ministry of Health developed capacity to use LQAS for measuring quality of care nationally and state-by-state, which will support efficient and equitable resource allocation. Overall, our data revealed a desperate need for improving the quality of care in all states. © 2014 John Wiley & Sons Ltd.

  20. Out of pocket expenditure to deliver at public health facilities in India: a cross sectional analysis.

    Science.gov (United States)

    Issac, Anns; Chatterjee, Susmita; Srivastava, Aradhana; Bhattacharyya, Sanghita

    2016-08-24

    To expand access to safe deliveries, some developing countries have initiated demand-side financing schemes promoting institutional delivery. In the context of conditional cash incentive scheme and free maternity care in public health facilities in India, studies have highlighted high out of pocket expenditure (OOPE) of Indian families for delivery and maternity care. In this context the study assesses the components of OOPE that women incurred while accessing maternity care in public health facilities in Uttar Pradesh, India. It also assesses the determinants of OOPE and the level of maternal satisfaction while accessing care from these facilities. It is a cross-sectional analysis of 558 recently delivered women who have delivered at four public health facilities in Uttar Pradesh, India. All OOPE related information was collected through interviews using structured pre-tested questionnaires. Frequencies, Mann-Whitney test and categorical regression were used for data reduction. The analysis showed that the median OOPE was INR 700 (US$ 11.48) which varied between INR 680 (US$ 11.15) for normal delivery and INR 970 (US$ 15.9) for complicated cases. Tips for getting services (consisting of gifts and tips for services) with a median value of INR 320 (US$ 5.25) contributed to the major share in OOPE. Women from households with income more than INR 4000 (US$ 65.57) per month, general castes, primi-gravida, complicated delivery and those not accompanied by community health workers incurred higher OOPE. The significant predictors for high OOPE were caste (General Vs. OBC, SC/ST), type of delivery (Complicated Vs. Normal), and presence of ASHA (No Vs. Yes). OOPE while accessing care for delivery was one among the least satisfactory items and 76 % women expressed their dissatisfaction. Even though services at the public health facilities in India are supposed to be provided free of cost, it is actually not free, and the women in this study paid almost half of their mandated

  1. Rapid assessment of infrastructure of primary health care facilities – a relevant instrument for health care systems management

    OpenAIRE

    2015-01-01

    Background Health care infrastructure constitutes a major component of the structural quality of a health system. Infrastructural deficiencies of health services are reported in literature and research. A number of instruments exist for the assessment of infrastructure. However, no easy-to-use instruments to assess health facility infrastructure in developing countries are available. Present tools are not applicable for a rapid assessment by health facility staff. Therefore, health informatio...

  2. Effects of health and safety problem recognition on small business facility investment.

    Science.gov (United States)

    Park, Jisu; Jeong, Harin; Hong, Sujin; Park, Jong-Tae; Kim, Dae-Sung; Kim, Jongseo; Kim, Hae-Joon

    2013-10-23

    This study involved a survey of the facility investment experiences, which was designed to recognize the importance of health and safety problems, and industrial accident prevention. Ultimately, we hope that small scale industries will create effective industrial accident prevention programs and facility investments. An individual survey of businesses' present physical conditions, recognition of the importance of the health and safety problems, and facility investment experiences for preventing industrial accidents was conducted. The survey involved 1,145 business operators or management workers in small business places with fewer than 50 workers in six industrial complexes. Regarding the importance of occupational health and safety problems (OHS), 54.1% said it was "very important". Received technical and financial support, and industrial accidents that occurred during the past three years were recognized as highly important for OHS. In an investigation regarding facility investment experiences for industrial accident prevention, the largest factors were business size, greater numbers of industrial accidents, greater technical and financial support received, and greater recognition of the importance of the OHS. The related variables that decided facility investment for industry accident prevention in a logistic regression analysis were the experiences of business facilities where industrial accidents occurred during the past three years, received technical and financial support, and recognition of the OHS. Those considered very important were shown to be highly significant. Recognition of health and safety issues was higher when small businesses had experienced industrial accidents or received financial support. The investment in industrial accidents was greater when health and safety issues were recognized as important. Therefore, the goal of small business health and safety projects is to prioritize health and safety issues in terms of business management and

  3. Environmental sanitation and health facilities in schools of an urban city of south India

    Directory of Open Access Journals (Sweden)

    Nitin Joseph

    2012-01-01

    Full Text Available Background : Environmental sanitation and health facilities in schools are an important public health issue. Aims : To assess the school environment, sanitation and health related facilities and to compare the availability of these facilities between government, aided and private schools. Materials and Methods : This cross sectional study was done in 30 schools in Mangalore city of south India in February 2010. Results : Out of the 30 schools surveyed, four were government, 12 were aided and 14 were private schools. Overcrowding was seen in one third of schools. The recommended minus desks was lacking in 23(76.7% and chairs with back rest was lacking in 11(36.7% schools. More than a quarter of schools had no drinking water purification facility. Water storage units were not cleaned periodically in 6(20% schools. Quarter of all government schools and half of all aided schools had no dining hall for serving mid-day meals. Toilets were not adequate in 10(33.3% and it was not separated for boys and girls in 8(26.7% schools. Four of the surveyed schools had no medical examination of students and in 13(43.3% schools daily morning inspection by teachers was not done. Hardly few schools had staff trained to deal with medical emergencies and in counselling activities. None of the schools had an immunization register. Although the performance scores between the types of schools did not differ significantly, the combined performance of only private schools were found to be satisfactory. Conclusion : A good number of schools in this urban area were found to be falling short of several essential requirements regarding sanitation and health facilities which needs to be rectified.

  4. Codependency and related health variables.

    Science.gov (United States)

    Martsolf, D S; Sedlak, C A; Doheny, M O

    2000-06-01

    Codependency is a controversial concept especially for feminist scholars who are concerned about pathologizing traditional female roles. This study's purpose was to determine: (1) the prevalence of codependency in a sample of older women who because of age may ascribe to traditional roles; (2) how the Hughes-Hammer/Martsolf theoretical model of codependency relates to other health variables; and (3) whether previous findings about the relationship between codependency and depression replicate. Survey design was used with a sample of 238 women (ages 65 to 91) attending a flu shot clinic. Subjects completed the Codependency Assessment Tool, Beck Depression Inventory, Quality of Life Scale, Perceived Health Report, Measurement of Patient Functional Abilities, and Illness Prevention Screening Behaviors Checklist. Of these women, 99% had low codependency scores. Statistically significant correlations existed between codependency and perceived health (p Codependency was not significantly correlated with illness prevention behaviors and quality of life. Codependency and depression, as in previous studies, were significantly correlated (r = .446, p = .0001). Using analysis of variance, 3 codependency subscales had significant positive effect on depression: Low Self-Worth, Medical Problems, and Hiding Self. Further studies should examine the degree of ascribing to traditional female roles in women dealing with codependency issues.

  5. Heat stress and inadequate sanitary facilities at workplaces – an occupational health concern for women?

    Science.gov (United States)

    Venugopal, Vidhya; Rekha, Shanmugam; Manikandan, Krishnamoorthy; Latha, Perumal Kamalakkannan; Vennila, Viswanathan; Ganesan, Nalini; Kumaravel, Perumal; Chinnadurai, Stephen Jeremiah

    2016-01-01

    Background Health concerns unique to women are growing with the large number of women venturing into different trades that expose them to hot working environments and inadequate sanitation facilities, common in many Indian workplaces. Objective The study was carried out to investigate the health implications of exposures to hot work environments and inadequate sanitation facilities at their workplaces for women workers. Design A cross-sectional study was conducted with 312 women workers in three occupational sectors in 2014–2015. Quantitative data on heat exposures and physiological heat strain indicators such as core body temperature (CBT), sweat rate (SwR), and urine specific gravity (USG) were collected. A structured questionnaire captured workers perceptions about health impacts of heat stress and inadequate sanitary facilities at the workplace. Results Workplace heat exposures exceeded the threshold limit value for safe manual work for 71% women (Avg. wet bulb globe temperature=30°C±2.3°C) during the study period. Eighty-seven percent of the 200 women who had inadequate/no toilets at their workplaces reported experiencing genitourinary problems periodically. Above normal CBT, SwR, and USG in about 10% women workers indicated heat strain and moderate dehydration that corroborated well with their perceptions. Observed significant associations between high-heat exposures and SwR (t=−2.3879, p=0.0192), inadequate toilet facilities and self-reported adverse heat-related health symptoms (χ2=4.03, p=0.0444), and prevalence of genitourinary issues (χ2=42.92, p=0.0005×10−7) reemphasize that heat is a risk and lack of sanitation facilities is a major health concern for women workers. Conclusions The preliminary evidence suggests that health of women workers is at risk due to occupational heat exposures and inadequate sanitation facilities at many Indian workplaces. Intervention through strong labor policies with gender sensitivity is the need of the hour to

  6. Heat stress and inadequate sanitary facilities at workplaces – an occupational health concern for women?

    Directory of Open Access Journals (Sweden)

    Vidhya Venugopal

    2016-09-01

    Full Text Available Background: Health concerns unique to women are growing with the large number of women venturing into different trades that expose them to hot working environments and inadequate sanitation facilities, common in many Indian workplaces. Objective: The study was carried out to investigate the health implications of exposures to hot work environments and inadequate sanitation facilities at their workplaces for women workers. Design: A cross-sectional study was conducted with 312 women workers in three occupational sectors in 2014–2015. Quantitative data on heat exposures and physiological heat strain indicators such as core body temperature (CBT, sweat rate (SwR, and urine specific gravity (USG were collected. A structured questionnaire captured workers perceptions about health impacts of heat stress and inadequate sanitary facilities at the workplace. Results: Workplace heat exposures exceeded the threshold limit value for safe manual work for 71% women (Avg. wet bulb globe temperature=30°C±2.3°C during the study period. Eighty-seven percent of the 200 women who had inadequate/no toilets at their workplaces reported experiencing genitourinary problems periodically. Above normal CBT, SwR, and USG in about 10% women workers indicated heat strain and moderate dehydration that corroborated well with their perceptions. Observed significant associations between high-heat exposures and SwR (t=−2.3879, p=0.0192, inadequate toilet facilities and self-reported adverse heat-related health symptoms (χ2=4.03, p=0.0444, and prevalence of genitourinary issues (χ2=42.92, p=0.0005×10−7 reemphasize that heat is a risk and lack of sanitation facilities is a major health concern for women workers. Conclusions: The preliminary evidence suggests that health of women workers is at risk due to occupational heat exposures and inadequate sanitation facilities at many Indian workplaces. Intervention through strong labor policies with gender sensitivity is the

  7. Reasons rural Laotians choose home deliveries over delivery at health facilities: a qualitative study

    Directory of Open Access Journals (Sweden)

    Sychareun Vanphanom

    2012-08-01

    Full Text Available Abstract Background Maternal mortality among poor rural women in the Lao People’s Democratic Republic (Lao PDR is among the highest in Southeast Asia, in part because only 15% give birth at health facilities. This study explored why women and their families prefer home deliveries to deliveries at health facilities. Methods A qualitative study was conducted from December 2008 to February 2009 in two provinces of Lao PDR. Data was collected through eight focus group discussions (FGD as well as through in-depth interviews with 12 mothers who delivered at home during the last year, eight husbands and eight grandmothers, involving a total of 71 respondents. Content analysis was used to analyze the FGD and interview transcripts. Results Obstacles to giving birth at health facilities included: (1 Distance to the health facilities and difficulties and costs of getting there; (2 Attitudes, quality of care, and care practices at the health facilities, including a horizontal birth position, episiotomies, lack of privacy, and the presence of male staff; (3 The wish to have family members nearby and the need for women to be close to their other children and the housework; and (4 The wish to follow traditional birth practices such as giving birth in a squatting position and lying on a “hot bed” after delivery. The decision about where to give birth was commonly made by the woman’s husband, mother, mother-in-law or other relatives in consultation with the woman herself. Conclusion This study suggests that the preference in rural Laos for giving birth at home is due to convenience, cost, comfort and tradition. In order to assure safer births and reduce rural Lao PDR’s high maternal mortality rate, health centers could consider accommodating the wishes and traditional practices of many rural Laotians: allowing family in the birthing rooms; allowing traditional practices; and improving attitudes among staff. Traditional birth attendants, women, and

  8. A 'mystery client' evaluation of adolescent sexual and reproductive health services in health facilities from two regions in Tanzania.

    Directory of Open Access Journals (Sweden)

    Zaina Mchome

    Full Text Available Unwelcoming behaviours and judgemental attitudes have long been recognised as a barrier to young people's access to reproductive health services. Over the last decade youth friendly reproductive health services have been promoted and implemented world-wide. However, long term evidence of the impact of these programmes is lacking. We report the results of a large mystery client evaluation of adolescent sexual and reproductive health services in Tanzania, a country that has had a long established youth friendly policy. Forty-eight visits made to thirty-three health facilities were conducted by twelve young people (six in each region trained to perform three different scripted scenarios (i.e., condom request, information on sexually transmitted infections and family planning. The study revealed barriers in relation to poor signage and reception for services. In addition health workers demonstrated paternalistic attitudes as well as lack of knowledge about adolescent sexual and reproductive health services. In some cases, health workers discouraged young people from using services such as condoms and family planning methods. Lack of confidentiality and privacy were also noted to be common challenges for the young people involved. Intervention strategies that focus on changing health workers' mind-set in relation to adolescent sexual and reproductive health are crucial for ensuring quality provision of sexual and reproductive health services to young people. The study identified the importance of reception or signs at the health units, as this can facilitate young people's efforts in seeking sexual and reproductive health services. Likewise, improvement of health workers knowledge of existing policy and practice on sexual and reproductive health services and youth friendly services is much needed.

  9. A 'mystery client' evaluation of adolescent sexual and reproductive health services in health facilities from two regions in Tanzania.

    Science.gov (United States)

    Mchome, Zaina; Richards, Esther; Nnko, Soori; Dusabe, John; Mapella, Elizabeth; Obasi, Angela

    2015-01-01

    Unwelcoming behaviours and judgemental attitudes have long been recognised as a barrier to young people's access to reproductive health services. Over the last decade youth friendly reproductive health services have been promoted and implemented world-wide. However, long term evidence of the impact of these programmes is lacking. We report the results of a large mystery client evaluation of adolescent sexual and reproductive health services in Tanzania, a country that has had a long established youth friendly policy. Forty-eight visits made to thirty-three health facilities were conducted by twelve young people (six in each region) trained to perform three different scripted scenarios (i.e., condom request, information on sexually transmitted infections and family planning). The study revealed barriers in relation to poor signage and reception for services. In addition health workers demonstrated paternalistic attitudes as well as lack of knowledge about adolescent sexual and reproductive health services. In some cases, health workers discouraged young people from using services such as condoms and family planning methods. Lack of confidentiality and privacy were also noted to be common challenges for the young people involved. Intervention strategies that focus on changing health workers' mind-set in relation to adolescent sexual and reproductive health are crucial for ensuring quality provision of sexual and reproductive health services to young people. The study identified the importance of reception or signs at the health units, as this can facilitate young people's efforts in seeking sexual and reproductive health services. Likewise, improvement of health workers knowledge of existing policy and practice on sexual and reproductive health services and youth friendly services is much needed.

  10. Rapid assessment of infrastructure of primary health care facilities - a relevant instrument for health care systems management.

    Science.gov (United States)

    Scholz, Stefan; Ngoli, Baltazar; Flessa, Steffen

    2015-05-01

    Health care infrastructure constitutes a major component of the structural quality of a health system. Infrastructural deficiencies of health services are reported in literature and research. A number of instruments exist for the assessment of infrastructure. However, no easy-to-use instruments to assess health facility infrastructure in developing countries are available. Present tools are not applicable for a rapid assessment by health facility staff. Therefore, health information systems lack data on facility infrastructure. A rapid assessment tool for the infrastructure of primary health care facilities was developed by the authors and pilot-tested in Tanzania. The tool measures the quality of all infrastructural components comprehensively and with high standardization. Ratings use a 2-1-0 scheme which is frequently used in Tanzanian health care services. Infrastructural indicators and indices are obtained from the assessment and serve for reporting and tracing of interventions. The tool was pilot-tested in Tanga Region (Tanzania). The pilot test covered seven primary care facilities in the range between dispensary and district hospital. The assessment encompassed the facilities as entities as well as 42 facility buildings and 80 pieces of technical medical equipment. A full assessment of facility infrastructure was undertaken by health care professionals while the rapid assessment was performed by facility staff. Serious infrastructural deficiencies were revealed. The rapid assessment tool proved a reliable instrument of routine data collection by health facility staff. The authors recommend integrating the rapid assessment tool in the health information systems of developing countries. Health authorities in a decentralized health system are thus enabled to detect infrastructural deficiencies and trace the effects of interventions. The tool can lay the data foundation for district facility infrastructure management.

  11. Prevalence of malaria among patients attending public health facilities in Maputo City, Mozambique.

    Science.gov (United States)

    Macedo de Oliveira, Alexandre; Mutemba, Rosalia; Morgan, Juliette; Streat, Elizabeth; Roberts, Jacquelin; Menon, Manoj; Mabunda, Samuel

    2011-12-01

    We conducted a health facility-based survey to estimate the prevalence of malaria among febrile patients at health facilities (HFs) in Maputo City. Patients answered a questionnaire on malaria risk factors and underwent malaria testing. A malaria case was defined as a positive result for malaria by microscopy in a patient with fever or history of fever in the previous 24 hours. Among 706 patients with complete information, 111 (15.7%) cases were identified: 105 were positive for Plasmodium falciparum only, two for Plasmodium ovale only, and four for both P. falciparum and P. ovale. Fever documented at study enrollment, age ≥ 5 years, rural HF, and travel outside Maputo City were statistically significantly associated with malaria by multivariate analysis. We found a high prevalence of laboratory-confirmed malaria among febrile patients in Maputo City. Further studies are needed to relate these findings with mosquito density to better support malaria prevention and control.

  12. Animal-assisted interventions: A national survey of health and safety policies in hospitals, eldercare facilities, and therapy animal organizations.

    Science.gov (United States)

    Linder, Deborah E; Siebens, Hannah C; Mueller, Megan K; Gibbs, Debra M; Freeman, Lisa M

    2017-08-01

    Animal-assisted intervention (AAI) programs are increasing in popularity, but it is unknown to what extent therapy animal organizations that provide AAI and the hospitals and eldercare facilities they work with implement effective animal health and safety policies to ensure safety of both animals and humans. Our study objective was to survey hospitals, eldercare facilities, and therapy animal organizations on their AAI policies and procedures. A survey of United States hospitals, eldercare facilities, and therapy animal organizations was administered to assess existing health and safety policies related to AAI programs. Forty-five eldercare facilities, 45 hospitals, and 27 therapy animal organizations were surveyed. Health and safety policies varied widely and potentially compromised human and animal safety. For example, 70% of therapy animal organizations potentially put patients at risk by allowing therapy animals eating raw meat diets to visit facilities. In general, hospitals had stricter requirements than eldercare facilities. This information suggests that there are gaps between the policies of facilities and therapy animal organizations compared with recent guidelines for animal visitation in hospitals. Facilities with AAI programs need to review their policies to address recent AAI guidelines to ensure the safety of animals and humans involved. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  13. Assessing health-related resources in senior living residences.

    Science.gov (United States)

    Kerr, Jacqueline; Carlson, Jordan A; Sallis, James F; Rosenberg, Dori; Leak, Chikarlo R; Saelens, Brian E; Chapman, James E; Frank, Lawrence D; Cain, Kelli L; Conway, Terry L; King, Abby C

    2011-08-01

    This study evaluated a new tool, "The Audit of Physical Activity Resources for Seniors" (APARS), which assesses the physical activity environment in Senior Living Residences (SLRs). Audits were conducted in 29 SLRs and inter-rater reliability was assessed. Pearson correlations were examined between APARS items and objectively measured physical activity and sedentary time, and self-rated health, collected from residents at a subset of 12 SLRs (N=147). Eighty-nine of the 90 items (98.9%) demonstrated Kappa or ICC values above .70 and/or percent agreement above 80%. The 90 items were summarized into nine scales. Two scales (outside supportive physical activity features/functionality and outside exercise facilities) were related to greater physical activity and less sedentary time. Four scales (inside social facilities, onsite services, exercise programs, and social activities) were related to greater sedentary time and better self-rated health. APARS items demonstrated adequate inter-rater reliability and some evidence for construct validity to assess health-related environments in retirement facilities. Social activities in SLRs could benefit residents by incorporating more physical activity. Use of APARS could inform more health-promoting designs of senior living facilities.

  14. Multi-year Content Analysis of User Facility Related Publications

    Energy Technology Data Exchange (ETDEWEB)

    Patton, Robert M [ORNL; Stahl, Christopher G [ORNL; Hines, Jayson [ORNL; Potok, Thomas E [ORNL; Wells, Jack C [ORNL

    2013-01-01

    Scientific user facilities provide resources and support that enable scientists to conduct experiments or simulations pertinent to their respective research. Consequently, it is critical to have an informed understanding of the impact and contributions that these facilities have on scientific discoveries. Leveraging insight into scientific publications that acknowledge the use of these facilities enables more informed decisions by facility management and sponsors in regard to policy, resource allocation, and influencing the direction of science as well as more effectively understand the impact of a scientific user facility. This work discusses preliminary results of mining scientific publications that utilized resources at the Oak Ridge Leadership Computing Facility (OLCF) at Oak Ridge National Laboratory (ORNL). These results show promise in identifying and leveraging multi-year trends and providing a higher resolution view of the impact that a scientific user facility may have on scientific discoveries.

  15. Assessing post-abortion care in health facilities in Afghanistan: a cross-sectional study.

    Science.gov (United States)

    Ansari, Nasratullah; Zainullah, Partamin; Kim, Young Mi; Tappis, Hannah; Kols, Adrienne; Currie, Sheena; Haver, Jaime; van Roosmalen, Jos; Broerse, Jacqueline E W; Stekelenburg, Jelle

    2015-02-03

    Complications of abortion are one of the leading causes of maternal mortality worldwide, along with hemorrhage, sepsis, and hypertensive diseases of pregnancy. In Afghanistan little data exist on the capacity of the health system to provide post-abortion care (PAC). This paper presents findings from a national emergency obstetric and neonatal care needs assessment related to PAC, with the aim of providing insight into the current situation and recommendations for improvement of PAC services. A national Emergency Obstetric and Neonatal Care Needs Assessment was conducted from December 2009 through February 2010 at 78 of the 127 facilities designated to provide emergency obstetric and neonatal care services in Afghanistan. Research tools were adapted from the Averting Maternal Death and Disability Program Needs Assessment Toolkit and national midwifery education assessment tools. Descriptive statistics were used to summarize facility characteristics, and linear regression models were used to assess the factors associated with providers' PAC knowledge and skills. The average number of women receiving PAC in the past year in each facility was 244, with no significant difference across facility types. All facilities had at least one staff member who provided PAC services. Overall, 70% of providers reported having been trained in PAC and 68% felt confident in their ability to perform these services. On average, providers were able to identify 66% of the most common complications of unsafe or incomplete abortion and 57% of the steps to take in examining and managing women with these complications. Providers correctly demonstrated an average of 31% of the tasks required for PAC during a simulated procedure. Training was significantly associated with PAC knowledge and skills in multivariate regression models, but other provider and facility characteristics were not. While designated emergency obstetric facilities in Afghanistan generally have most supplies and equipment for

  16. Selecting and Effectively Using a Health/Fitness Facility

    Science.gov (United States)

    ... give you opportunities to meet new people and exercise in a social environment. BEFORE JOINING Visit several facilities prior to making your investment. Some facilities offer a trial membership for a ...

  17. Tracking implementation and (un)intended consequences: a process evaluation of an innovative peripheral health facility financing mechanism in Kenya.

    Science.gov (United States)

    Waweru, Evelyn; Goodman, Catherine; Kedenge, Sarah; Tsofa, Benjamin; Molyneux, Sassy

    2016-03-01

    In many African countries, user fees have failed to achieve intended access and quality of care improvements. Subsequent user fee reduction or elimination policies have often been poorly planned, without alternative sources of income for facilities. We describe early implementation of an innovative national health financing intervention in Kenya; the health sector services fund (HSSF). In HSSF, central funds are credited directly into a facility's bank account quarterly, and facility funds are managed by health facility management committees (HFMCs) including community representatives. HSSF is therefore a finance mechanism with potential to increase access to funds for peripheral facilities, support user fee reduction and improve equity in access. We conducted a process evaluation of HSSF implementation based on a theory of change underpinning the intervention. Methods included interviews at national, district and facility levels, facility record reviews, a structured exit survey and a document review. We found impressive achievements: HSSF funds were reaching facilities; funds were being overseen and used in a way that strengthened transparency and community involvement; and health workers' motivation and patient satisfaction improved. Challenges or unintended outcomes included: complex and centralized accounting requirements undermining efficiency; interactions between HSSF and user fees leading to difficulties in accessing crucial user fee funds; and some relationship problems between key players. Although user fees charged had not increased, national reduction policies were still not being adhered to. Finance mechanisms can have a strong positive impact on peripheral facilities, and HFMCs can play a valuable role in managing facilities. Although fiduciary oversight is essential, mechanisms should allow for local decision-making and ensure that unmanageable paperwork is avoided. There are also limits to what can be achieved with relatively small funds in

  18. An assessment of equity in the distribution of non-financial health care inputs across public primary health care facilities in Tanzania.

    Science.gov (United States)

    Kuwawenaruwa, August; Borghi, Josephine; Remme, Michelle; Mtei, Gemini

    2017-07-11

    There is limited evidence on how health care inputs are distributed from the sub-national level down to health facilities and their potential influence on promoting health equity. To address this gap, this paper assesses equity in the distribution of health care inputs across public primary health facilities at the district level in Tanzania. This is a quantitative assessment of equity in the distribution of health care inputs (staff, drugs, medical supplies and equipment) from district to facility level. The study was carried out in three districts (Kinondoni, Singida Rural and Manyoni district) in Tanzania. These districts were selected because they were implementing primary care reforms. We administered 729 exit surveys with patients seeking out-patient care; and health facility surveys at 69 facilities in early 2014. A total of seventeen indices of input availability were constructed with the collected data. The distribution of inputs was considered in relation to (i) the wealth of patients accessing the facilities, which was taken as a proxy for the wealth of the population in the catchment area; and (ii) facility distance from the district headquarters. We assessed equity in the distribution of inputs through the use of equity ratios, concentration indices and curves. We found a significant pro-rich distribution of clinical staff and nurses per 1000 population. Facilities with the poorest patients (most remote facilities) have fewer staff per 1000 population than those with the least poor patients (least remote facilities): 0.6 staff per 1000 among the poorest, compared to 0.9 among the least poor; 0.7 staff per 1000 among the most remote facilities compared to 0.9 among the least remote. The negative concentration index for support staff suggests a pro-poor distribution of this cadre but the 45 degree dominated the concentration curve. The distribution of vaccines, antibiotics, anti-diarrhoeal, anti-malarials and medical supplies was approximately

  19. Preparedness of Tanzanian health facilities for outpatient primary care of hypertension and diabetes: a cross-sectional survey.

    Science.gov (United States)

    Peck, Robert; Mghamba, Janneth; Vanobberghen, Fiona; Kavishe, Bazil; Rugarabamu, Vivian; Smeeth, Liam; Hayes, Richard; Grosskurth, Heiner; Kapiga, Saidi

    2014-05-01

    Historically, health facilities in sub-Saharan Africa have mainly managed acute, infectious diseases. Few data exist for the preparedness of African health facilities to handle the growing epidemic of chronic, noncommunicable diseases (NCDs). We assessed the burden of NCDs in health facilities in northwestern Tanzania and investigated the strengths of the health system and areas for improvement with regard to primary care management of selected NCDs. Between November, 2012, and May, 2013, we undertook a cross-sectional survey of a representative sample of 24 public and not-for profit health facilities in urban and rural Tanzania (four hospitals, eight health centres, and 12 dispensaries). We did structured interviews of facility managers, inspected resources, and administered self-completed questionnaires to 335 health-care workers. We focused on hypertension, diabetes, and HIV (for comparison). Our key study outcomes related to service provision, availability of guidelines and supplies, management and training systems, and preparedness of human resources. Of adult outpatient visits to hospitals, 58% were for chronic diseases compared with 20% at health centres, and 13% at dispensaries. In many facilities, guidelines, diagnostic equipment, and fi rst-line drug therapy for the primary care of NCDs were inadequate, and management, training, and reporting systems were weak. Services for HIV accounted for most chronic disease visits and seemed stronger than did services for NCDs. Ten (42%) facilities had guidelines for HIV whereas three (13%) facilities did for NCDs. 261 (78%) health workers showed fair knowledge of HIV, whereas 198 (59%) did for hypertension and 187 (56%) did for diabetes. Generally, health systems were weaker in lower-level facilities. Front-line health-care workers (such as non-medical-doctor clinicians and nurses) did not have knowledge and experience of NCDs. For example, only 74 (49%) of 150 nurses had at least fair knowledge of diabetes care

  20. School Health Services: A Facility Planning and Design Guide for School Systems.

    Science.gov (United States)

    Maryland State Dept. of Education, Baltimore.

    This guide for Maryland schools outlines the role of school health services and proper facility design for these services. Chapter 1 provides an overview, describing coordinated school health programs, school health services programs, school health services programs in Maryland, how school health services are delivered, trends, the number of…

  1. Capacity of Health Facilities to Manage Hypertension in Mukono and Buikwe Districts in Uganda: Challenges and Recommendations.

    Directory of Open Access Journals (Sweden)

    Geofrey Musinguzi

    that they needed additional training in hypertension management. Several provider and patient related challenges were also observed in this study.Health facilities in this setting are inadequately equipped to provide services for management of hypertension. Diagnostic equipment, anti-hypertensive drugs and personnel present great challenges. To address the increasing burden of hypertension and other chronic diseases, measures are needed to substantially strengthen the healthcare facilities, including training of personnel in management of hypertension and other chronic diseases, and improving diagnostic and treatment supplies.

  2. Bypassing health facilities for childbirth: a multilevel study in three districts of Gujarat, India

    OpenAIRE

    2016-01-01

    Background: Bypassing available facilities for childbirth has important implications for maternal health service delivery and human resources within a health system. The results are the additional expenses imposed on the woman and her family, as well as the inefficient use of health system resources. Bypassing often indicates a lack of confidence in the care provided by the facility nearest to the mother, which implies a level of dysfunctionality that the health system needs to address. Over ...

  3. Location, use, and locational efficiency of health facilities in a Madras neighbourhood.

    Science.gov (United States)

    Kumaran, V V

    1983-01-01

    The present paper has two related aims: an attempt to measure locational efficiency of health facilities in a Madras neighbourhood - Alandur - through an analysis of use patterns obtained from a questionnaire study, and an application of two significant methods on problems relating to organisation of health services - set covering reasoning and maximal covering location method. Some major conclusions of the two related analyses are: - Generally use declines with distance. However, beyond the eleventh distance zone, the use increases sharply, only to decrease after the fourteenth distance zone, the number of visits attributable to quality services at locations in these distance zones. - Among the variables determining the use patterns, distance is most important, followed by cost of treatment, the quality care, nature of facility and its availability. - Set covering method yielded 5 potential health location sites which proved to be efficient in both population coverage and maximum time distances of five and ten minutes /maximal covering location method/. Two alternative sets identified by set covering method proved to be inefficient on both population and distance counts when maximal covering method was applied.

  4. Quality along the continuum: a health facility assessment of intrapartum and postnatal care in Ghana.

    Directory of Open Access Journals (Sweden)

    Robin C Nesbitt

    Full Text Available To evaluate quality of routine and emergency intrapartum and postnatal care using a health facility assessment, and to estimate "effective coverage" of skilled attendance in Brong Ahafo, Ghana.We conducted an assessment of all 86 health facilities in seven districts in Brong Ahafo. Using performance of key signal functions and the availability of relevant drugs, equipment and trained health professionals, we created composite quality categories in four dimensions: routine delivery care, emergency obstetric care (EmOC, emergency newborn care (EmNC and non-medical quality. Linking the health facility assessment to surveillance data we estimated "effective coverage" of skilled attendance as the proportion of births in facilities of high quality.Delivery care was offered in 64/86 facilities; only 3-13% fulfilled our requirements for the highest quality category in any dimension. Quality was lowest in the emergency care dimensions, with 63% and 58% of facilities categorized as "low" or "substandard" for EmOC and EmNC, respectively. This implies performing less than four EmOC or three EmNC signal functions, and/or employing less than two skilled health professionals, and/or that no health professionals were present during our visit. Routine delivery care was "low" or "substandard" in 39% of facilities, meaning 25/64 facilities performed less than six routine signal functions and/or had less than two skilled health professionals and/or less than one midwife. While 68% of births were in health facilities, only 18% were in facilities with "high" or "highest" quality in all dimensions.Our comprehensive facility assessment showed that quality of routine and emergency intrapartum and postnatal care was generally low in the study region. While coverage with facility delivery was 68%, we estimated "effective coverage" of skilled attendance at 18%, thus revealing a large "quality gap." Effective coverage could be a meaningful indicator of progress towards

  5. Quality along the continuum: a health facility assessment of intrapartum and postnatal care in Ghana.

    Science.gov (United States)

    Nesbitt, Robin C; Lohela, Terhi J; Manu, Alexander; Vesel, Linda; Okyere, Eunice; Edmond, Karen; Owusu-Agyei, Seth; Kirkwood, Betty R; Gabrysch, Sabine

    2013-01-01

    To evaluate quality of routine and emergency intrapartum and postnatal care using a health facility assessment, and to estimate "effective coverage" of skilled attendance in Brong Ahafo, Ghana. We conducted an assessment of all 86 health facilities in seven districts in Brong Ahafo. Using performance of key signal functions and the availability of relevant drugs, equipment and trained health professionals, we created composite quality categories in four dimensions: routine delivery care, emergency obstetric care (EmOC), emergency newborn care (EmNC) and non-medical quality. Linking the health facility assessment to surveillance data we estimated "effective coverage" of skilled attendance as the proportion of births in facilities of high quality. Delivery care was offered in 64/86 facilities; only 3-13% fulfilled our requirements for the highest quality category in any dimension. Quality was lowest in the emergency care dimensions, with 63% and 58% of facilities categorized as "low" or "substandard" for EmOC and EmNC, respectively. This implies performing less than four EmOC or three EmNC signal functions, and/or employing less than two skilled health professionals, and/or that no health professionals were present during our visit. Routine delivery care was "low" or "substandard" in 39% of facilities, meaning 25/64 facilities performed less than six routine signal functions and/or had less than two skilled health professionals and/or less than one midwife. While 68% of births were in health facilities, only 18% were in facilities with "high" or "highest" quality in all dimensions. Our comprehensive facility assessment showed that quality of routine and emergency intrapartum and postnatal care was generally low in the study region. While coverage with facility delivery was 68%, we estimated "effective coverage" of skilled attendance at 18%, thus revealing a large "quality gap." Effective coverage could be a meaningful indicator of progress towards reducing maternal

  6. Cold chain management practices of health care workers in primary health care facilities in Southern Nigeria

    Science.gov (United States)

    Ogboghodo, Esohe Olivia; Omuemu, Vivian Ossaidiom; Odijie, Oisedebame; Odaman, Ofure Jennifer

    2017-01-01

    Introduction Vaccination has caused a dramatic reduction in the threat of diseases that were once widespread and often times fatal. The efficient practice of cold chain management is therefore key to ensuring that the benefits of vaccination are sustained. The objective of this study is to assess the practice of cold chain management among health workers in primary health care facilities in Benin City, Edo State. Methods A descriptive cross-sectional study design was employed in this study. The study population consisted of registered nurses, auxiliary nurses and community health extension workers in primary health care facilities in Benin City, Edo State. The tool for data collection was pre-tested, structured self-administered questionnaire. Bivariate analysis between socio-demographic variables and practice of cold chain management was done. Binary logistic regression was also done to determine significant predictors of practice of cold chain management. The level of significance was set at p cold chain management. Significant determinants of practice of cold chain management were cold chain management training (p = 0.004), presence of functional refrigerators (p = 0.016), NPI supervision (p cold chain management among respondents was fair. All stakeholders should ensure they work collectively towards ensuring that favorable environments which would improve the practice among health workers are put in place. PMID:28761610

  7. The influence of facility design and human resource management on health care professionals.

    Science.gov (United States)

    Sadatsafavi, Hessam; Walewski, John; Shepley, Mardelle M

    2015-01-01

    Cost control of health care services is a strategic concern for organizations. To lower costs, some organizations reduce staffing levels. However, this may not be worth the trade-off, as the quality of services will likely be reduced, morale among health care providers tends to suffer, and patient satisfaction is likely to decline. The potential synergy between human resource management and facility design and operation was investigated to achieve the goal of providing cost containment strategies without sacrificing the quality of services and the commitment of employees. About 700 health care professionals from 10 acute-care hospitals participated in this cross-sectional study. The authors used structural equation modeling to test whether employees' evaluations of their physical work environment and human resource practices were significantly associated with lower job-related anxiety, higher job satisfaction, and higher organizational commitment. The analysis found that employees' evaluations of their physical work environment and human resource practices influenced their job-related feelings and attitudes. Perceived organizational support mediated this relationship. The study also found a small but positive interaction effect between the physical work environment and human resource practices. The influence of physical work environment was small, mainly because of the high predictive value of human resource practices and strong confounding variables included in the analysis. This study specifically showed the role of facility design in reducing job-related anxiety among caregivers. Preliminary evidence is provided that facility design can be used as a managerial tool for improving job-related attitudes and feelings of employees and earning their commitment. Providing a healthy and safe work environment can be perceived by employees as an indication that the organization respects them and cares about their well-being, which might be reciprocated with higher levels

  8. Organizational factors influencing health information technology adoption in long-term-care facilities.

    Science.gov (United States)

    Wang, Tiankai; Wang, Yangmei; Moczygemba, Jackie

    2014-01-01

    Long-term care (LTC) is an important sector of the health care industry. However, the adoption of health information technology (HIT) systems in LTC facilities lags behind that in other sectors of health care. Previous literature has focused on the financial and technical barriers. This study examined the organizational factors associated with HIT adoption in LTC facilities. A survey of 500 LTC facilities in Texas enabled researchers to compile HIT indexes for further statistical analyses. A general linear model was used to study the associations between the clinical/administrative HIT indexes and organizational factors. The empirical outcomes show that the size of an LTC facility has a significant association with HIT adoption. Rural LTC facilities, especially freestanding ones, adopt less HIT than their urban counterparts, whereas freestanding LTC facilities have the lowest HIT adoption overall. There is not enough evidence to support ownership status as a significant factor in HIT adoption. Some implications are proposed, but further research is necessary.

  9. HealthSouth's inpatient rehabilitation facilities: how does their performance compare with other for-profit and nonprofit inpatient rehabilitation facilities?

    Science.gov (United States)

    McCue, Michael J; Thompson, Jon M

    2010-05-01

    To assess the financial and operational differences in freestanding inpatient rehabilitation facilities (IRFs) that are operated by HealthSouth Corporation relative to other for-profit and nonprofit system-affiliated ownership groups. Since 2003, when it faced fraud charges and financial penalties, HealthSouth has experienced new management and refocused its business strategy. Because HealthSouth is the largest provider of freestanding IRF services, it is important to understand how their performance may differ relative to other ownership groups. We used the Mann-Whitney U test to assess differences in median values for financial and operational variables of HealthSouth-owned IRFs compared with other for-profit system IRFs and nonprofit system IRFs. System-affiliated freestanding IRFs in the United States. Sixty-four HealthSouth IRFs, 18 nonprofit system-affiliated IRFs, and 18 for-profit system-affiliated IRFs. Not applicable. Net patient revenue per adjusted discharge, operating expense per adjusted discharge, salary expense per full-time equivalent, and cash flow margin. HealthSouth IRFs had significantly lower net patient revenue per adjusted discharge and operating expense per adjusted discharge; however, its cash flow margin was significantly higher than other comparison groups. HealthSouth IRFs treated a higher case mix of patients relative to these comparison groups. The financial and operating performance of HealthSouth IRFs is stronger than other ownership groups. Strong cash flow will enable HealthSouth to pay down long-term debt.

  10. Performance of general health workers in leprosy control activities at public health facilities in Amhara and Oromia States, Ethiopia.

    Science.gov (United States)

    Abeje, Tadiye; Negera, Edessa; Kebede, Eshetu; Hailu, Tsegaye; Hassen, Ismaile; Lema, Tsehainesh; Yamuah, Lawrence; Shiguti, Birru; Fenta, Melkamu; Negasa, Megersa; Beyene, Demissew; Bobosha, Kidist; Aseffa, Abraham

    2016-04-07

    towards leprosy was positive for the majority of the respondents. The result showed that 519 (86.3%) had poor knowledge. Overall 155 (25.8%) of the respondents had positive attitude towards leprosy while 205 (34.1%) had intermediate (mixed) attitude and 241 (40.1%) had negative attitude to the disease. Among 83 respondents assessed for diagnosis of leprosy only 15(18.0%) diagnosed leprosy correctly. Variation in knowledge and attitude indicated a significant difference (p leprosy control activities are integrated to the general health services in the country, the knowledge and skills of leprosy diagnosis, treatment and management by health workers was unsatisfactory. Hence, attention should be given to develop training strategies that can improve health worker knowledge and promote better leprosy management at public health facilities. This could be achieved through pre-service and in-service training and giving adequate emphasis to leprosy related practical work and continuous follow- up.

  11. Availability of emergency obstetric care (EmOC) among public and private health facilities in rural northwest Bangladesh.

    Science.gov (United States)

    Sikder, Shegufta S; Labrique, Alain B; Ali, Hasmot; Hanif, Abu A M; Klemm, Rolf D W; Mehra, Sucheta; West, Keith P; Christian, Parul

    2015-01-31

    Although safe motherhood strategies recommend that women seek timely care from health facilities for obstetric complications, few studies have described facility availability of emergency obstetric care (EmOC). We sought to describe and compare availability and readiness to provide EmOC among public and private health facilities commonly visited for pregnancy-related complications in two districts of northwest Bangladesh. We also described aspects of financial and geographic access to healthcare and key constraints to EmOC provision. Using data from a large population-based community trial, we identified and surveyed the 14 health facilities (7 public, 7 private) most frequently visited for obstetric complications and near misses as reported by women. Availability of EmOC was based on provision of medical services, assessed through clinician interviews and record review. Levels of EmOC availability were defined as basic or comprehensive. Readiness for EmOC provision was based on scores in four categories: staffing, equipment, laboratory capacity, and medicines. Readiness scores were calculated using unweighted averages. Costs of C-section procedures and geographic locations of facilities were described. Textual analysis was used to identify key constraints. The seven surveyed private facilities offered comprehensive EmOC compared to four of the seven public facilities. With 100% representing full readiness, mean EmOC readiness was 81% (range: 63%-91%) among surveyed private facilities compared to 67% (range: 48%-91%) in public facilities (p = 0.040). Surveyed public clinics had low scores on staffing and laboratory capacity (69%; 50%). The mean cost of the C-section procedure in private clinics was $77 (standard deviation: $16) and free in public facilities. The public sub-district facilities were the only facilities located in rural areas, with none providing comprehensive EmOC. Shortages in specialized staff were listed as the main barrier to EmOC provision in

  12. Public health facility resource availability and provider adherence to first antenatal guidelines in a low resource setting in Accra, Ghana

    NARCIS (Netherlands)

    Amoakoh-Coleman, Mary; Agyepong, Irene Akua; Kayode, Gbenga A; Grobbee, Diederick E; Klipstein-Grobusch, Kerstin; Ansah, Evelyn K

    2016-01-01

    BACKGROUND: Lack of resources has been identified as a reason for non-adherence to clinical guidelines. Our aim was to describe public health facility resource availability in relation to provider adherence to first antenatal visit guidelines. METHODS: A cross-sectional analysis of the baseline data

  13. Public health facility resource availability and provider adherence to first antenatal guidelines in a low resource setting in Accra, Ghana

    NARCIS (Netherlands)

    Amoakoh-Coleman, Mary; Agyepong, Irene Akua; Kayode, Gbenga A; Grobbee, Diederick E; Klipstein-Grobusch, Kerstin; Ansah, Evelyn K

    2016-01-01

    BACKGROUND: Lack of resources has been identified as a reason for non-adherence to clinical guidelines. Our aim was to describe public health facility resource availability in relation to provider adherence to first antenatal visit guidelines. METHODS: A cross-sectional analysis of the baseline data

  14. NHRIC (National Health Related Items Code)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Health Related Items Code (NHRIC) is a system for identification and numbering of marketed device packages that is compatible with other numbering...

  15. NHRIC (National Health Related Items Code)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Health Related Items Code (NHRIC) is a system for identification and numbering of marketed device packages that is compatible with other numbering...

  16. Utilization of the BARC critical facility for ADS related experiments

    Indian Academy of Sciences (India)

    Rajeev Kumar; R Srivenkatesan

    2007-02-01

    The paper discusses the basic design of the critical facility, whose main purpose is the physics validation of AHWR. Apart from moderator level control, the facility will have shutdown systems based on shutoff rods and multiple ranges of neutron detection systems. In addition, it will have a flux mapping system based on 25 fission chambers, distributed in the core. We are planning to use this reactor for experiments with a suitable source to simulate an ADS system. Any desired sub-criticality can be achieved by adjusting the moderator level. Apart from perfecting our experimental techniques, in simple configurations, we intend to study the one-way coupled core in this facility. Preliminary calculations, employing a Monte Carlo code TRIPOLI, are presented.

  17. The role of civil society in strengthening intercultural maternal health care in local health facilities: Puno, Peru

    Directory of Open Access Journals (Sweden)

    Jeannie Samuel

    2016-12-01

    Full Text Available Background and objective: Peru's Ministry of Health has made efforts to increase the cultural inclusiveness of maternal health services. In 2005, the Ministry adopted an intercultural birthing policy (IBP that authorizes and encourages the use of culturally acceptable birthing practices in government-run health facilities. However, studies suggest that indigenous women may receive inconsistent benefits from these kinds of policies. This article examines whether a grassroots accountability initiative based on citizen monitoring of local health facilities by indigenous women can help to promote the objectives of the IBP and improve intercultural maternal health care. Design: Findings are drawn from a larger qualitative research study completed in 2015 that included fieldwork done between 2010 and 2011. Semi-structured interviews were conducted with 23 women working as citizen monitors in local health facilities in Puno and 30 key informants, including frontline health workers, health officials, and civil society actors in Puno and Lima, and human rights lawyers from the Defensoría del Pueblo Office in Puno. Results: Monitors confirmed from their own personal experiences in the 1990s and early 2000s that respect for intercultural aspects of maternal health care, including traditional indigenous birthing practices, were not readily accepted in publicly funded health facilities. It was also common for indigenous women to face discrimination when seeking health service provided by the state. Although the government's adoption of the IBP in 2005 was a positive step, considerable efforts are still needed to ensure high-quality, culturally appropriate maternal health care is consistently available in local health facilities. Conclusions: Despite important progress in the past two decades, policies aimed at improving intercultural maternal health care are unevenly implemented in local health facilities. Civil society, in particular indigenous women

  18. The effect of user fee exemption on the utilization of maternal health care at mission health facilities in Malawi.

    Science.gov (United States)

    Manthalu, Gerald; Yi, Deokhee; Farrar, Shelley; Nkhoma, Dominic

    2016-11-01

    The Government of Malawi has signed contracts called service level agreements (SLAs) with mission health facilities in order to exempt their catchment populations from paying user fees. Government in turn reimburses the facilities for the services that they provide. SLAs started in 2006 with 28 out of 165 mission health facilities and increased to 74 in 2015. Most SLAs cover only maternal, neonatal and in some cases child health services due to limited resources. This study evaluated the effect of user fee exemption on the utilization of maternal health services. The difference-in-differences approach was combined with propensity score matching to evaluate the causal effect of user fee exemption. The gradual uptake of the policy provided a natural experiment with treated and control health facilities. A second control group, patients seeking non-maternal health care at CHAM health facilities with SLAs, was used to check the robustness of the results obtained using the primary control group. Health facility level panel data for 142 mission health facilities from 2003 to 2010 were used. User fee exemption led to a 15% (P facilities. No effects were found for the proportion of pregnant women who made the first ANC visit in the first trimester and the proportion of women who made postpartum care visits. We conclude that user fee exemption is an important policy for increasing maternal health care utilization. For certain maternal services, however, other determinants may be more important. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  19. Annual Report To Congress. Department of Energy Activities Relating to the Defense Nuclear Facilities Safety Board, Calendar Year 2003

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2004-02-28

    The Department of Energy (Department) submits an Annual Report to Congress each year detailing the Department’s activities relating to the Defense Nuclear Facilities Safety Board (Board), which provides advice and recommendations to the Secretary of Energy (Secretary) regarding public health and safety issues at the Department’s defense nuclear facilities. In 2003, the Department continued ongoing activities to resolve issues identified by the Board in formal recommendations and correspondence, staff issue reports pertaining to Department facilities, and public meetings and briefings. Additionally, the Department is implementing several key safety initiatives to address and prevent safety issues: safety culture and review of the Columbia accident investigation; risk reduction through stabilization of excess nuclear materials; the Facility Representative Program; independent oversight and performance assurance; the Federal Technical Capability Program (FTCP); executive safety initiatives; and quality assurance activities. The following summarizes the key activities addressed in this Annual Report.

  20. Quality of physical resources of health facilities in Indonesia: a panel study 1993-2007.

    Science.gov (United States)

    Diana, Aly; Hollingworth, Samantha A; Marks, Geoffrey C

    2013-10-01

    The merits of mixed public and private health systems are debated. Although private providers have become increasingly important in the Indonesian health system, there is no comprehensive assessment of the quality of private facilities. This study examined the quality of physical resources of public and private facilities in Indonesia from 1993 to 2007. Data from the Indonesian Family Life Surveys in 1993, 1997, 2000 and 2007 were used to evaluate trends in the quality of physical resources for public and private facilities, stratified by urban/rural areas and Java-Bali/outer Java-Bali regions. The quality of six categories of resources was measured using an adapted MEASURE Evaluation framework. Overall quality was moderate, but higher in public than in private health facilities in all years regardless of the region. The higher proportion of nurses and midwives in private practice was a determinant of scope of services and facilities available. There was little improvement in quality of physical resources following decentralization. Despite significant increases in public investment in health between 2000 and 2006 and the potential benefits of decentralization (2001), the quality of both public and private health facilities in Indonesia did not improve significantly between 1993 and 2007. As consumers commonly believe the quality is better in private facilities and are increasingly using them, it is essential to improve quality in both private and public facilities. Implementation of minimum standards and effective partnerships with private practice are considered important.

  1. A survey of husbandry practices for lorisid primates in North American zoos and related facilities.

    Science.gov (United States)

    Fuller, Grace; Kuhar, Christopher W; Dennis, Patricia M; Lukas, Kristen E

    2013-01-01

    Zoos and related facilities in North America currently manage five species in the primate family Lorisidae: the greater (Nycticebus coucang), Bengal (N. bengalensis) and pygmy (N. pygmaeus) slow lorises, red slender loris (Loris tardigradus), and potto (Perodicticus potto). We used an online survey to describe institutional housing and husbandry practices for these species and assess the extent to which practices are consistent with established guidelines. Our results show that most captive lorisids are housed solitarily or in pairs. Most individuals occupy a single exhibit space in a building dedicated to nocturnal animals. Facilities are commonly meeting recommendations for abiotic exhibit design and are providing animals with an enriched environment. However, pottos and slender lorises currently occupy exhibit spaces smaller than the recommended minimum, and the impact of cleaning protocols on olfactory communication should be critically evaluated. Few facilities are taking advantage of the benefits of positive reinforcement training for promoting animal welfare. Research is greatly needed on the effects of exhibit lighting on behavior, health, and reproduction; and to determine how best to manage the social needs of lorisids with naturally dispersed social structures. Although captive populations of slender lorises, pottos, and slow lorises are declining, we suggest that improved husbandry knowledge has the potential to positively influence population sustainability and to enhance future efforts to manage the growing pygmy loris population. © 2012 Wiley Periodicals, Inc.

  2. Intervention to promote physical health in staff within mental health facilities and the impact on patients’ physical health

    DEFF Research Database (Denmark)

    Hjorth, Peter; Davidsen, Annette Sofie; Killian, Reinhold;

    2016-01-01

    -month intervention study, and the interventionwas active awareness on physical health. Results: In the intervention group the staff reducedtheir waist circumference by 2.3 cm (95% CI: 0.3–4.4) when controlling for gender, age andcigarette consumption. In the control group, the staff changed their waist...... of an intervention programme for improving physical health in staff working in longtermpsychiatric treatment facilities. Furthermore, the paper measured the association betweenstaff’s changes in physical health and the patients’ changes in physical health. Methods: Thestudy was a cluster randomized controlled 12......’s changes in health parameters (body mass index, total body fat and qualityof life). Conclusion: The staff in the intervention group showed a significant reduction of waistcircumference, while staff in the control group showed a non-significant increase. Furthermore,a significant reduction in the diastolic...

  3. The problems related to confidentiality and effectiveness of health care.

    Science.gov (United States)

    Scherrer, J R

    1983-08-01

    The problem of the impact of confidentiality on health effectiveness is discussed along five points: (1) Communication facilities between health departments are main features of health information systems. (2) Efforts, costs, limits of data protection. The privacy violation risks have to be related to the data protection costs. (3) Paradox of the fundamental rights to confidentiality regarding privacy of the individual and the preponderant interest of the State. (4) Facing the increasing health costs, the need for medical and hospital control systems is assessed. (5) New benefits in medicine and in the quality of care are partly the results of more or less extensive studies in epidemiology at national levels. The general conclusion is concerned with the risks that the computer could become an instrumental substitute for human reason with the progressive drop out of responsibility of health officers.

  4. Building-related health impacts in European and Chinese cities

    DEFF Research Database (Denmark)

    Tuomisto, Jouni T; Niittynen, Marjo; Pärjälä, Erkki

    2015-01-01

    consumption. Active climate mitigation policies will also, aside of their long term global impacts, have short term local impacts, both positive and negative, on public health. Our main objective was to develop a generic open impact model to estimate health impacts of emissions due to heat and power...... facilities may have rapid and large impacts on emissions. However, the life cycle impacts of different fuels is somewhat an open question. CONCLUSIONS: In conclusion, we were able to develop a practical model for city-level assessments promoting evidence-based policy in general and health aspects...... consumption of buildings. In addition, the model should be usable for policy comparisons by non-health experts on city level with city-specific data, it should give guidance on the particular climate mitigation questions but at the same time increase understanding on the related health impacts and the model...

  5. Organisation of facilities management in relation to core business

    DEFF Research Database (Denmark)

    Jensen, Per Anker

    2011-01-01

    Purpose: The purpose of this article is to clarify the organisational relationships between Facilities Management (FM) and core business and how these relationships vary for strategic and operational support functions. Approach: The research takes a starting point in Michael Porter’s theory...

  6. Differences in essential newborn care at birth between private and public health facilities in eastern Uganda

    Directory of Open Access Journals (Sweden)

    Peter Waiswa

    2015-03-01

    Full Text Available Background: In Uganda and elsewhere, the private sector provides an increasing and significant proportion of maternal and child health services. However, little is known whether private care results in better quality services and improved outcomes compared to the public sector, especially regarding care at the time of birth. Objective: To describe the characteristics of care-seekers and assess newborn care practices and services received at public and private facilities in rural eastern Uganda. Design: Within a community-based maternal and newborn care intervention with health systems strengthening, we collected data from mothers with infants at baseline and endline using a structured questionnaire. Descriptive, bivariate, and multivariate data analysis comparing nine newborn care practices and three composite newborn care indicators among private and public health facilities was conducted. Results: The proportion of women giving birth at private facilities decreased from 25% at baseline to 17% at endline, whereas overall facility births increased. Private health facilities did not perform significantly better than public health facilities in terms of coverage of any essential newborn care interventions, and babies were more likely to receive thermal care practices in public facilities compared to private (68% compared to 60%, p=0.007. Babies born at public health facilities received an average of 7.0 essential newborn care interventions compared to 6.2 at private facilities (p<0.001. Women delivering in private facilities were more likely to have higher parity, lower socio-economic status, less education, to seek antenatal care later in pregnancy, and to have a normal delivery compared to women delivering in public facilities. Conclusions: In this setting, private health facilities serve a vulnerable population and provide access to service for those who might not otherwise have it. However, provision of essential newborn care practices was

  7. Improving primary health care facility performance in Ghana: efficiency analysis and fiscal space implications.

    Science.gov (United States)

    Novignon, Jacob; Nonvignon, Justice

    2017-06-12

    Health centers in Ghana play an important role in health care delivery especially in deprived communities. They usually serve as the first line of service and meet basic health care needs. Unfortunately, these facilities are faced with inadequate resources. While health policy makers seek to increase resources committed to primary healthcare, it is important to understand the nature of inefficiencies that exist in these facilities. Therefore, the objectives of this study are threefold; (i) estimate efficiency among primary health facilities (health centers), (ii) examine the potential fiscal space from improved efficiency and (iii) investigate the efficiency disparities in public and private facilities. Data was from the 2015 Access Bottlenecks, Cost and Equity (ABCE) project conducted by the Institute for Health Metrics and Evaluation. The Stochastic Frontier Analysis (SFA) was used to estimate efficiency of health facilities. Efficiency scores were then used to compute potential savings from improved efficiency. Outpatient visits was used as output while number of personnel, hospital beds, expenditure on other capital items and administration were used as inputs. Disparities in efficiency between public and private facilities was estimated using the Nopo matching decomposition procedure. Average efficiency score across all health centers included in the sample was estimated to be 0.51. Also, average efficiency was estimated to be about 0.65 and 0.50 for private and public facilities, respectively. Significant disparities in efficiency were identified across the various administrative regions. With regards to potential fiscal space, we found that, on average, facilities could save about GH₵11,450.70 (US$7633.80) if efficiency was improved. We also found that fiscal space from efficiency gains varies across rural/urban as well as private/public facilities, if best practices are followed. The matching decomposition showed an efficiency gap of 0.29 between private

  8. Quality of the delivery services in health facilities in Northern Ethiopia.

    Science.gov (United States)

    Fisseha, Girmatsion; Berhane, Yemane; Worku, Alemayehu; Terefe, Wondwossen

    2017-03-09

    Substantial improvements have been observed in the coverage of and access to maternal health service, especially in skilled birth attendants, in Ethiopia. However, the quality of care has been lagging behind. Therefore, this study investigated the status of the quality of delivery services in Northern Ethiopia. A facility based survey was conducted from December 2014 to February 2015 in Northern Ethiopia. The quality of delivery service was assessed in 32 health facilities using a facility audit checklist, by reviewing delivery, by conducting in-depth interview and observation, and by conducting exit interviews with eligible mothers. Facilities were considered as 'good quality' if they scored positively on 75% of the quality indicators set in the national guidelines for all the three components; input (materials, infrastructure, and human resource), process (adherence to standard care procedures during intrapartum and immediate postpartum periods) and output (the mothers' satisfaction and utilization of lifesaving procedures). Overall 2 of 32 (6.3%) of the study facilities fulfilled all the three quality components; input, process and output. Two of the three components were assessed as good in 11 of the 32 (34.4%) health facilities. The input quality was the better of the other quality components; which was good in 21 out of the 32 (65.6%) health facilities. The process and output quality was good in only 10 of the 32 (31.3%) facilities. Only 6.3% of the studied health facilities had good quality in all three dimensions of quality measures that was done in accordance to the national delivery service guidelines. The most compromised quality component was the process. Systematic and sustained efforts need to be strengthened to improve all dimensions of quality in order to achieve the desired quality of delivery services and increase the proportion of births occurring in health facilities.

  9. Public health response to a measles outbreak in a large correctional facility, Queensland, 2013.

    Science.gov (United States)

    Chatterji, Madhumati; Baldwin, Anne M; Prakash, Rajendra; Vlack, Susan A; Lambert, Stephen B

    2014-12-31

    This report documents the prompt, co-ordinated and effective public health response to a measles outbreak in Queensland in 2013. There were 17 cases in a large, high-security, regional correctional facility, a setting with unique challenges. Recommendations are provided to reduce the likelihood and magnitude of measles outbreaks in correctional facilities.

  10. Older Adult Participation in Health Promotion Programs: Perspectives of Facility Administrators

    Science.gov (United States)

    Wright, Tim; Hyner, Gerald C.

    2011-01-01

    Administrators of older adult-centered facilities must identify barriers to the planning and implementation of health promotion programs. In this qualitative research those barriers were identified through in-depth interviews with administrators of older adult-centered facilities. As identified by administrators, the predominant barriers to the…

  11. Readiness of health facilities to deliver safe male circumcision services in Tanzania: a descriptive study

    Directory of Open Access Journals (Sweden)

    Frank Felix Mosha

    2013-03-01

    Full Text Available Assessing the readiness of health facilities to deliver safe male circumcision services is more important in sub-Saharan Africa because of the inadequacy state of health facilities in many ways. The World Health Organization recommends that only facilities equipped with available trained staff, capable to perform at least minor surgery, able to offer minimum MC package and appropriate equipment for resuscitation, and compliant with requirements for sterilization and infection control should be allowed to deliver safe circumcision services. A cross-sectional study using quantitative data collection technique was conducted to assess the readiness of the health facilities to deliver safe circumcision services in selected districts of Tanzania. All hospitals, health centres and 30% of all dispensaries in these districts were selected to participate in the study. Face-toface questionnaires were administered to the heads of the health facilities and to health practitioners. Overall, 49/69 (59% of the facilities visited provided circumcision services and only 46/203 (24% of the health practitioners performed circumcision procedures. These were mainly assistant medical officers and clinical officers. The vast majority – 190/203 (95% – of the health practitioners require additional training prior to providing circumcision services. Most facilities – 63/69 (91% – had all basic supplies (gloves, basin, chlorine and waste disposal necessary for infection prevention, 44/69 (65% provided condoms, HIV counselling and testing, and sexuallytransmitted infections services, while 62/69 (90% had the capability to perform at least minor surgery. However, only 25/69 (36% and 15/69 (22% of the facilities had functioning sterilization equipment and appropriate resuscitation equipment, respectively. There is readiness for roll out of circumcision services; however, more practitioners need to be trained on circumcision procedures, demand forecasting

  12. 12 CFR 560.37 - Real estate for office and related facilities.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Real estate for office and related facilities... LENDING AND INVESTMENT Lending and Investment Powers for Federal Savings Associations § 560.37 Real estate for office and related facilities. A federal savings association may invest in real estate (improved...

  13. Resident-to-resident relational aggression and subjective well-being in assisted living facilities

    NARCIS (Netherlands)

    Trompetter, Hester; Scholte, Ron; Westerhof, Gerben

    2011-01-01

    Purpose: Research in settings similar to assisted living facilities suggests that relational aggression, an indirect and mature form of aggression, might occur in assisted living facilities. This empirical study investigates the existence of relational aggression in a sample of residents and the rel

  14. The Vapor Plume at Material Disposal Are C in Relation to Pajarito Corridor Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Masse, William B. [Los Alamos National Laboratory

    2012-04-02

    A vapor plume made up of volatile organic compounds is present beneath Material Disposal Area C (MDA C) at Los Alamos National Laboratory (LANL). The location and concentrations within the vapor plume are discussed in relation to existing and planned facilities and construction activities along Pajarito Road (the 'Pajarito Corridor') and in terms of worker health and safety. This document provides information that indicates that the vapor plume does not pose a threat to the health of LANL workers nor will it pose a threat to workers during construction of proposed facilities along Pajarito Road. The Los Alamos National Laboratory (LANL or the Laboratory) monitors emissions, effluents, and environmental media to meet environmental compliance requirements, determine actions to protect the environment, and monitor the long-term health of the local environment. LANL also studies and characterizes 'legacy' waste from past Laboratory operations to make informed decisions regarding eventual corrective actions and the disposition of that waste. Starting in 1969, these activities have been annually reported in the LANL Environmental Report (formerly Environmental Surveillance Report), and are detailed in publicly accessible technical reports meeting environmental compliance requirements. Included among the legacy sites being investigated are several formerly used material disposal areas (MDAs) set aside by the Laboratory for the general on-site disposal of waste from mission-related activities. One such area is MDA C located in Technical Area 50 (TA-50), which was used for waste disposal between 1948 and 1974. The location of TA-50 is depicted in Figure 1. The present paper uses a series of maps and cross sections to address the public concerns raised about the vapor plume at MDA C. As illustrated here, extensive sampling and data interpretation indicate that the vapor plume at MDA C does not pose a threat to the health of LANL workers nor will it pose a

  15. Community residential facilities in mental health services: A ten-year comparison in Lombardy.

    Science.gov (United States)

    Barbato, Angelo; Civenti, Graziella; D'Avanzo, Barbara

    2017-06-01

    Residential mental health services grew steadily since 2000 in Italy. A reorganisation of residential facilities was implemented in 2007 in Lombardy, introducing supported housing in addition to staffed facilities. We compare the provision and characteristics of residential facilities in the 2007 and 2016. In 2007 there were 3462 beds (35.9/100,000 population) in 276 facilities. In 2016 beds were 4783 (47.8/100,000) in 520 facilities. The increase were unevenly distributed in the public and private sector, and the overall increase was due to a higher increase in the private sector. 72% of beds were in highly supervised facilities in 2007 and 66% in 2016. The public sector managed more facilities with a rehabilitation goal, while the private sector more for long-term accommodation. Mean numbers of beds were higher in facilities managed by the private sector in both years. The 2007 reorganisation and the stop to opening new facilities in the last years were not enough to correct the imbalance between highly supervised and flexible solutions. A wider and more diverse offer might have triggered off an increased demand, rather than a more rational use. Given the costs of highly staffed facilities, and the risk of reproducing custodial models, close evaluation of the use of residential facilities should inform policies. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Health facility-based data on women receiving sulphadoxine-pyrimethamine during pregnancy in Tanzania

    DEFF Research Database (Denmark)

    Mubyazi, Godfrey M.; Byskov, Jens; Magnussen, Pascal;

    2014-01-01

    A study of health facility (HF) data on women receiving sulphadoxine-pyrimethamine (SP) for intermittent preventive treatment of malaria during pregnancy (IPTp) was carried out at antenatal care (ANC) clinics in Mkuranga and Mufindi districts.......A study of health facility (HF) data on women receiving sulphadoxine-pyrimethamine (SP) for intermittent preventive treatment of malaria during pregnancy (IPTp) was carried out at antenatal care (ANC) clinics in Mkuranga and Mufindi districts....

  17. Women's Use of Private and Government Health Facilities for Childbirth in Nairobi's Informal Settlements

    OpenAIRE

    Bazant, Eva S.; Koenig, Michael A; Fotso, Jean-Christophe; Mills, Samuel

    2009-01-01

    The private sector's role in increasing the use of maternal health care for the poor in developing countries has received increasing attention, yet few data exist for urban slums. Using household-survey data from 1,926 mothers in two informal settlements in Nairobi, Kenya, collected in 2006, we describe and examine the factors associated with women's use of private and government health facilities for childbirth. More women gave birth at private facilities located in the settlements than at g...

  18. Health facility-based data on women receiving sulphadoxine-pyrimethamine during pregnancy in Tanzania

    DEFF Research Database (Denmark)

    Mubyazi, Godfrey M.; Byskov, Jens; Magnussen, Pascal

    2014-01-01

    A study of health facility (HF) data on women receiving sulphadoxine-pyrimethamine (SP) for intermittent preventive treatment of malaria during pregnancy (IPTp) was carried out at antenatal care (ANC) clinics in Mkuranga and Mufindi districts.......A study of health facility (HF) data on women receiving sulphadoxine-pyrimethamine (SP) for intermittent preventive treatment of malaria during pregnancy (IPTp) was carried out at antenatal care (ANC) clinics in Mkuranga and Mufindi districts....

  19. Water, sanitation and hygiene in health care facilities: Challenges and priorities

    Directory of Open Access Journals (Sweden)

    Jovanović Dragana

    2017-01-01

    Full Text Available The microbial agents that cause infectious diseases are highly prevalent in health care facilities. Adequate water supply, sanitation and hygiene are the key elements for the provision of basic health services. The consequences of poor sanitary and hygienic conditions and inadequate water supply are numerous in health care facilities. The importance of improving water supply, sanitation and hygiene in health care facilities has been recognized as an international priority and set in the 2030 Agenda for Sustainable Development, particularly through goal 3.8 and 6. The establishment and maintenance of safe water supply and adequate sanitary and hygienic conditions has multiple benefits for health care facilities. It is necessary to introduce and implement risk assessment and risk management approach as effective way of continuously ensuring and maintaining the safety of drinking water quality in health care facilities as recommended by the World Health Organization, in order to reduce the risks associated with inadequate water supply and protect health of patients and staff. Realization of activities on the improvement requires a multidisciplinary approach and good inter-sectoral cooperation at all levels local, national and global.

  20. Do Physical Proximity and Availability of Adequate Infrastructure at Public Health Facility Increase Institutional Delivery? A Three Level Hierarchical Model Approach.

    Science.gov (United States)

    Patel, Rachana; Ladusingh, Laishram

    2015-01-01

    This study aims to examine the inter-district and inter-village variation of utilization of health services for institutional births in EAG states in presence of rural health program and availability of infrastructures. District Level Household Survey-III (2007-08) data on delivery care and facility information was used for the purpose. Bivariate results examined the utilization pattern by states in presence of correlates of women related while a three-level hierarchical multilevel model illustrates the effect of accessibility, availability of health facility and community health program variables on the utilization of health services for institutional births. The study found a satisfactory improvement in state Rajasthan, Madhya Pradesh and Orissa, importantly, in Bihar and Uttaranchal. The study showed that increasing distance from health facility discouraged institutional births and there was a rapid decline of more than 50% for institutional delivery as the distance to public health facility exceeded 10 km. Additionally, skilled female health worker (ANM) and observed improved public health facility led to significantly increase the probability of utilization as compared to non-skilled ANM and not-improved health centers. Adequacy of essential equipment/laboratory services required for maternal care significantly encouraged deliveries at public health facility. District/village variables neighborhood poverty was negatively related to institutional delivery while higher education levels in the village and women's residing in more urbanized districts increased the utilization. "Inter-district" variation was 14 percent whereas "between-villages" variation for the utilization was 11 percent variation once controlled for all the three-level variables in the model. This study suggests that the mere availability of health facilities is necessary but not sufficient condition to promote utilization until the quality of service is inadequate and inaccessible considering

  1. Delivering at home or in a health facility? health-seeking behaviour of women and the role of traditional birth attendants in Tanzania.

    Science.gov (United States)

    Pfeiffer, Constanze; Mwaipopo, Rosemarie

    2013-02-28

    Traditional birth attendants retain an important role in reproductive and maternal health in Tanzania. The Tanzanian Government promotes TBAs in order to provide maternal and neonatal health counselling and initiating timely referral, however, their role officially does not include delivery attendance. Yet, experience illustrates that most TBAs still often handle complicated deliveries. Therefore, the objectives of this research were to describe (1) women's health-seeking behaviour and experiences regarding their use of antenatal (ANC) and postnatal care (PNC); (2) their rationale behind the choice of place and delivery; and to learn (3) about the use of traditional practices and resources applied by traditional birth attendants (TBAs) and how they can be linked to the bio-medical health system. Qualitative and quantitative interviews were conducted with over 270 individuals in Masasi District, Mtwara Region and Ilala Municipality, Dar es Salaam, Tanzania. The results from the urban site show that significant achievements have been made in terms of promoting pregnancy- and delivery-related services through skilled health workers. Pregnant women have a high level of awareness and clearly prefer to deliver at a health facility. The scenario is different in the rural site (Masasi District), where an adequately trained health workforce and well-equipped health facilities are not yet a reality, resulting in home deliveries with the assistance of either a TBA or a relative. Instead of focusing on the traditional sector, it is argued that more attention should be paid towards (1) improving access to as well as strengthening the health system to guarantee delivery by skilled health personnel; and (2) bridging the gaps between communities and the formal health sector through community-based counselling and health education, which is provided by well-trained and supervised village health workers who inform villagers about promotive and preventive health services, including

  2. Health physics manual of good practices for tritium facilities

    Energy Technology Data Exchange (ETDEWEB)

    Blauvelt, R.K.; Deaton, M.R.; Gill, J.T. [and others

    1991-12-01

    The purpose of this document is to provide written guidance defining the generally accepted good practices in use at Department of Energy (DOE) tritium facilities. A {open_quotes}good practice{close_quotes} is an action, policy, or procedure that enhances the radiation protection program at a DOE site. The information selected for inclusion in this document should help readers achieve an understanding of the key radiation protection issues at tritium facilities and provide guidance as to what characterizes excellence from a radiation protection point of view. The ALARA (As Low as Reasonable Achievable) program at DOE sites should be based, in part, on following the good practices that apply to their operations.

  3. Factors associated with delivery outside a health facility: cross-sectional study in rural Malawi.

    Science.gov (United States)

    Mazalale, Jacob; Kambala, Christabel; Brenner, Stephan; Chinkhumba, Jobiba; Lohmann, Julia; Mathanga, Don P; Robberstad, Bjarne; Muula, Adamson S; De Allegri, Manuela

    2015-05-01

    To identify factors associated with delivery outside a health facility in rural Malawi. A cross-sectional survey was conducted in Balaka, Dedza, Mchinji and Ntcheu districts in Malawi in 2013 among women who had completed a pregnancy 12 months prior to the day of the survey. Multilevel logistic regression was used to assess factors associated with delivery outside a facility. Of the 1812 study respondents, 9% (n = 159) reported to have delivered outside a facility. Unmarried women were significantly more likely [OR = 1.88; 95% CI (1.086-3.173)] to deliver outside a facility, while women from households with higher socio-economic status [third-quartile OR = 0.51; 95% CI (0.28-0.95) and fourth-quartile OR = 0.48; 95% CI (0.29-0.79)] and in urban areas [OR = 0.39; 95%-CI (0.23-0.67)] were significantly less likely to deliver outside a facility. Women without formal education [OR 1.43; 95% CI (0.96-2.14)] and multigravidae [OR = 1.14; 95% CI (0.98-1.73)] were more likely to deliver outside a health facility at 10% level of significance. About 9% of women deliver outside a facility. Policies to encourage facility delivery should not only focus on health systems but also be multisectoral to address women's vulnerability and inequality. Facility-based delivery can contribute to curbing the high maternal illness burden if authorities provide incentives to those not delivering at the facility without losing existing users. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  4. [Health requirements of sauna facilities in East Germany].

    Science.gov (United States)

    Scharf, R

    1989-07-01

    There was a considerable increase in sauna attendance in the GDR in recent years. For excluding the risk of an infection transfer when attenting the sauna it is necessary to pay particular hygienic attention to this special type of sports and recreational facilities. The special hygienic requirements to the staff and sauna users are explained. The tasks and responsibilities of the state sanitary inspection when opening and controlling public saunas are described.

  5. Assessment of Obstetric and Neonatal Health Services in Developing Country Health Facilities

    Science.gov (United States)

    Manasyan, Albert; Saleem, Sarah; Koso-Thomas, Marion; Althabe, Fernando; Pasha, Omrana; Chomba, Elwyn; Goudar, Shivaprasad S.; Patel, Archana; Esamai, Fabian; Garces, Ana; Kodkany, Bhala; Belizan, Jose; McClure, Elizabeth M.; Derman, Richard J.; Hibberd, Patricia; Liechty, Edward A.; Hambidge, K. Michael; Carlo, Waldemar A.; Buekens, Pierre; Moore, Janet; Wright, Linda L.; Goldenberg, Robert L.

    2013-01-01

    Objective To describe the staffing and availability of medical equipment and medications and the performance of procedures at health facilities providing maternal and neonatal care at African, Asian, and Latin American sites participating in a multicenter trial to improve emergency obstetric/neonatal care in communities with high maternal and perinatal mortality. Study Design In 2009, prior to intervention, we surveyed 136 hospitals and 228 clinics in 7 sites in Africa, Asia, and Latin America regarding staffing, availability of equipment/ medications, and procedures including cesarean section. Results The coverage of physicians and nurses/midwives was poor in Africa and Latin America. In Africa, only 20% of hospitals had full-time physicians. Only 70% of hospitals in Africa and Asia had performed cesarean sections in the last 6 months. Oxygen was unavailable in 40% of African hospitals and 17% of Asian hospitals. Blood was unavailable in 80% of African and Asian hospitals. Conclusions Assuming that adequate facility services are necessary to improve pregnancy outcomes, it is not surprising that maternal and perinatal mortality rates in the areas surveyed are high. The data presented emphasize that to reduce mortality in these areas, resources that result in improved staffing and sufficient equipment, supplies, and medication, along with training, are required. PMID:23329566

  6. Public Health Risks from Mismanagement of Healthcare Wastes in Shinyanga Municipality Health Facilities, Tanzania.

    Science.gov (United States)

    Kuchibanda, Kizito; Mayo, Aloyce W

    2015-01-01

    The increase of healthcare facilities in Shinyanga municipality has resulted in an increase of healthcare wastes, which poses serious threats to the environment, health workers, and the general public. This research was conducted to investigate management practices of healthcare wastes in Shinyanga municipality with a view of assessing health risks to health workers and the general public. The study, which was carried out in three hospitals, involved the use of questionnaires, in-depth interview, and observation checklist. The results revealed that healthcare wastes are not quantified or segregated in all the three hospitals. Healthcare wastes at the Shinyanga Regional Referral Hospital are disposed of by on-site incineration and burning and some wastes are disposed off-site. At Kolandoto DDH only on-site burning and land disposal are practiced, while at Kambarage UHC healthcare solid wastes are incinerated, disposed of on land disposal, and burned. Waste management workers do not have formal training in waste management techniques and the hospital administrations pay very little attention to appropriate management of healthcare wastes. In light of this, it is evident that management of healthcare solid wastes is not practiced in accordance with the national and WHO's recommended standards.

  7. Public Health Risks from Mismanagement of Healthcare Wastes in Shinyanga Municipality Health Facilities, Tanzania

    Directory of Open Access Journals (Sweden)

    Kizito Kuchibanda

    2015-01-01

    Full Text Available The increase of healthcare facilities in Shinyanga municipality has resulted in an increase of healthcare wastes, which poses serious threats to the environment, health workers, and the general public. This research was conducted to investigate management practices of healthcare wastes in Shinyanga municipality with a view of assessing health risks to health workers and the general public. The study, which was carried out in three hospitals, involved the use of questionnaires, in-depth interview, and observation checklist. The results revealed that healthcare wastes are not quantified or segregated in all the three hospitals. Healthcare wastes at the Shinyanga Regional Referral Hospital are disposed of by on-site incineration and burning and some wastes are disposed off-site. At Kolandoto DDH only on-site burning and land disposal are practiced, while at Kambarage UHC healthcare solid wastes are incinerated, disposed of on land disposal, and burned. Waste management workers do not have formal training in waste management techniques and the hospital administrations pay very little attention to appropriate management of healthcare wastes. In light of this, it is evident that management of healthcare solid wastes is not practiced in accordance with the national and WHO’s recommended standards.

  8. Prevalence and predictors of giving birth in health facilities in Bugesera District, Rwanda

    Directory of Open Access Journals (Sweden)

    Joharifard Shahrzad

    2012-12-01

    Full Text Available Abstract Background The proportion of births attended by skilled health personnel is one of two indicators used to measure progress towards Millennium Development Goal 5, which aims for a 75% reduction in global maternal mortality ratios by 2015. Rwanda has one of the highest maternal mortality ratios in the world, estimated between 249–584 maternal deaths per 100,000 live births. The objectives of this study were to quantify secular trends in health facility delivery and to identify factors that affect the uptake of intrapartum healthcare services among women living in rural villages in Bugesera District, Eastern Province, Rwanda. Methods Using census data and probability proportional to size cluster sampling methodology, 30 villages were selected for community-based, cross-sectional surveys of women aged 18–50 who had given birth in the previous three years. Complete obstetric histories and detailed demographic data were elicited from respondents using iPad technology. Geospatial coordinates were used to calculate the path distances between each village and its designated health center and district hospital. Bivariate and multivariate logistic regressions were used to identify factors associated with delivery in health facilities. Results Analysis of 3106 lifetime deliveries from 859 respondents shows a sharp increase in the percentage of health facility deliveries in recent years. Delivering a penultimate baby at a health facility (OR = 4.681 [3.204 - 6.839], possessing health insurance (OR = 3.812 [1.795 - 8.097], managing household finances (OR = 1.897 [1.046 - 3.439], attending more antenatal care visits (OR = 1.567 [1.163 - 2.112], delivering more recently (OR = 1.438 [1.120 - 1.847] annually, and living closer to a health center (OR = 0.909 [0.846 - 0.976] per km were independently associated with facility delivery. Conclusions The strongest correlates of facility-based delivery in Bugesera District include previous delivery at a

  9. Measuring relative humidity in the radioactive environment of the IRRAD proton facility

    CERN Document Server

    Paerg, Marten

    2017-01-01

    The aim of the project was to obtain information on relative humidity conditions at different locations in the IRRAD proton facility. Due to high radiation levels inside the facility, different sensors had to be qualified and dedicated electronics had to be built to transfer the data of the sensors over long wires to a less radioactive area, where it could be collected.

  10. Healthy firms: constraints to growth among private health sector facilities in Ghana and Kenya.

    Directory of Open Access Journals (Sweden)

    Nicholas E Burger

    Full Text Available BACKGROUND: Health outcomes in developing countries continue to lag the developed world, and many countries are not on target to meet the Millennium Development Goals. The private health sector provides much of the care in many developing countries (e.g., approximately 50 percent in Sub-Saharan Africa, but private providers are often poorly integrated into the health system. Efforts to improve health systems performance will need to include the private sector and increase its contributions to national health goals. However, the literature on constraints private health care providers face is limited. METHODOLOGY/PRINCIPAL FINDINGS: We analyze data from a survey of private health facilities in Kenya and Ghana to evaluate growth constraints facing private providers. A significant portion of facilities (Ghana: 62 percent; Kenya: 40 percent report limited access to finance as the most significant barrier they face; only a small minority of facilities report using formal credit institutions to finance day to day operations (Ghana: 6 percent; Kenya: 11 percent. Other important barriers include corruption, crime, limited demand for goods and services, and poor public infrastructure. Most facilities have paper-based rather than electronic systems for patient records (Ghana: 30 percent; Kenya: 22 percent, accounting (Ghana: 45 percent; Kenya: 27 percent, and inventory control (Ghana: 41 percent; Kenya: 24 percent. A majority of clinics in both countries report undertaking activities to improve provider skills and to monitor the level and quality of care they provide. However, only a minority of pharmacies report undertaking such activities. CONCLUSIONS/SIGNIFICANCE: The results suggest that improved access to finance and improving business processes especially among pharmacies would support improved contributions by private health facilities. These strategies might be complementary if providers are more able to take advantage of increased access to

  11. Assessment of disease profiles and drug prescribing patterns of health care facilities in Edo State, Nigeria

    Directory of Open Access Journals (Sweden)

    Ehijie F.O. Enato

    2012-10-01

    Full Text Available Few studies have systematically characterized drug-prescribing patterns, particularly at the primary care level in Nigeria, a country disproportionately burdened with disease. The aim of this study was to assess the disease profiles and drug-prescribing pattern in two health care facilities in Edo State, Nigeria. The medical records of 495 patients who attended a primary or secondary health care facility in Owan-East Local Government Area of Edo State, Nigeria, between June and November 2009 were reviewed. Disease profiles and drug prescribing patterns were assessed. Data were analyzed based on the World Health Organization Anatomic Therapeutic Chemical classification system, and core drug prescribing indicators. Five hundred and twelve clinical conditions were identified. Infectious disease was most prevalent (38.3%, followed by disorder of the alimentary tract (16.4%. Malaria was responsible for 55.6% of the infectious diseases seen, and 21.3% (109/512 of the total clinical conditions managed at the two health facilities during the study period. Consequently, anti-infective medications were the most frequently prescribed medicines (21.5%, followed by vitamins (18.2%. Use of artesunate monotherapy at both facilities (15.7%, and chloroquine at the primary health facility (24.9% were common. Paracetamol (41.8% and non-steroidal anti-inflammatory drugs (24.9% were the most frequently used analgesic/antipyretic. At the primary health care facility, dipyrone was used in 21.6% of cases. The core drug prescribing use indicators showed inappropriate prescribing, indicating poly-pharmacy, overuse of antibiotics and injectio. Inappropriate drug use patterns were identified at both health care facilities, especially with regard to the use of ineffective antimalarial drugs and the use of dipyrone.

  12. Australia's international health relations in 2003.

    Science.gov (United States)

    Barraclough, Simon

    2005-02-21

    A survey for the year 2003 of significant developments in Australia's official international health relations, and their domestic ramifications, is presented. The discussion is set within the broader context of Australian foreign policy. Sources include official documents, media reports and consultations with officers of the Department of Health and Ageing responsible for international linkages.

  13. Dual indices for prioritizing investment in decentralized HIV services at Nigerian primary health care facilities.

    Science.gov (United States)

    Fronczak, Nancy; Oyediran, Kola' A; Mullen, Stephanie; Kolapo, Usman M

    2016-04-01

    Decentralizing health services, including those for HIV prevention and treatment, is one strategy for maximizing the use of limited resources and expanding treatment options; yet few methods exist for systematically identifying where investments for service expansion might be most effective, in terms of meeting needs and rapid availability of improved services. The Nigerian Government, the United States Government under the President's Emergency Plan for AIDS Relief (PEPFAR) program and other donors are expanding services for prevention of mother-to-child transmission (PMTCT) of HIV to primary health care facilities in Nigeria. Nigerian primary care facilities vary greatly in their readiness to deliver HIV/AIDS services. In 2012, MEASURE Evaluation assessed 268 PEPFAR-supported primary health care facilities in Nigeria and developed a systematic method for prioritizing these facilities for expansion of PMTCT services. Each assessed facility was scored based on two indices with multiple, weighted variables: one measured facility readiness to provide PMTCT services, the other measured local need for the services and feasibility of expansion. These two scores were compiled and the summary score used as the basis for prioritizing facilities for PMTCT service expansion. The rationale was that using need and readiness to identify where to expand PMTCT services would result in more efficient allocation of resources. A review of the results showed that the indices achieved the desired effect-that is prioritizing facilities with high need even when readiness was problematic and also prioritizing facilities where rapid scale-up was feasible. This article describes the development of the two-part index and discusses advantages of using this approach when planning service expansion. The authors' objective is to contribute to development of methodologies for prioritizing investments in HIV, as well as other public health arenas, that should improve cost-effectiveness and

  14. Factors related to receipt of dental care in Eastern Iowa nursing facilities.

    Science.gov (United States)

    Ghazal, Tariq S; Caplan, Daniel J; Cowen, Howard J; Oliveira, Deise

    2015-01-01

    To assess factors related to nursing facility residents' receipt of dental treatment when it was offered on site. Screening forms that included demographic, general, and dental health information were obtained from residents of 10 nursing facilities in Eastern Iowa, and their dental procedure history for up to 7 years after screening was recorded. Residents were grouped as having received either no procedures; diagnostic procedures only; or nondiagnostic procedures. Of the 586 residents, the mean age was 83.8 years at screening and 31.3% were edentulous. The odds of receiving nondiagnostic procedures were lower among residents who were older (OR = 0.98, 95%CI 0.96-0.99) or edentulous (OR = 0.31, 95%CI 0.20-0.46), compared to those who received no dental procedures. Those who were older or edentulous had lower odds of receiving nondiagnostic dental procedures. Well-designed prospective cohort studies are needed to better evaluate barriers to receipt of dental treatment among the institutionalized elderly. © 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.

  15. A National Survey of Mental Health Screening and Assessment Practices in Juvenile Correctional Facilities

    Science.gov (United States)

    Swank, Jacqueline M.; Gagnon, Joseph C.

    2017-01-01

    Background: Mental health screening and assessment is crucial within juvenile correctional facilities (JC). However, limited information is available about the current screening and assessment procedures specifically within JC. Objective: The purpose of the current study was to obtain information about the mental health screening and assessment…

  16. Diagnosis and treatment of malaria in peripheral health facilities in Uganda

    DEFF Research Database (Denmark)

    Ndyomugyenyi, Richard; Magnussen, Pascal; Clarke, Siân

    2007-01-01

    Background Early recognition of symptoms and signs perceived as malaria are important for effective case management, as few laboratories are available at peripheral health facilities. The validity and reliability of clinical signs and symptoms used by health workers to diagnose malaria were...

  17. The Oral Health Care Manager in a Patient-Centered Health Facility.

    Science.gov (United States)

    Theile, Cheryl Westphal; Strauss, Shiela M; Northridge, Mary Evelyn; Birenz, Shirley

    2016-06-01

    The dental hygienist team member has an opportunity to coordinate care within an interprofessional practice as an oral health care manager. Although dental hygienists are currently practicing within interprofessional teams in settings such as pediatric offices, hospitals, nursing homes, schools, and federally qualified health centers, they often still assume traditional responsibilities rather than practicing to the full extent of their training and licenses. This article explains the opportunity for the dental hygiene professional to embrace patient-centered care as an oral health care manager who can facilitate integration of oral and primary care in a variety of health care settings. Based on an innovative model of collaboration between a college of dentistry and a college of nursing, an idea emerged among several faculty members for a new management method for realizing continuity and coordination of comprehensive patient care. Involved faculty members began working on the development of an approach to interprofessional practice with the dental hygienist serving as an oral health care manager who would address both oral health care and a patient's related primary care issues through appropriate referrals and follow-up. This approach is explained in this article, along with the results of several pilot studies that begin to evaluate the feasibility of a dental hygienist as an oral health care manager. A health care provider with management skills and leadership qualities is required to coordinate the interprofessional provision of comprehensive health care. The dental hygienist has the opportunity to lead closer integration of oral and primary care as an oral health care manager, by coordinating the team of providers needed to implement comprehensive, patient-centered care. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Relative Deprivation, Poor Health Habits and Mortality

    Science.gov (United States)

    Eibner, Christine E.; Evans, William N.

    2005-01-01

    The results of the study conducted, using the data from National Health Interview Survey (NHIS) (BRFSS), to find the relationship between the relative deprivation and mortality, while controlling individual income and reference group fixed effects, are presented.

  19. Development and implementation of the internal audit mechanisms to be used in the health care facilities.

    Science.gov (United States)

    Smeyanov, V; Tarasenko, S; Smeyanova, O

    2013-06-01

    Issues concerning the quality of care service improvement have become of national importance in the health-care system for both developed and developing countries. Internal audit is effective and efficient method to improve the quality of care in various health care facilities. Data from 452 outpatient cards of the case patients with arterial hypertension were analyzed, the level of awareness and patient compliance were defined. The stages of internal audit mechanisms implementation in the health care facilities were developed. As a result of medical records audit and awareness monitoring of patients with arterial hypertension ways to improve quality of medical care were defined.

  20. Prevention by Design: Construction and Renovation of Health Care Facilities for Patient Safety and Infection Prevention.

    Science.gov (United States)

    Olmsted, Russell N

    2016-09-01

    The built environment supports the safe care of patients in health care facilities. Infection preventionists and health care epidemiologists have expertise in prevention and control of health care-associated infections (HAIs) and assist with designing and constructing facilities to prevent HAIs. However, design elements are often missing from initial concepts. In addition, there is a large body of evidence that implicates construction and renovation as being associated with clusters of HAIs, many of which are life threatening for select patient populations. This article summarizes known risks and prevention strategies within a framework for patient safety.

  1. Missed opportunities for immunisation in health facilities in Cape ...

    African Journals Online (AJOL)

    The study included a health facilitybased crosssectional exit survey of caregivers with children up to 5 ... level) and one central hospital (hospital C – ... applied for model building. ..... a systematic review of the published literature, 19992009.

  2. Primary health care facility infrastructure and services and the ...

    African Journals Online (AJOL)

    a Nutritional Intervention Research Unit, Medical Research Council ab Currently from Center of Excellence in Nutrition, North West ... Inadequate health services and an unhealthy environment are ..... Lack/shortage of diagnostic equipment.

  3. Recreational facilities: a guide to recreational facilities in the East Coast Area Health Board

    LENUS (Irish Health Repository)

    2012-02-01

    OBJECTIVE: To determine whether persons with generalized joint hypermobility have an increased risk of lower limb joint injury during sport. DATA SOURCES: PubMed, CINAHL, EMBASE, and SportDiscus were searched through February 2009, without language restrictions, using terms related to risk; hip, ankle, and knee injuries; and joint instability. Reference lists of included studies and relevant reviews were searched by hand. STUDY SELECTION: Selection criteria were peer-reviewed studies with a prospective design that used an objective scale to measure generalized joint hypermobility; the participants were engaged in sport activity, and the injury data were quantitative and based on diagnosis by a health professional, were self-reported, or resulted in time lost to athletic participation. The studies were screened by 1 researcher and checked by a second. Study methods were independently assessed by 2 investigators using the 6-point scale for prognostic studies developed by Pengel. Disagreements were resolved through discussion. Of 4841 studies identified, 18 met inclusion criteria. Of these, 8 were included in random-effects meta-analyses. DATA EXTRACTION: The data extracted by 2 reviewers included participant and sport characteristics and details of joint hypermobility and injury measurements. More detailed data for 4 investigations were obtained from the study authors. Where possible, hypermobility was defined as >\\/=4 of 9 points on the British Society of Rheumatology Scale (BSRS). MAIN RESULTS: Lower limb joint injuries (3 studies, 1047 participants) occurred in 14% of participants. Using the BSRS of joint hypermobility, any lower limb injury was not associated with hypermobility [odds ratio (OR), 1.43; 95% confidence interval (CI), 0.56-3.67]. Using the original authors\\' definitions, hypermobility was associated with risk of knee joint injuries (OR, 2.62; 95% CI, 1.04-6.58) in 5 studies. In 4 studies in which the BSRS could be used (1167 participants; incidence

  4. Quality of Malaria Case Management in Malawi: Results from a Nationally Representative Health Facility Survey

    Science.gov (United States)

    Steinhardt, Laura C.; Chinkhumba, Jobiba; Wolkon, Adam; Luka, Madalitso; Luhanga, Misheck; Sande, John; Oyugi, Jessica; Ali, Doreen; Mathanga, Don; Skarbinski, Jacek

    2014-01-01

    Background Malaria is endemic throughout Malawi, but little is known about quality of malaria case management at publicly-funded health facilities, which are the major source of care for febrile patients. Methods In April–May 2011, we conducted a nationwide, geographically-stratified health facility survey to assess the quality of outpatient malaria diagnosis and treatment. We enrolled patients presenting for care and conducted exit interviews and re-examinations, including reference blood smears. Moreover, we assessed health worker readiness (e.g., training, supervision) and health facility capacity (e.g. availability of diagnostics and antimalarials) to provide malaria case management. All analyses accounted for clustering and unequal selection probabilities. We also used survey weights to produce estimates of national caseloads. Results At the 107 facilities surveyed, most of the 136 health workers interviewed (83%) had received training on malaria case management. However, only 24% of facilities had functional microscopy, 15% lacked a thermometer, and 19% did not have the first-line artemisinin-based combination therapy (ACT), artemether-lumefantrine, in stock. Of 2,019 participating patients, 34% had clinical malaria (measured fever or self-reported history of fever plus a positive reference blood smear). Only 67% (95% confidence interval (CI): 59%, 76%) of patients with malaria were correctly prescribed an ACT, primarily due to missed malaria diagnosis. Among patients without clinical malaria, 31% (95% CI: 24%, 39%) were prescribed an ACT. By our estimates, 1.5 million of the 4.4 million malaria patients seen in public facilities annually did not receive correct treatment, and 2.7 million patients without clinical malaria were inappropriately given an ACT. Conclusions Malawi has a high burden of uncomplicated malaria but nearly one-third of all patients receive incorrect malaria treatment, including under- and over-treatment. To improve malaria case

  5. Quality of malaria case management in Malawi: results from a nationally representative health facility survey.

    Directory of Open Access Journals (Sweden)

    Laura C Steinhardt

    Full Text Available BACKGROUND: Malaria is endemic throughout Malawi, but little is known about quality of malaria case management at publicly-funded health facilities, which are the major source of care for febrile patients. METHODS: In April-May 2011, we conducted a nationwide, geographically-stratified health facility survey to assess the quality of outpatient malaria diagnosis and treatment. We enrolled patients presenting for care and conducted exit interviews and re-examinations, including reference blood smears. Moreover, we assessed health worker readiness (e.g., training, supervision and health facility capacity (e.g. availability of diagnostics and antimalarials to provide malaria case management. All analyses accounted for clustering and unequal selection probabilities. We also used survey weights to produce estimates of national caseloads. RESULTS: At the 107 facilities surveyed, most of the 136 health workers interviewed (83% had received training on malaria case management. However, only 24% of facilities had functional microscopy, 15% lacked a thermometer, and 19% did not have the first-line artemisinin-based combination therapy (ACT, artemether-lumefantrine, in stock. Of 2,019 participating patients, 34% had clinical malaria (measured fever or self-reported history of fever plus a positive reference blood smear. Only 67% (95% confidence interval (CI: 59%, 76% of patients with malaria were correctly prescribed an ACT, primarily due to missed malaria diagnosis. Among patients without clinical malaria, 31% (95% CI: 24%, 39% were prescribed an ACT. By our estimates, 1.5 million of the 4.4 million malaria patients seen in public facilities annually did not receive correct treatment, and 2.7 million patients without clinical malaria were inappropriately given an ACT. CONCLUSIONS: Malawi has a high burden of uncomplicated malaria but nearly one-third of all patients receive incorrect malaria treatment, including under- and over-treatment. To improve

  6. Health facility and skilled birth deliveries among poor women with Jamkesmas health insurance in Indonesia: a mixed-methods study.

    Science.gov (United States)

    Brooks, Mohamad I; Thabrany, Hasbullah; Fox, Matthew P; Wirtz, Veronika J; Feeley, Frank G; Sabin, Lora L

    2017-02-02

    The growing momentum for quality and affordable health care for all has given rise to the recent global universal health coverage (UHC) movement. As part of Indonesia's strategy to achieve the goal of UHC, large investments have been made to increase health access for the poor, resulting in the implementation of various health insurance schemes targeted towards the poor and near-poor, including the Jamkesmas program. In the backdrop of Indonesia's aspiration to reach UHC is the high rate of maternal mortality that disproportionally affects poor women. The objective of this study was to evaluate the association of health facility and skilled birth deliveries among poor women with and without Jamkesmas and explore perceived barriers to health insurance membership and maternal health service utilization. We used a mixed-methods design. Utilizing data from the 2012 Indonesian Demographic and Health Survey (n = 45,607), secondary analysis using propensity score matching was performed on key outcomes of interest: health facility delivery (HFD) and skilled birth delivery (SBD). In-depth interviews (n = 51) were conducted in the provinces of Jakarta and Banten among poor women, midwives, and government representatives. Thematic framework analysis was performed on qualitative data to explore perceived barriers. In 2012, 63.0% of women did not have health insurance; 19.1% had Jamkesmas. Poor women with Jamkesmas were 19% (OR = 1.19 [1.03-1.37]) more likely to have HFD and 17% (OR = 1.17 [1.01-1.35]) more likely to have SBD compared to poor women without insurance. Qualitative interviews highlighted key issues, including: lack of proper documentation for health insurance registration; the preference of pregnant women to deliver in their parents' village; the use of traditional birth attendants; distance to health facilities; shortage of qualified health providers; overcrowded health facilities; and lack of health facility accreditation. Poor women with

  7. Availability of emergency obstetric care (EmOC) among public and private health facilities in rural northwest Bangladesh

    National Research Council Canada - National Science Library

    Sikder, Shegufta S; Labrique, Alain B; Ali, Hasmot; Hanif, Abu A M; Klemm, Rolf D W; Mehra, Sucheta; West, Jr, Keith P; Christian, Parul

    2015-01-01

    Although safe motherhood strategies recommend that women seek timely care from health facilities for obstetric complications, few studies have described facility availability of emergency obstetric care (EmOC...

  8. Food security practice in Kansas schools and health care facilities.

    Science.gov (United States)

    Yoon, Eunju; Shanklin, Carol W

    2007-02-01

    This pilot study investigated perceived importance and frequency of specific preventive measures, and food and nutrition professionals' and foodservice directors' willingness to develop a food defense management plan. A mail questionnaire was developed based on the US Department of Agriculture document, Biosecurity Checklist for School Foodservice Programs--Developing a Biosecurity Management Plan. The survey was sent to food and nutrition professionals and foodservice operators in 151 acute care hospitals, 181 long-term-care facilities, and 450 school foodservice operations. Chemical use and storage was perceived as the most important practice to protect an operation and was the practice implemented most frequently. Results of the study indicate training programs on food security are needed to increase food and nutrition professionals' motivation to implement preventive measures.

  9. Determinants of Quality of Family Planning Counseling among Private Health Facilities in Lagos.

    Science.gov (United States)

    Johnson, Doug; Ugaz, Jorge

    2016-09-01

    We use a unique dataset that includes an objective measure of the quality of family planning counseling from 927 private health facilities in Lagos State, Nigeria, to determine which variables at the facility and provider levels are most closely correlated with the quality of family planning counseling. Our data on quality come from mystery client surveys in which the clients posed as women seeking family planning counseling. We find that quality is strongly associated with the cadre of provider, with doctors delivering substantially higher-quality counselling than nurses. Doctors not only outperform nurses overall, but also perform better on each category of quality and spend nearly three minutes longer on average counseling the mystery client. Location, fees charged for the service, and facility type are also strongly correlated with quality. The degree to which a facility specializes in family planning and facility size are only weakly predictive of quality.

  10. South Yorkshire Cohort: a 'cohort trials facility' study of health and weight - Protocol for the recruitment phase

    Directory of Open Access Journals (Sweden)

    Copeland Rob

    2011-08-01

    , longitudinal cohort study design with a population based cohort facility for multiple randomised controlled trials in a range of long term health and weight related conditions (including obesity. This infrastructure will allow the rapid and cheap identification and recruitment of patients, and facilitate the provision of robust evidence to inform the management and self-management of health and weight.

  11. Assessment of human resources for health using cross-national comparison of facility surveys in six countries.

    Science.gov (United States)

    Gupta, Neeru; Dal Poz, Mario R

    2009-03-12

    Health facility assessments are being increasingly used to measure and monitor indicators of health workforce performance, but the global evidence base remains weak. Partly this is due to the wide variability in assessment methods and tools, hampering comparability across and within countries and over time. The World Health Organization coordinated a series of facility-based surveys using a common approach in six countries: Chad, Côte d'Ivoire, Jamaica, Mozambique, Sri Lanka and Zimbabwe. The objectives were twofold: to inform the development and monitoring of human resources for health (HRH) policy within the countries; and to test and validate the use of standardized facility-based human resources assessment tools across different contexts. The survey methodology drew on harmonized questionnaires and guidelines for data collection and processing. In accordance with the survey's dual objectives, this paper presents both descriptive statistics on a number of policy-relevant indicators for monitoring and evaluation of HRH as well as a qualitative assessment of the usefulness of the data collection tool for comparative analyses. The findings revealed a large diversity in both the organization of health services delivery and, in particular, the distribution and activities of facility-based health workers across the sampled countries. At the same time, some commonalities were observed, including the importance of nursing and midwifery personnel in the skill mix and the greater tendency of physicians to engage in dual practice. While the use of standardized questionnaires offered the advantage of enhancing cross-national comparability of the results, some limitations were noted, especially in relation to the categories used for occupations and qualifications that did not necessarily conform to the country situation. With increasing experience in health facility assessments for HRH monitoring comes greater need to establish and promote best practices regarding methods

  12. Assessment of human resources for health using cross-national comparison of facility surveys in six countries

    Directory of Open Access Journals (Sweden)

    Dal Poz Mario R

    2009-03-01

    Full Text Available Abstract Background Health facility assessments are being increasingly used to measure and monitor indicators of health workforce performance, but the global evidence base remains weak. Partly this is due to the wide variability in assessment methods and tools, hampering comparability across and within countries and over time. The World Health Organization coordinated a series of facility-based surveys using a common approach in six countries: Chad, Côte d'Ivoire, Jamaica, Mozambique, Sri Lanka and Zimbabwe. The objectives were twofold: to inform the development and monitoring of human resources for health (HRH policy within the countries; and to test and validate the use of standardized facility-based human resources assessment tools across different contexts. Methods The survey methodology drew on harmonized questionnaires and guidelines for data collection and processing. In accordance with the survey's dual objectives, this paper presents both descriptive statistics on a number of policy-relevant indicators for monitoring and evaluation of HRH as well as a qualitative assessment of the usefulness of the data collection tool for comparative analyses. Results The findings revealed a large diversity in both the organization of health services delivery and, in particular, the distribution and activities of facility-based health workers across the sampled countries. At the same time, some commonalities were observed, including the importance of nursing and midwifery personnel in the skill mix and the greater tendency of physicians to engage in dual practice. While the use of standardized questionnaires offered the advantage of enhancing cross-national comparability of the results, some limitations were noted, especially in relation to the categories used for occupations and qualifications that did not necessarily conform to the country situation. Conclusion With increasing experience in health facility assessments for HRH monitoring comes

  13. Analysis of factors related to man-induced hazard for nuclear facilities

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young Soon; Jung, Jea Hee; Lee, Keun O; Son, Ki Sang; Wang, Sang Chul; Lee, Chang Jin; Ku, Min Ho; Park, Nam Young [Seoul National Univ. of Technology, Seoul (Korea, Republic of)

    2003-03-15

    This study is to show a guide for installing hazardous facilities adjoined atomic power plant after finding out how much these facilities could impact to the atomic plant. Nuclear power plant is an important facility which is closely connected with public life, industrial activity, and the conduct of public business, so it should not be damaged. Therefore, if there are hazardous and harmful facilities near the plant, then they must be evaluated by the size, the type, and the shape. First of all, any factors that could cause man induced accident must be investigated. And they must be exactly evaluated from how much it will damage the plant facilities. The purpose of this study is to set a technical standard for the installation of these facilities by evaluating the man induced accident. Also, it is to make out the evaluation methods by investigating the hazardous facilities which are placed near the plant. Our country is now using CFR standard : reg. guide and IAEA safety series. However, not only the standard of technology which is related to man induced accident but also the evaluation methods for facilities are not yet layed down. As It was mentioned above, we should evaluate these facilities adequately, and these methods must be made out.

  14. Computer usage among nurses in rural health-care facilities in South Africa: obstacles and challenges.

    Science.gov (United States)

    Asah, Flora

    2013-04-01

    This study discusses factors inhibiting computer usage for work-related tasks among computer-literate professional nurses within rural healthcare facilities in South Africa. In the past two decades computer literacy courses have not been part of the nursing curricula. Computer courses are offered by the State Information Technology Agency. Despite this, there seems to be limited use of computers by professional nurses in the rural context. Focus group interviews held with 40 professional nurses from three government hospitals in northern KwaZulu-Natal. Contributing factors were found to be lack of information technology infrastructure, restricted access to computers and deficits in regard to the technical and nursing management support. The physical location of computers within the health-care facilities and lack of relevant software emerged as specific obstacles to usage. Provision of continuous and active support from nursing management could positively influence computer usage among professional nurses. A closer integration of information technology and computer literacy skills into existing nursing curricula would foster a positive attitude towards computer usage through early exposure. Responses indicated that change of mindset may be needed on the part of nursing management so that they begin to actively promote ready access to computers as a means of creating greater professionalism and collegiality. © 2011 Blackwell Publishing Ltd.

  15. CITY PLANNING IN GRAECO-ROMAN TIMES WITH EMPHASIS ON HEALTH FACILITIES

    Directory of Open Access Journals (Sweden)

    L. Cilliers

    2012-03-01

    Full Text Available In this overview of city planning in Graeco-Roman times, starting with Greek gridiron street planning and functional city zoning in the 9th century BC, emphasis is placed on those aspects related to urban health and recreational activities. Etruscan-Roman expertise in hydraulic engineering facilitated the availability of ample water supplies, e.g. for public baths and latrines, and for efficient drainage systems, which had been problematic in the earlier Greek era. The Pax Romana obviated the need for defensive city walls and also potentiated the establishment and maintenance of long distance water supplies. Before the xenodocheia of the Christian era the only hospitals were Roman military institutions (valetudinaria and some latifundia for sick slaves on large farms. Doctors practiced from very basic consulting facilities (iatreia, later tabernae. Graeco-Roman concepts of “death pollution” restricted structural burial facilities to a minimum, and situated outside the city walls. Greek recreation revolved around athletic sports practiced in stadia, gymnasia and occasionally in urban agoras; dramas were performed in open air theatres. The Romans preferred horse races and blood-thirsty sports in huge amphitheatres in which gladiators fought each other to the death.

  16. Improving Quality of Care in Primary Health-Care Facilities in Rural Nigeria

    OpenAIRE

    Okoli Ugo; Eze-Ajoku Ezinne; Oludipe Modupe; Spieker Nicole; Ekezie Winifred; Ohiri Kelechi

    2016-01-01

    Background: Nigeria has a high population density but a weak health-care system. To improve the quality of care, 3 organizations carried out a quality improvement pilot intervention at the primary health-care level in selected rural areas. Objective: To assess the change in quality of care in primary health-care facilities in rural Nigeria following the provision of technical governance support and to document the successes and challenges encountered. Method: A total of 6 states were selected...

  17. Smart health and innovation: facilitating health-related behaviour change.

    Science.gov (United States)

    Redfern, J

    2017-08-01

    Non-communicable diseases (NCD) are the leading cause of death globally. Smart health technology and innovation is a potential strategy for increasing reach and for facilitating health behaviour change. Despite rapid growth in the availability and affordability of technology there remains a paucity of published and robust research in the area as it relates to health. The objective of the present paper is to review and provide a snapshot of a variety of contemporary examples of smart health strategies with a focus on evidence and research as it relates to prevention with a CVD management lens. In the present analysis, five examples will be discussed and they include a physician-directed strategy, consumer directed strategies, a public health approach and a screening strategy that utilises external hardware that connects to a smartphone. In conclusion, NCD have common risk factors and all have an association with nutrition and health. Smart health and innovation is evolving rapidly and may help with diagnosis, treatment and management. While on-going research, development and knowledge is needed, the growth of technology development and utilisation offers opportunities to reach more people and achieve better health outcomes at local, national and international levels.

  18. Comparison of a Commonwealth-initiated regional radiation oncology facility in Toowoomba with a Queensland Health facility.

    Science.gov (United States)

    Poulsen, M; Middleton, M; McQuitty, S; Ramsay, J; Gogna, K; Martin, J; Khoo, E; Wong, W; Fairweather, R; Walpole, E

    2010-08-01

    The aim was to compare a private Commonwealth-initiated regional radiation oncology facility in Toowoomba with a Queensland Health facility (QHF) in Brisbane. The comparison concentrated on staffing, case mix and operational budgets, but was not able to look at changes in access to services. Data were collected from the two facilities from January 2008 to June 2008 inclusive. A number of factors were compared, including case mix, staffing levels, delay times for treatment, research, training and treatment costs. The case mix between the two areas was similar with curative treatments making up just over half the work load in both centres and two-thirds the work being made up of cancers of breast and prostate. Staffing levels were leaner in Toowoomba, especially in the areas of nursing, administration and trial coordinators. Research activity was slightly higher in Toowoomba. The average medicare cost per treatment course was similar in both centres ($5000 per course). Total costs of an average treatment including patient, State and Commonwealth costs, showed a 30% difference in costing favouring Toowoomba. This regional radiation oncology centre has provided state-of-the-art cancer care that is close to home for patients living in the Darling Downs region. Both public and private patients have been treated with modest costs to the patient and significant savings to QH. The case mix is similar to the QHF, and there has been significant activity in clinical research. A paperless working environment is one factor that has allowed staffing levels to be reduced. Ongoing support from Governments are required if private facilities are to participate in important ongoing staff training.

  19. Treatment of malaria from monotherapy to artemisinin-based combination therapy by health professionals in rural health facilities in southern Cameroon

    Directory of Open Access Journals (Sweden)

    Bley Daniel

    2009-07-01

    Full Text Available Abstract Background One year after the adoption of artesunate-amodiaquine (AS/AQ as first-line therapy for the treatment of uncomplicated malaria, this study was designed to assess the treatment practices regarding anti-malarial drugs at health facilities in four rural areas in southern Cameroon. Methods Between April and August 2005, information was collected by interviewing fifty-two health professionals from twelve rural health facilities, using a structured questionnaire. Results In 2005, only three anti-malarial drugs were used in rural health facilities, including: amodiaquine, quinine and sulphadoxine-pyrimethamine. Only 2.0% of the health professionals prescribed the recommended AS/AQ combination. After reading the treatment guidelines, 75.0% were in favour of the treatment protocol with the following limitations: lack of paediatric formulations, high cost and large number of tablets per day. Up to 21.0% of professionals did not prescribe AS/AQ because of the level of adverse events attributed to the use of amodiaquine as monotherapy. Conclusion The present study indicates that AS/AQ was not available in the public health facilities at the time of the study, and health practitioners were not informed about the new treatment guidelines. Results of qualitative analysis suggest that prescribers should be involved as soon as possible in projects related to the optimization of treatment guidelines and comply with new drugs. Adapted formulations should be made available at the international level and implemented locally before new drugs and treatments are proposed through a national control programme. This baseline information will be useful to monitor progresses in the implementation of artemisinin-based combination therapy in Cameroon.

  20. Strengthening health facilities for maternal and newborn care: experiences from rural eastern Uganda

    Directory of Open Access Journals (Sweden)

    Gertrude Namazzi

    2015-03-01

    Full Text Available Background: In Uganda maternal and neonatal mortality remains high due to a number of factors, including poor quality of care at health facilities. Objective: This paper describes the experience of building capacity for maternal and newborn care at a district hospital and lower-level health facilities in eastern Uganda within the existing system parameters and a robust community outreach programme. Design: This health system strengthening study, part of the Uganda Newborn Study (UNEST, aimed to increase frontline health worker capacity through district-led training, support supervision, and mentoring at one district hospital and 19 lower-level facilities. A once-off supply of essential medicines and equipment was provided to address immediate critical gaps. Health workers were empowered to requisition subsequent supplies through use of district resources. Minimal infrastructure adjustments were provided. Quantitative data collection was done within routine process monitoring and qualitative data were collected during support supervision visits. We use the World Health Organization Health System Building Blocks to describe the process of district-led health facility strengthening. Results: Seventy two per cent of eligible health workers were trained. The mean post-training knowledge score was 68% compared to 32% in the pre-training test, and 80% 1 year later. Health worker skills and competencies in care of high-risk babies improved following support supervision and mentoring. Health facility deliveries increased from 3,151 to 4,115 (a 30% increase in 2 years. Of 547 preterm babies admitted to the newly introduced kangaroo mother care (KMC unit, 85% were discharged alive to continue KMC at home. There was a non-significant declining trend for in-hospital neonatal deaths across the 2-year study period. While equipment levels remained high after initial improvement efforts, maintaining supply of even the most basic medications was a challenge, with

  1. European network for promoting the physical health of residents in psychiatric and social care facilities (HELPS: background, aims and methods

    Directory of Open Access Journals (Sweden)

    Marginean Roxana

    2009-08-01

    disorders must take into account behavioural, environmental and iatrogenic health risks. A European health promotion toolkit needs to consider heterogeneity of mental disorders, the multitude of physical health problems, health-relevant behaviour, health-related attitudes, health-relevant living conditions, and resource levels in mental health and social care facilities.

  2. Improving Quality of Care in Primary Health-Care Facilities in Rural Nigeria

    Directory of Open Access Journals (Sweden)

    Okoli Ugo

    2016-08-01

    Full Text Available Background: Nigeria has a high population density but a weak health-care system. To improve the quality of care, 3 organizations carried out a quality improvement pilot intervention at the primary health-care level in selected rural areas. Objective: To assess the change in quality of care in primary health-care facilities in rural Nigeria following the provision of technical governance support and to document the successes and challenges encountered. Method: A total of 6 states were selected across the 6 geopolitical zones of the country. However, assessments were carried out in 40 facilities in only 5 states. Selection was based on location, coverage, and minimum services offered. The facilities were divided randomly into 2 groups. The treatment group received quality-of-care assessment, continuous feedback, and improvement support, whereas the control group received quality assessment and no other support. Data were collected using the SafeCare Healthcare Standards and managed on the SafeCare Data Management System—AfriDB. Eight core areas were assessed at baseline and end line, and compliance to quality health-care standards was compared. Result: Outcomes from 40 facilities were accepted and analyzed. Overall scores increased in the treatment facilities compared to the control facilities, with strong evidence of improvement ( t = 5.28, P = .0004 and 11% average improvement, but no clear pattern of improvement emerged in the control group. Conclusion: The study demonstrated governance support and active community involvement offered potential for quality improvement in primary health-care facilities.

  3. Job Satisfactions of Nurses and Physicians Working in the Same Health Care Facility in Turkey

    Directory of Open Access Journals (Sweden)

    Züleyha Alper

    2011-01-01

    Full Text Available Background: Job satisfaction is defined as the degree to which employees like or enjoy their jobs and the degreeof satisfaction is based on the importance placed upon this reward and benefit.Objective: Aim of this study was to determine the job satisfaction levels of nurses and physicians working in thesame health care facility, analyze the factors that may affect job satisfaction levels. This study was conducted asa descriptive study and was carried out in one Medical Care Center Northwestern Region of Turkey, Bursa.Results:A job satisfaction scale developed by researchers according to literature review. The scale contained 36items related to measure job satisfaction levels of the participants. Data were collected from 65 nurses and 15physicians. Motivation of nurses is significantly higher than physicians. There is no affect of nurses’ educationlevels on general job satisfaction levels (p>0.05. No significant association was found between gender andmotivation (p>0.05. Payments and organization–related factors affect job satisfaction among nurses andphysicians.Conclusion:This scale yielded significant results in all subgroups except for satisfaction with patient treatment,care services and age. Seniority in the profession and age correlates with general job satisfaction level. Futurestudies need to focus on if job dissatisfaction affects health care workers to quit their jobs, differences amonggenders and profession.

  4. A Health Facility Planning Methodology for Army Troop Medical Clinics.

    Science.gov (United States)

    1981-04-01

    Herbert H. Hyman, Basic Health Planning Methods, (Germantown, Md: Aspen Systems Corp., 1978), p.14 . 16 17 1 3James A. Rice, " Interinstitutional Planning...another for collaboration throughout the developmental process in order for that project to come to fruition. In the final analysis, the planning...Space Needs." Hospitals 54 (December 16, 1980): 109-112. Rice, James A. " Interinstitutional Planning Process, Part 1. Free Standing Hospitals." Hospitals

  5. Medical equipment in government health facilities: Missed opportunities

    OpenAIRE

    Pardeshi Geeta

    2005-01-01

    BACKGROUND: The availability and optimal utilization of medical equipment is important for improving the quality of health services. Significant investments are made for the purchase, maintenance and repair of medical equipment. Inadequate management of these equipment will result in financial losses and deprive the public of the intended benefits. This analysis is based on the conceptual framework drawn from the WHO recommended- lifecycle of medical equipment. AIMS: (1) To identify the probl...

  6. Medical equipment in government health facilities: Missed opportunities

    OpenAIRE

    Pardeshi Geeta

    2005-01-01

    BACKGROUND: The availability and optimal utilization of medical equipment is important for improving the quality of health services. Significant investments are made for the purchase, maintenance and repair of medical equipment. Inadequate management of these equipment will result in financial losses and deprive the public of the intended benefits. This analysis is based on the conceptual framework drawn from the WHO recommended- lifecycle of medical equipment. AIMS: (1) To identify the probl...

  7. Health-Related Quality of Life

    DEFF Research Database (Denmark)

    Linde, Louise; Sørensen, Jan; Ostergaard, Mikkel

    2008-01-01

    OBJECTIVE: To compare validity, reliability, and responsiveness of generic and disease specific health-related quality of life (HRQOL) instruments in rheumatoid arthritis (RA). METHODS: Two samples of patients completed the Medical Outcomes Study Short Form-36 Health Survey (SF-36), EuroQol (EQ)-5D......, 15D, Rheumatoid Arthritis Quality of Life Scale (RAQoL), Health Assessment Questionnaire (HAQ), and visual analog scales (VAS) for pain, fatigue, and global RA. Validity (convergent, discriminant, and known-groups) was evaluated in a cross-section of 200 patients. Reliability was evaluated...

  8. Health-Related Quality of Life

    DEFF Research Database (Denmark)

    Linde, Louise; Sørensen, Jan; Ostergaard, Mikkel

    2008-01-01

    OBJECTIVE: To compare validity, reliability, and responsiveness of generic and disease specific health-related quality of life (HRQOL) instruments in rheumatoid arthritis (RA). METHODS: Two samples of patients completed the Medical Outcomes Study Short Form-36 Health Survey (SF-36), EuroQol (EQ)-5D......, 15D, Rheumatoid Arthritis Quality of Life Scale (RAQoL), Health Assessment Questionnaire (HAQ), and visual analog scales (VAS) for pain, fatigue, and global RA. Validity (convergent, discriminant, and known-groups) was evaluated in a cross-section of 200 patients. Reliability was evaluated...

  9. Evaluating malaria case management at public health facilities in two provinces in Angola.

    Science.gov (United States)

    Plucinski, Mateusz M; Ferreira, Manzambi; Ferreira, Carolina Miguel; Burns, Jordan; Gaparayi, Patrick; João, Lubaki; da Costa, Olinda; Gill, Parambir; Samutondo, Claudete; Quivinja, Joltim; Mbounga, Eliane; de León, Gabriel Ponce; Halsey, Eric S; Dimbu, Pedro Rafael; Fortes, Filomeno

    2017-05-03

    Malaria accounts for the largest portion of healthcare demand in Angola. A pillar of malaria control in Angola is the appropriate management of malaria illness, including testing of suspect cases with rapid diagnostic tests (RDTs) and treatment of confirmed cases with artemisinin-based combination therapy (ACT). Periodic systematic evaluations of malaria case management are recommended to measure health facility readiness and adherence to national case management guidelines. Cross-sectional health facility surveys were performed in low-transmission Huambo and high-transmission Uíge Provinces in early 2016. In each province, 45 health facilities were randomly selected from among all public health facilities stratified by level of care. Survey teams performed inventories of malaria commodities and conducted exit interviews and re-examinations, including RDT testing, of a random selection of all patients completing outpatient consultations. Key health facility readiness and case management indicators were calculated adjusting for the cluster sampling design and utilization. Availability of RDTs or microscopy on the day of the survey was 71% (54-83) in Huambo and 85% (67-94) in Uíge. At least one unit dose pack of one formulation of an ACT (usually artemether-lumefantrine) was available in 83% (66-92) of health facilities in Huambo and 79% (61-90) of health facilities in Uíge. Testing rates of suspect malaria cases in Huambo were 30% (23-38) versus 69% (53-81) in Uíge. Overall, 28% (13-49) of patients with uncomplicated malaria, as determined during the re-examination, were appropriately treated with an ACT with the correct dose in Huambo, compared to 60% (42-75) in Uíge. Incorrect case management of suspect malaria cases was associated with lack of healthcare worker training in Huambo and ACT stock-outs in Uíge. The results reveal important differences between provinces. Despite similar availability of testing and ACT, testing and treatment rates were lower in

  10. Public relations effectiveness in public health institutions.

    Science.gov (United States)

    Springston, Jeffrey K; Weaver Lariscy, Ruth Ann

    2005-01-01

    This article explores public relations effectiveness in public health institutions. First, the two major elements that comprise public relations effectiveness are discussed: reputation management and stakeholder relations. The factors that define effective reputation management are examined, as are the roles of issues and crisis management in building and maintaining reputation. The article also examines the major facets of stakeholder relations, including an inventory of stakeholder linkages and key audiences, such as the media. Finally, methods of evaluating public relations effectiveness at both the program level and the institutional level are explored.

  11. Assisted Living Facilities - CARE_LONG_TERM_FACILITIES_ISDH_IN: Residential Care Facilities, Nursing Homes, and Hospices in Indiana in 2007 (Indiana State Department of Health, Point Shapefile)

    Data.gov (United States)

    NSGIC State | GIS Inventory — CARE_LONG_TERM_FACILITIES_ISDH_IN is a point shapefile showing the locations of 86 residential care facilities, 525 long-term care facilities (nursing homes), and 81...

  12. Assisted Living Facilities - CARE_LONG_TERM_FACILITIES_ISDH_IN: Residential Care Facilities, Nursing Homes, and Hospices in Indiana in 2007 (Indiana State Department of Health, Point Shapefile)

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — CARE_LONG_TERM_FACILITIES_ISDH_IN is a point shapefile showing the locations of 86 residential care facilities, 525 long-term care facilities (nursing homes), and...

  13. Uses of inorganic hypochlorite (bleach) in health-care facilities.

    OpenAIRE

    1997-01-01

    Hypochlorite has been used as a disinfectant for more than 100 years. It has many of the properties of an ideal disinfectant, including a broad antimicrobial activity, rapid bactericidal action, reasonable persistence in treated potable water, ease of use, solubility in water, relative stability, relative nontoxicity at use concentrations, no poisonous residuals, no color, no staining, and low cost. The active species is undissociated hypochlorous acid (HOCl). Hypochlorites are lethal to most...

  14. Programme level implementation of malaria rapid diagnostic tests (RDTs use: outcomes and cost of training health workers at lower level health care facilities in Uganda

    Directory of Open Access Journals (Sweden)

    Kyabayinze Daniel J

    2012-04-01

    Full Text Available Abstract Background The training of health workers in the use of malaria rapid diagnostic tests (RDTs is an important component of a wider strategy to improve parasite-based malaria diagnosis at lower level health care facilities (LLHFs where microscopy is not readily available for all patients with suspected malaria. This study describes the process and cost of training to attain competence of lower level health workers to perform malaria RDTs in a public health system setting in eastern Uganda. Methods Health workers from 21 health facilities in Uganda were given a one-day central training on the use of RDTs in malaria case management, including practical skills on how to perform read and interpret the test results. Successful trainees subsequently integrated the use of RDTs into their routine care for febrile patients at their LLHFs and transferred their acquired skills to colleagues (cascade training model. A cross-sectional evaluation of the health workers’ competence in performing RDTs was conducted six weeks following the training, incorporating observation, in-depth interviews with health workers and the review of health facility records relating to tests offered and antimalarial drug (AMD prescriptions pre and post training. The direct costs relating to the training processes were also documented. Results Overall, 135 health workers were trained including 63 (47% nursing assistants, a group of care providers without formal medical training. All trainees passed the post-training concordance test with ≥ 80% except 12 that required re-training. Six weeks after the one-day training, 51/64 (80% of the health workers accurately performed the critical steps in performing the RDT. The performance was similar among the 10 (16% participants who were peer-trained by their trained colleagues. Only 9 (14% did not draw the appropriate amount of blood using pipette. The average cost of the one-day training was US$ 101 (range $92-$112, with the

  15. Summary of Information and Resources Related to Energy Use in Healthcare Facilities - Version 1

    Energy Technology Data Exchange (ETDEWEB)

    Singer, Brett C.; Coughlin, Jennifer L.; Mathew, Paul A.

    2009-09-08

    This document presents the results of a review of publicly available information on energy use in health care facilities. The information contained in this document and in the sources cited herein provides the background and context for efforts to reduce energy use and costs in health care. Recognizing the breadth and diversity of relevant information, the author acknowledges that the report is likely not comprehensive. It is intended only to present a broad picture of what is currently known about health care energy use. This review was conducted as part of a 'High Performance Health Care Buildings' research study funded by the California Energy Commission. The study was motivated by the recognition that health care facilities collectively account for a substantial fraction of total commercial building energy use, due in large part to the very high energy intensity of hospitals and other inpatient care facilities. The goal of the study was to develop a roadmap of research, development and deployment (RD&D) needs for the health care industry. In addition to this information review, the road map development process included interviews with industry experts and a full-day workshop at LBNL in March 2009. This report is described as 'Version 1' with the intent that it will be expanded and updated as part of an ongoing LBNL program in healthcare energy efficiency. The document is being released in this form with the hope that it can assist others in finding and accessing the resources described within.

  16. Family planning and reproductive health supply stockouts: problems and remedies for faith-based health facilities in Africa

    Directory of Open Access Journals (Sweden)

    Amy M. Metzger

    2017-01-01

    Full Text Available Background and aims: Faith-based organizations (FBOs provide a substantial portion of the health care services in many African countries. FBO facilities do consider family planning and reproductive health services as essential to reducing maternal and child mortality, and to the growth of healthy families. Many health facilities, however, struggle to maintain adequate stocks of reproductive health (RH supplies because of the various RH supply chains and funding sources, which often operate separately from other medicines and supplies. The purpose of this study is to identify the types of supply chain systems used by African faith-based health facilities to acquire reproductive health products (clotrimazole, combined oral contraceptive pills, contraceptive implants, CycleBeads®, emergency contraception, Erythromycin, female condoms, injectable contraceptives, intra-uterine contraceptive devices, magnesium sulfate, male condoms, Methyldopa, Misoprostol, Nifedpine, Oxytocin, and Progestin-only pills, to describe their problems and challenges, and to identify possible corrective actions. Methods: Through email surveys, phone interviews, and on-site visits, we studied the supply chains of 46 faith-based health facilities in 13 African countries. Sixteen RH commodities, including contraceptives, were selected as indicators. Results: Of the 46 facilities surveyed, 55 percent faced stockouts of one or more products in the three months prior to the survey. Stockouts were less common for contraceptives than for other RH products. Significant strengths of the FBO supply chain included creativity in finding other sources of commodities in the face of stockouts, staff designated to monitor quality of the commodities, high capacity for storage, low incidence of expired products, few instances of poor quality, and strong financial sustainability mechanisms, often including patient fees. Weaknesses included unreliable commodity sources and power supplies, long

  17. Profit versus public health: the need to improve the food environment in recreational facilities.

    Science.gov (United States)

    Olstad, Dana Lee; Raine, Kim D

    2013-01-08

    Despite their wellness mandate, many publicly funded recreational facilities offer primarily unhealthy foods. Governments have developed programs and resources to assist facilities to improve their food offerings, however the challenge to incent preferential sale of healthier foods remains substantial. In the Canadian province of Alberta, uptake of government-issued voluntary nutrition guidelines for recreational facilities has been limited, and offers of free assistance to implement them as part of a research study were not embraced. Financial constraints appear to be the most important barrier to offering healthier items in Alberta's recreational facilities, as facility and food service managers perceive that selling healthier foods is unprofitable and might jeopardize sponsorship agreements. Mandatory government regulation may therefore be required to overcome the barriers to offering healthier foods in this setting. The advantages of a regulatory approach appear to outweigh any disadvantages, with benefits for population health, more effective use of public funds, and greater equity for the public and industry. Adverse effects on corporate profitability and freedom of choice are expected to be limited. Regulation may offer an efficient, effective and equitable means of ensuring that recreational facilities support child health and do not undermine it by exposing children to unhealthy food environments.

  18. Application of NAA and related analytical facilities at MINT, Malaysia

    Energy Technology Data Exchange (ETDEWEB)

    Wood, Ab. Khalik Haji [Malaysian Inst. for Nuclear Technology Research (MINT), Bangi, Selangor (Malaysia)

    2003-03-01

    The Analytical Chemistry Laboratory of MINT equipped with analytical equipments to analyse trace chemical components that are important for various field of studies particularly the environmental studies. Even though we are equipped with various analytical technique, we consider the NAA still playing very important role in the analysis of inorganic trace chemical contents in the environmental samples. The reasons due to advantages offered by the nuclear analytical technique such as of it ability to be carried out instrumentally, for a relatively small quantity of samples with good sensitivity. We analysed slightly more than 2,000 samples peryear and about 60% of the samples analysed entirely by the NAA technique. We believed the number of samples analysed will further increase if we apply proper QC/QA procedure to enhance the quality of generated data. To achieved this objective we participated in the IAEA/RCA regional program entitled Quality Assurance and Quality Control (QA/QC) in Nuclear Analytical Technique. In addition to the QC/QA program, we are also will further equipped our analytical systems with additional gamma spectrometer systems and automatic sample changer. It is envisaged that the additional equipments will be made available next year. The additional equipment will enable us to analyse more samples. (author)

  19. Health and climate benefits of offshore wind facilities in the Mid-Atlantic United States

    Science.gov (United States)

    Buonocore, Jonathan J.; Luckow, Patrick; Fisher, Jeremy; Kempton, Willett; Levy, Jonathan I.

    2016-07-01

    Electricity from fossil fuels contributes substantially to both climate change and the health burden of air pollution. Renewable energy sources are capable of displacing electricity from fossil fuels, but the quantity of health and climate benefits depend on site-specific attributes that are not often included in quantitative models. Here, we link an electrical grid simulation model to an air pollution health impact assessment model and US regulatory estimates of the impacts of carbon to estimate the health and climate benefits of offshore wind facilities of different sizes in two different locations. We find that offshore wind in the Mid-Atlantic is capable of producing health and climate benefits of between 54 and 120 per MWh of generation, with the largest simulated facility (3000 MW off the coast of New Jersey) producing approximately 690 million in benefits in 2017. The variability in benefits per unit generation is a function of differences in locations (Maryland versus New Jersey), simulated years (2012 versus 2017), and facility generation capacity, given complexities of the electrical grid and differences in which power plants are offset. This work demonstrates health and climate benefits of offshore wind, provides further evidence of the utility of geographically-refined modeling frameworks, and yields quantitative insights that would allow for inclusion of both climate and public health in benefits assessments of renewable energy.

  20. Gender equality and childbirth in a health facility: Nigeria and MDG5.

    Science.gov (United States)

    Singh, Kavita; Bloom, Shelah; Haney, Erica; Olorunsaiye, Comfort; Brodish, Paul

    2012-09-01

    This paper examined how addressing gender equality can lead to reductions in maternal mortality in Nigeria through an increased use of facility delivery. Because the majority of maternal complications cannot be predicted and often arise suddenly during labor, delivery and the immediate postpartum period, childbirth in a health facility is key to reducing maternal mortality. This paper used data from the 2008 Nigeria Demographic and Health Survey (DHS) to examine associations of gender measures on the utilization of facility delivery after controlling for socio-demographic factors. Four gender equality measures were studied: household decision-making, financial decision-making, attitudes towards wife beating, and attitudes regarding a wife's ability to refuse sex. Results found older, more educated, wealthier, urban, and working women were more likely to have a facility delivery than their counterparts. In addition ethnicity was a significant variable indicating the importance of cultural and regional diversity. Notably, after controlling for the socioeconomic variables, two of the gender equality variables were significant: household decision-making and attitudes regarding a wife's ability to refuse sex. In resource-poor settings such as Nigeria, women with more decision-making autonomy are likely better able to advocate for and access a health facility for childbirth. Thus programs and policies that focus on gender in addition to focusing on education and poverty have the potential to reduce maternal mortality even further.

  1. Health-related quality of life and mental health outcomes in Mexican TBI caregivers.

    Science.gov (United States)

    Gulin, Shaina L; Perrin, Paul B; Stevens, Lillian F; Villaseñor-Cabrera, Teresita J; Jiménez-Maldonado, Miriam; Martínez-Cortes, Ma Luisa; Arango-Lasprilla, Juan Carlos

    2014-03-01

    Research has documented the deleterious effects on caregivers of providing care for an individual with traumatic brain injury (TBI). TBI caregivers in Mexico specifically have reduced health-related quality of life (HRQOL) across both physical and mental health domains. The purpose of the current study was to uncover the system of connections between Mexican TBI caregivers' HRQOL and their mental health. A cross-sectional survey was conducted at a public medical facility in Guadalajara, México. Ninety family caregivers of individuals with TBI completed measures of HRQOL, satisfaction with life, depression, and burden. A canonical correlation analysis revealed that the better the caregivers' HRQOL, the better their mental health was, with the effect reaching a large-sized effect. A distinct pattern emerged linking caregivers' higher energy levels and better social functioning to lower depression and greater satisfaction with life. A series of multiple regressions similarly uncovered that the most robust independent HRQOL predictors of caregiver mental health were vitality and social functioning. Especially for TBI caregivers with poor health, behavioral health interventions in Latin America that target the HRQOL domains of social functioning and vitality may significantly improve caregiver mental health, and as a result, informal care for TBI.

  2. [Gerodontology consultation in geriatric facilities: general health status (I)].

    Science.gov (United States)

    Katsoulis, Joannis; Huber, Sandra; Mericske-Stern, Regina

    2009-01-01

    Dental undertreatment is often seen in the older population. This is particularly true for the elderly living in nursing homes and geriatric hospitals. The progression of chronic diseases results in loss of their independence. They rely on daily support and care due to physical or mental impairment. The visit of a dentist in private praxis becomes difficult or impossible and is a logistic problem. These elderly patients are often not aware of oral and dental problems or these are not addressed. The geriatric hospital Bern, Ziegler, has integrated dental care in the concept of physical rehabilitation of geriatric patients. A total of 139 patients received dental treatment in the years 2005/2006. Their mean age was 83 years, but the segment with > 85 years of age amounted to 46%. The general health examinations reveald multiple and complex disorders. The ASA classification (American Society of Anesthesiologists, Physical Status Classification System) was applied and resulted in 15% = P2 (mild systemic disease, no functional limitation), 47% = P3 (severe systemic disease, definite functional limitations) and 38% = P4 (severe systemic disease, constant threat to life). Eighty-seven of the patients exhibited 3 or more chronic diseases with a prevalence of cardiovascular diseases, musculoskelettal disorders and dementia. Overall the differences between men and women were small, but broncho-pulmonary dieseases were significantly more frequent in women, while men were more often diagnosed with dementia and depression. Verbal communication was limited or not possible with 60% of the patients due to cognitive impairment or aphasia after a stroke. Although the objective treatment need is high, providing dentistry for frail and geriatric patients is characterized by risks due to poor general health conditions, difficulties in communication, limitations in feasibility and lack of adequate aftercare. In order to prevent the problem of undertreatment, elderly independently living

  3. Household decision-making about delivery in health facilities: evidence from Tanzania.

    Science.gov (United States)

    Danforth, E J; Kruk, M E; Rockers, P C; Mbaruku, G; Galea, S

    2009-10-01

    This study investigated how partners' perceptions of the healthcare system influence decisions about delivery-location in low-resource settings. A multistage population-representative sample was used in Kasulu district, Tanzania, to identify women who had given birth in the last five years and their partners. Of 826 couples in analysis, 506 (61.3%) of the women delivered in the home. In multivariate analysis, factors associated with delivery in a health facility were agreement of partners on the importance of delivering in a health facility and agreement that skills of doctors are better than those of traditional birth attendants. When partners disagreed, the opinion of the woman was more influential in determining delivery-location. Agreement of partners regarding perceptions about the healthcare system appeared to be an important driver of decisions about delivery-location. These findings suggest that both partners should be included in the decision-making process regarding delivery to raise rates of delivery at facility.

  4. Medical equipment in government health facilities: missed opportunities.

    Science.gov (United States)

    Pardeshi, Geeta S

    2005-01-01

    The availability and optimal utilization of medical equipment is important for improving the quality of health services. Significant investments are made for the purchase, maintenance and repair of medical equipment. Inadequate management of these equipment will result in financial losses and deprive the public of the intended benefits. This analysis is based on the conceptual framework drawn from the WHO recommended- lifecycle of medical equipment. (1) To identify the problems in different stages of the life cycle. (2) To assess its financial implications and effect on service delivery. Analysis of secondary data from the latest Comptroller and Auditor General (CAG) Reports for the states in India. The study variables were category of equipment, financial implications and problems in the stages of life cycle. Calculation of proportions. A total of forty instances mentioning problems in the first phase of the life cycle of medical equipment were noted in 12 state reports. The equipment from the radiology department (15), equipment in the wards (5), laboratory (3) and operation theatres (4) were the ones most frequently implicated. In a majority of cases the financial implications amounted to twenty-five lakhs. The financial implications were in the form of extra expenditure, unfruitful expenditure or locking of funds. In 25 cases the equipment could not be put to use because of non-availability of trained staff and inadequate infrastructural support. Careful procurement, incoming inspection, successful installation and synchronization of qualified trained staff and infrastructural support will ensure timely onset of use of the equipment.

  5. Substance use and health related issues

    NARCIS (Netherlands)

    Didden, H.C.M.; Nagel, J.E.L. van der; Duijvenbode, N. van

    2016-01-01

    Individuals with intellectual and developmental disabilities (IDD) have an increased risk for developing problems related to use and misuse of substances such as alcohol and drugs. The consequences for mental and somatic health are often detrimental. Substance use disorder is a chronic and

  6. Adoption factors associated with electronic health record among long-term care facilities: a systematic review.

    Science.gov (United States)

    Kruse, Clemens Scott; Mileski, Michael; Alaytsev, Vyachelslav; Carol, Elizabeth; Williams, Ariana

    2015-01-28

    The Health Information Technology for Economic and Clinical Health (HITECH) Act created incentives for adopting electronic health records (EHRs) for some healthcare organisations, but long-term care (LTC) facilities are excluded from those incentives. There are realisable benefits of EHR adoption in LTC facilities; however, there is limited research about this topic. The purpose of this systematic literature review is to identify EHR adoption factors for LTC facilities that are ineligible for the HITECH Act incentives. We conducted systematic searches of Cumulative Index of Nursing and Allied Health Literature (CINAHL) Complete via Ebson B. Stephens Company (EBSCO Host), Google Scholar and the university library search engine to collect data about EHR adoption factors in LTC facilities since 2009. Search results were filtered by date range, full text, English language and academic journals (n=22). Multiple members of the research team read each article to confirm applicability and study conclusions. Researchers identified common themes across the literature: specifically facilitators and barriers to adoption of the EHR in LTC. Results identify facilitators and barriers associated with EHR adoption in LTC facilities. The most common facilitators include access to information and error reduction. The most prevalent barriers include initial costs, user perceptions and implementation problems. Similarities span the system selection phases and implementation process; of those, cost was the most common mentioned. These commonalities should help leaders in LTC facilities align strategic decisions to EHR adoption. This review may be useful for decision-makers attempting successful EHR adoption, policymakers trying to increase adoption rates without expanding incentives and vendors that produce EHRs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. A retrospective audit of antibiotic prescriptions in primary health-care facilities in Eastern Region, Ghana

    DEFF Research Database (Denmark)

    Ahiabu, Mary-Anne; Tersbøl, Britt Pinkowski; Biritwum, Richard

    2016-01-01

    assured antibiotics and more optimal drugs and poor antibiotic use practices. The appropriate use of antibiotics to slow the pace of resistance development is crucial. The study retrospectively assessed antibiotic prescription practices in four public and private primary health-care facilities in Eastern...

  8. Quality of Tuberculosis Care in Private Health Facilities of Addis Ababa, Ethiopia

    Directory of Open Access Journals (Sweden)

    Gezahegn Gebrekidan

    2014-01-01

    Full Text Available Ensuring provision of good quality tuberculosis (TB care, especially in private for profit health facilities, is an important component of TB control strategy to reduce poor medical practice which results in multidrug resistant TB (MDR-TB. The aim of this study was to investigate quality of TB care in private health facilities of Addis Ababa. A facility based cross-sectional study was conducted based on Donabedian’s structure-process-outcome model of health care quality. Quality of care was determined by adherence to National TB Program guidelines, treatment success rate, and client satisfaction. Exit interview was conducted on 292 patients on the intensive phase of treatment and 384 patient records were reviewed in eight private health facilities. Initial diagnostic AFB test was done for 95.4% of pulmonary TB patients. Most important components of TB care recommended by national guidelines were delivered for a significant proportion of patients. Majority (75% of the clients were found to be satisfied with each component of TB care. The treatment success rate was 90.9%. The quality of TB care was fairly good. However, only 77.7% of the patients were counseled for HIV testing. Strengthening HIV counseling and testing, tackling shortage of streptomycin and laboratory reagent at private TB clinic is crucial.

  9. Assessment of prescription pattern at the public health facilities of Lucknow district

    Directory of Open Access Journals (Sweden)

    Kumari Ranjeeta

    2008-01-01

    Full Text Available Objectives: To study the prescription pattern at the different levels of public health facilities of Lucknow district and to assess the average cost of drugs prescribed. Methods: Multi-stage stratified random sampling was done to select 1625 prescriptions of the patients attending the different level of public health facilities in Lucknow district, from August 2005 to September 2006, which was used for the development of study tools, collection of data and analysis. Results: The important components of prescription viz. examination findings, weight of the child, follow up visit and the signatures of the prescribers were absent in the prescriptions at the primary level. Polypharmacy was common (3.1 ± 1.6 drugs per prescription. The prescription of drugs by generic name was low (27.1%. The prescriptions at the secondary level health facilities were incomplete with respect to mentioning the suffix/prefix of the drug, full name, dose, frequency and strength of the drugs, and directions specifying the route and duration of the treatment. The average cost of drugs/prescription/day in US$ (Mean, SD was found to be the highest at the tertiary level (0.34, 0.43, which decreased significantly at the primary level health facilities. Conclusion: The pattern of prescription in terms of completeness and rationality was poor. There is an urgent need to improve the standards of drug prescription.

  10. Safety in Elevators and Grain Handling Facilities. Module SH-27. Safety and Health.

    Science.gov (United States)

    Center for Occupational Research and Development, Inc., Waco, TX.

    This student module on safety in elevators and grain handling facilities is one of 50 modules concerned with job safety and health. Following the introduction, 15 objectives (each keyed to a page in the text) the student is expected to accomplish are listed (e.g., Explain how explosion suppression works). Then each objective is taught in detail,…

  11. [3D printing in health care facilities: What legislation in France?].

    Science.gov (United States)

    Montmartin, M; Meyer, C; Euvrard, E; Pazart, L; Weber, E; Benassarou, M

    2015-11-01

    Health care facilities more and more use 3D printing, including making their own medical devices (MDs). However, production and marketing of MDs are regulated. The goal of our work was to clarify what is the current French regulation that should be applied concerning the production of custom-made MDs produced by 3D printing in a health care facility. MDs consist of all devices used for diagnosis, prevention, or treatment of diseases in patients. Prototypes and anatomic models are not considered as MDs and no specific laws apply to them. Cutting guides, splints, osteosynthesis plates or prosthesis are MDs. In order to become a MD manufacturer in France, a health care facility has to follow the requirements of the 93/42/CEE directive. In addition, custom-made 3D-printed MDs must follow the annex VIII of the directive. This needs the writing of a declaration of conformity and the respect of the essential requirements (proving that a MD is secure and conform to what is expected), the procedure has to be qualified, a risk analysis and a control of the biocompatibility of the material have to be fulfilled. The documents proving that these rules have been respected have to be available. Becoming a regulatory manufacturer of MD in France is possible for a health care facility but the specifications have to be respected.

  12. The problems of design and construction of health facilities in Angola

    Directory of Open Access Journals (Sweden)

    Bindanda Antonio Afonso

    2014-03-01

    Full Text Available Angola is a country with great economic potential, which can contribute to the solution of construction, architecture and social problems of the country in case of rational use of financial resources. The author focuses on the negative factors that prevent the health authorities from the efficient construction of large hospitals and clinical facilities in Angola. Brief description of the Angolan population is given. The article provides a brief overview of the climate and overall social health problems. Basing on the stated goals, the following problems are considered: Features of architectural and planning decisions of clinical facilities and a brief description of the existing hospitals. The article deals with those minor progressive changes in planning decisions and in the siting of health facilities. Space-planning decisions, the most rational options and requirements for building new hospitals in Angola. The author indentified the main factors that influence architectural solutions for the design and construction of medical facilities. The most rational design options for clinic hospitals were determined. The objectives of the study were formulated with a view to identifying architectural solutions in the construction of new clinical hospitals. The main objective of the study is to improve health care in Angola. The problems are considered in order to identify rational architectural design of new clinical hospitals.

  13. A ‘Mystery Client’ Evaluation of Adolescent Sexual and Reproductive Health services in Health Facilities from Two Regions in Tanzania

    Science.gov (United States)

    Mchome, Zaina; Richards, Esther; Nnko, Soori; Dusabe, John; Mapella, Elizabeth; Obasi, Angela

    2015-01-01

    Unwelcoming behaviours and judgemental attitudes have long been recognised as a barrier to young people’s access to reproductive health services. Over the last decade youth friendly reproductive health services have been promoted and implemented world-wide. However, long term evidence of the impact of these programmes is lacking. We report the results of a large mystery client evaluation of adolescent sexual and reproductive health services in Tanzania, a country that has had a long established youth friendly policy. Forty-eight visits made to thirty-three health facilities were conducted by twelve young people (six in each region) trained to perform three different scripted scenarios (i.e., condom request, information on sexually transmitted infections and family planning). The study revealed barriers in relation to poor signage and reception for services. In addition health workers demonstrated paternalistic attitudes as well as lack of knowledge about adolescent sexual and reproductive health services. In some cases, health workers discouraged young people from using services such as condoms and family planning methods. Lack of confidentiality and privacy were also noted to be common challenges for the young people involved. Intervention strategies that focus on changing health workers’ mind-set in relation to adolescent sexual and reproductive health are crucial for ensuring quality provision of sexual and reproductive health services to young people. The study identified the importance of reception or signs at the health units, as this can facilitate young people’s efforts in seeking sexual and reproductive health services. Likewise, improvement of health workers knowledge of existing policy and practice on sexual and reproductive health services and youth friendly services is much needed. PMID:25803689

  14. Medical equipment in government health facilities: Missed opportunities

    Directory of Open Access Journals (Sweden)

    Pardeshi Geeta

    2005-01-01

    Full Text Available BACKGROUND: The availability and optimal utilization of medical equipment is important for improving the quality of health services. Significant investments are made for the purchase, maintenance and repair of medical equipment. Inadequate management of these equipment will result in financial losses and deprive the public of the intended benefits. This analysis is based on the conceptual framework drawn from the WHO recommended- lifecycle of medical equipment. AIMS: (1 To identify the problems in different stages of the life cycle. (2 To assess its financial implications and effect on service delivery. SETTINGS AND DESIGN: Analysis of secondary data from the latest Comptroller and Auditor General (CAG Reports for the states in India. The study variables were category of equipment, financial implications and problems in the stages of life cycle. STATISTICAL ANALYSIS: Calculation of proportions. RESULTS AND CONCLUSIONS: A total of forty instances mentioning problems in the first phase of the life cycle of medical equipment were noted in 12 state reports. The equipment from the radiology department (15, equipment in the wards (5, laboratory (3 and operation theatres (4 were the ones most frequently implicated. In a majority of cases the financial implications amounted to twenty-five lakhs. The financial implications were in the form of extra expenditure, unfruitful expenditure or locking of funds. In 25 cases the equipment could not be put to use because of non-availability of trained staff and inadequate infrastructural support. Careful procurement, incoming inspection, successful installation and synchronization of qualified trained staff and infrastructural support will ensure timely onset of use of the equipment.

  15. European network for promoting the physical health of residents in psychiatric and social care facilities (HELPS)

    DEFF Research Database (Denmark)

    Weiser, Prisca; Becker, Thomas; Losert, Carolin;

    2009-01-01

    consisting of 15 European countries has been established and took up the work. As one main result of the project they expect that a widespread use of the HELPS toolkit could have a significant positive effect on the physical health status of residents of mental health and social care facilities, as well...... by promoting behaviour-based and/or environment-based interventions. METHODS AND DESIGN: HELPS is an interdisciplinary European network that aims at (i) gathering relevant knowledge on physical illness in people with mental illness, (ii) identifying health promotion initiatives in European countries that meet...... as to hold resonance for community dwelling people with mental health problems. DISCUSSION: A general strategy on health promotion for people with mental disorders must take into account behavioural, environmental and iatrogenic health risks. A European health promotion toolkit needs to consider...

  16. The effect of the National Health Insurance Scheme (NHIS) on health service delivery in mission facilities in Ghana: a retrospective study

    OpenAIRE

    Aryeetey, Genevieve Cecilia; Nonvignon, Justice; Amissah, Caroline; Buckle, Gilbert; Aikins, Moses

    2016-01-01

    Background In 2004, Ghana began implementation of a National Health Insurance Scheme (NHIS) to minimize out-of-pocket expenditure at the point of use of service. The implementation of the scheme was accompanied by increased access and use of health care services. Evidence suggests most health facilities are faced with management challenges in the delivery of services. The study aimed to assess the effect of the introduction of the NHIS on health service delivery in mission health facilities i...

  17. Predictors for health facility delivery in Busia district of Uganda: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Anyait Agnes

    2012-11-01

    Full Text Available Abstract Background Among the factors contributing to the high maternal morbidity and mortality in Uganda is the high proportion of pregnant women who do not deliver under supervision in health facilities. This study aimed to identify the independent predictors of health facility delivery in Busia a rural district in Uganda with a view of suggesting measures for remedial action. Methods In a cross sectional survey, 500 women who had a delivery in the past two years (from November 16 2005 to November 15 2007 were interviewed regarding place of delivery, demographic characteristics, reproductive history, attendance for antenatal care, accessibility of health services, preferred delivery positions, preference for disposal of placenta and mother’s autonomy in decision making. In addition the household socio economic status was assessed. The independent predictors of health facility delivery were identified by comparing women who delivered in health facilities to those who did not, using bivariate and binary logistic regression analysis. Results Eight independent predictors that favoured delivery in a health facility include: being of high socio-economic status (adjusted odds ratio [AOR] 2.8 95% Confidence interval [95% CI]1.2–6.3, previous difficult delivery (AOR 4.2, 95% CI 3.0–8.0, parity less than four (AOR 2.9, 95% CI 1.6–5.6, preference of supine position for second stage of labour (AOR 5.9, 95% CI 3.5–11.1 preferring health workers to dispose the placenta (AOR 12.1, 95% CI 4.3–34.1, not having difficulty with transport (AOR 2.0, 95% CI 1.2–3.5, being autonomous in decision to attend antenatal care (AOR 1.9, 95% CI 1.1–3.4 and depending on other people (e.g. spouse in making a decision of where to deliver from (AOR 2.4, 95% CI 1.4–4.6. A model with these 8 variables had an overall correct classification of 81.4% (chi square = 230.3, P  Conclusions These data suggest that in order to increase health facility deliveries

  18. Factor structure of health and oral health-related behaviors among adolescents in Arusha, northern Tanzania.

    Science.gov (United States)

    Astrøm, Anne Nordrehaug; Mbawalla, Hawa

    2011-09-01

    This study aimed to evaluate the factor structure of health and oral health-related behaviors and it's invariance across gender and to identify factors associated with behavioral patterns. A cross-sectional study included 2412 students attending 20 secondary schools in Arusha. Self-administered questionnaires were completed at school. Principal component analysis of seven single health and oral health-related behaviors (tooth brushing, hand wash after latrine, hand wash before eating, using soap, intake of sugared mineral water, intake of fast foods and intake of sweets) suggested two factors labeled hygiene behavior and snacking. Confirmatory factor analyses, CFA, provided acceptable fit for the hypothesized two-factor model; CFI = 0.97. Multiple group CFA across gender showed no statistically significant difference in fit between unconstrained and constrained models (p = 0.203). Logistic regression revealed ORs for hygiene behaviors of 1.5, 0.5, 1.5, 1.5 and 0.6 if being a girl, current smoker, reporting good relationship with school, access to hygiene facilities and bad life satisfaction, respectively. ORs for snacking were 1.3, 1.4, 0.4 and 0.5 if female, in the least poor household quartile, low family socio-economic status and high perceived control, respectively. The two factors suggest that behaviors within each might be approached jointly in health promoting programs. A positive relationship with school and access to hygiene facilities might play a role in health promotion. Provision of healthy snacks and improved perceived behavioral control regarding sugar avoidance might restrict snacking during school hours.

  19. Job satisfaction and determinant factors among midwives working at health facilities in Addis Ababa city, Ethiopia

    Science.gov (United States)

    Bekru, Eyasu Tamru; Cherie, Amsale; Anjulo, Antehun Alemayehu

    2017-01-01

    Background Midwives are the primary source of care and support for mothers and newborns at the most vulnerable time in their lives.The Ethiopian National Reproductive Health Strategy targeted reduction of Maternal Mortality rate to 267/100,000 live births in the years 2006–2015. Midwives play a crucial role in the care of pregnant women, from the first antenatal visit right through to the delivery and the postpartum period. Methodology Institution based cross-sectional study was carried out from March 2015 to April 2015 in Addis Ababa city, Ethiopia to assess job satisfaction and its determinants among midwives working at government health facilities. A total of 234 midwives were involved from 84 health centers and 8 governmental hospitals proportional to the size of health centers and hospitals using simple random sampling method. A total of 175 and 59 midwives were taken from health centers and government hospitals respectively. Different variables like Socio demographic, Job related domain and Organizational domain were collected using pre structured questionnaire after getting written consent. Data entry and analysis were done using SPSS 21.00. Binary logistic regression was used to determine factors affecting job satisfaction. P-values less than 0.05 were considered statistically significant. Result From 234 eligible respondents 221 midwives participated in this study which makes a response rate of 94.44%. The overall mean job satisfaction was 52.9%. Independent predictors of job satisfaction includes Sex [AOR = 4.07 (95%CI: 1.36–12.37)], working unit [AOR = 0.04 (95%CI:(0.001–0.45)], Educational status [AOR = 5.74(95%CI: 1.48–40.47)], Marital status [AOR = 3.48 [1.01–11.97)], supervision [AOR = 4.33 (95%CI: 1.53–20.22)], standard of care[AOR 4.80, (3.38–50.10)] and work load [AOR 8.94, (95%CI 2.37–22.65)]. Midwives were least satisfied from salary, extrinsic reward and professional opportunity subscales while they were most satisfied from

  20. Keeping health facilities safe: one way of strengthening the interaction between disease-specific programmes and health systems.

    Science.gov (United States)

    Harries, Anthony D; Zachariah, Rony; Tayler-Smith, Katie; Schouten, Erik J; Chimbwandira, Frank; Van Damme, Wim; El-Sadr, Wafaa M

    2010-12-01

    The debate on the interaction between disease-specific programmes and health system strengthening in the last few years has intensified as experts seek to tease out common ground and find solutions and synergies to bridge the divide. Unfortunately, the debate continues to be largely academic and devoid of specificity, resulting in the issues being irrelevant to health care workers on the ground. Taking the theme 'What would entice HIV- and tuberculosis (TB)-programme managers to sit around the table on a Monday morning with health system experts', this viewpoint focuses on infection control and health facility safety as an important and highly relevant practical topic for both disease-specific programmes and health system strengthening. Our attentions, and the examples and lessons we draw on, are largely aimed at sub-Saharan Africa where the great burden of TB and HIV ⁄ AIDS resides, although the principles we outline would apply to other parts of the world as well. Health care infections, caused for example by poor hand hygiene, inadequate testing of donated blood, unsafe disposal of needles and syringes, poorly sterilized medical and surgical equipment and lack of adequate airborne infection control procedures, are responsible for a considerable burden of illness amongst patients and health care personnel, especially in resource-poor countries. Effective infection control in a district hospital requires that all the components of a health system function well: governance and stewardship, financing,infrastructure, procurement and supply chain management, human resources, health information systems, service delivery and finally supervision. We argue in this article that proper attention to infection control and an emphasis on safe health facilities is a concrete first step towards strengthening the interaction between disease-specific programmes and health systems where it really matters – for patients who are sick and for the health care workforce who provide

  1. Violence towards health care workers in a Public Health Care Facility in Italy: a repeated cross-sectional study

    Directory of Open Access Journals (Sweden)

    Magnavita Nicola

    2012-05-01

    Full Text Available Abstract Background Violence at work is one of the major concerns in health care activities. The aim of this study was to identify the prevalence of physical and non-physical violence in a general health care facility in Italy and to assess the relationship between violence and psychosocial factors, thereby providing a basis for appropriate intervention. Methods All health care workers from a public health care facility were invited to complete a questionnaire containing questions on workplace violence. Three questionnaire-based cross-sectional surveys were conducted. The response rate was 75 % in 2005, 71 % in 2007, and 94 % in 2009. The 2009 questionnaire contained the VIF (Violent Incident Form for reporting violent incidents, the DCS (demand/control/support model for job strain, the Colquitt 20 item questionnaire for perceived organizational justice, and the GHQ-12 General Health Questionnaire for the assessment of mental health. Results One out of ten workers reported physical assault, and one out of three exposure to non-physical violence in the workplace in the previous year. Nurses and physicians were the most exposed occupational categories, whereas the psychiatric and emergency departments were the services at greatest risk of violence. Workers exposed to non-physical violence were subject to high job strain, low support, low perceived organizational justice, and high psychological distress. Conclusion Our study shows that health care workers in an Italian local health care facility are exposed to violence. Workplace violence was associated with high demand and psychological disorders, while job control, social support and organizational justice were protective factors.

  2. Quality Assessment of Family Planning Sterilization Services at Health Care Facilities: Case Record Audit.

    Science.gov (United States)

    Mathur, Medha; Goyal, Ram Chandra; Mathur, Navgeet

    2017-05-01

    Quality of sterilization services is a matter of concern in India because population control is a necessity. Family Planning Sterilization (FPS) services provided at public health care facilities need to be as per Standard Operating Procedures. To assess the quality of FPS services by audit of case records at selected health care facilities. This cross-sectional study was conducted for two and a half year duration at selected public health care facilities of central India by simple random sampling where FPS services were provided. As per the standards of Government of India, case records were audited and compliance was calculated to assess the quality of services. Results of record audit were satisfactory but important criteria like previous contraceptive history and postoperative counselling were found to be deviated from standards. At Primary Health Centres (PHCs) only 89.5% and at Community Health Centres (CHCs) 58.7% of records were having details of previous contraceptive history. Other criteria like mental illness (only 70% at CHCs) assessment were also inadequate. Although informed consent was found to be having 100% compliance in all records. Quality of care in FPS services is the matter of concern in present scenario for better quality of services. This study may enlighten the policy makers regarding improvements needed for providing quality care.

  3. Implementation of a Zebrafish Health Program in a Research Facility: A 4-Year Retrospective Study.

    Science.gov (United States)

    Borges, Ana C; Pereira, Nuno; Franco, Maysa; Vale, Liliana; Pereira, Margarida; Cunha, Mónica V; Amaro, Ana; Albuquerque, Teresa; Rebelo, Manuel

    2016-07-01

    In the past two decades, zebrafish (Danio rerio)-based research has contributed to significant scientific advances. Still, husbandry and health programs did not evolve at the same pace, as evidenced by the absence of general guidelines. Health monitoring is essential to animal welfare, to permit animal exchanges across facilities, to contribute to robust experimental results, and for data reproducibility. In this study, we report a health program implemented in a zebrafish research facility to prevent, monitor, and control pathogen, and disease dissemination. This program includes quarantine, routine health screening of sentinels, and nonroutine screenings of retired animals and sick/moribund individuals. An extensive list of clinical signs, lesions, and pathogens was monitored based on: daily observation of fish, necropsy, histology, and bacterial culture. The results indicate that the combined analysis of sentinels with the evaluation of sick/moribund animals enables a comprehensive description not only of pathogen prevalence but also of clinical and histopathologic lesions of resident animals. The establishment of a quarantine program revealed to be effective in the reduction of Pseudoloma neurophilia frequency in the main aquaria room. Finally, characterization of the colony health status based on this multiapproach program shows a low prevalence of lesions and pathogens in the facility.

  4. Health Facilities Safety in Natural Disasters: Experiences and Challenges from South East Europe

    Directory of Open Access Journals (Sweden)

    Vesela Radovic

    2012-05-01

    Full Text Available The United Nations named 2010 as a year of natural disasters, and launched a worldwide campaign to improve the safety of schools and hospitals from natural disasters. In the region of South East Europe, Croatia and Serbia have suffered the greatest impacts of natural disasters on their communities and health facilities. In this paper the disaster management approaches of the two countries are compared, with a special emphasis on the existing technological and legislative systems for safety and protection of health facilities and people. Strategic measures that should be taken in future to provide better safety for health facilities and populations, based on the best practices and positive experiences in other countries are recommended. Due to the expected consequences of global climate change in the region and the increased different environmental risks both countries need to refine their disaster preparedness strategies. Also, in the South East Europe, the effects of a natural disaster are amplified in the health sector due to its critical medical infrastructure. Therefore, the principles of environmental security should be implemented in public health policies in the described region, along with principles of disaster management through regional collaborations.

  5. The health effects of nuclear facilities under the microscope; Los efectos de las instalaciones nucleares sobre la salud a examen

    Energy Technology Data Exchange (ETDEWEB)

    Catalan, J. M.

    2009-07-01

    The health effects of nuclear facilities under the microscope. The forthcoming months will see the conclusion of the epidemiological study that the Nuclear Safety Council (CSN) and the Carlos III Institute of Health (ISCIII) are carrying out to investigate the possible effects on the population of the ionising radiations produced by the operation of nuclear facilities. (Author)

  6. Annual report to Congress: Department of Energy activities relating to the Defense Nuclear Facilities Safety Board, Calendar Year 1999

    Energy Technology Data Exchange (ETDEWEB)

    None

    2000-02-01

    This is the tenth Annual Report to the Congress describing Department of Energy activities in response to formal recommendations and other interactions with the Defense Nuclear Facilities Safety Board (Board). The Board, an independent executive-branch agency established in 1988, provides advice and recommendations to the Secretary of Energy regarding public health and safety issues at the Department's defense nuclear facilities. The Board also reviews and evaluates the content and implementation of health and safety standards, as well as other requirements, relating to the design, construction, operation, and decommissioning of the Department's defense nuclear facilities. During 1999, Departmental activities resulted in the closure of nine Board recommendations. In addition, the Department has completed all implementation plan milestones associated with three Board recommendations. One new Board recommendation was received and accepted by the Department in 1999, and a new implementation plan is being developed to address this recommendation. The Department has also made significant progress with a number of broad-based initiatives to improve safety. These include expanded implementation of integrated safety management at field sites, opening of a repository for long-term storage of transuranic wastes, and continued progress on stabilizing excess nuclear materials to achieve significant risk reduction.

  7. Use of health services by residents at a seniors-only living facility

    Directory of Open Access Journals (Sweden)

    Elen Ferraz Teston

    2013-10-01

    Full Text Available The objective of the study was to compare the use of medical and dental services by seniors residing at a seniors-only living facility and in the general community. It was a quantitative study, among 50 residents of the living facility and 173 in the general community. The data were collected between November 2011 and February 2012 through a questionnaire, and subjected to statistical analysis. Performance of clinical exams and satisfaction with health services was greater among seniors living in the general community; however, physical therapy treatment was more common among those living in the facility. The use of medical and dental services showed a statistically significant difference. The seniors in both groups need oral health monitoring and those living in the facility also require coverage by the Family Health Strategy. The presence of professionals with the right profile to adequately serve residents and the network of available services are determining factors for the success of this new housing policy.

  8. Prevalence of herbal medicine use and associated factors among pregnant women attending antenatal care at public health facilities in Hossana Town, Southern Ethiopia: facility based cross sectional study.

    Science.gov (United States)

    Laelago, Tariku; Yohannes, Tadele; Lemango, Fiseha

    2016-01-01

    The use of herbal medicine has been on increase in many developing and industrialized countries. More pregnant women use herbal remedies to treat pregnancy related problems due to cost-effectiveness of therapy and easy access of these products. We sought to assess the prevalence of herbal medicine use and associated factors among pregnant women attending antenatal clinics of public health facilities. Facility based cross sectional study was conducted among 363 pregnant women attending antenatal clinics from May to June 2015 at public health facilities in Hossana town, Hadiya zone, Southern Ethiopia. Pretested structured questionnaire was used to collect data from each study subject. Bivariate logistic regression analysis was used to see significance of association between the outcome and independent variables. Odds ratios at 95 % CI were computed to measure the strength of the association between the outcome and the independent variables. P-value ginger (55.8 %), garlic (69.8 %), eucalyptus (11.6 %), tenaadam (rutachalenssis) (26.4 %), damakesse (ocimumlamiifolium) (22.8 %), feto (3.5 %) and omore (3.1 %). Being students (AOR: (5.68, 95 % CI: (1.53, 21.13), second trimester of pregnancy (AOR: 0.22, 95 % CI: (0.08, 0.76), sufficient knowledge on herbal medicine (AOR: 0.37, 95 % CI: (0.19, 0.79), no formal education (AOR: 4.41, 95 % CI: (1.11, 17.56), primary education (AOR: 4.15, 95 % CI: (1.51, 11.45) and secondary education (AOR: 2.55, 95 % CI: (1.08,6.03) were significantly associated with herbal medicine use. The findings of this study showed that herbal medicine use during pregnancy is a common experience. Commonly used herbal medicines during current pregnancy were garlic, ginger, tenaadam, damakasse and eucalyptus. Educational status, occupation, knowledge on herbal medicine and second trimester of pregnancy were the major factors affecting use of herbal medicine. Health education about the effects of herbal medicine on pregnancy should be given

  9. Potential of mediation for resolving environmental disputes related to energy facilities

    Energy Technology Data Exchange (ETDEWEB)

    None

    1979-12-01

    This study assesses the potential of mediation as a tool for resolving disputes related to the environmental regulation of new energy facilities and identifies possible roles the Federal government might play in promoting the use of mediation. These disputes result when parties challenge an energy project on the basis of its potential environmental impacts. The paper reviews the basic theory of mediation, evaluates specific applications of mediation to recent environmental disputes, discusses the views of environmental public-interest groups towards mediation, and identifies types of energy facility-related disputes where mediation could have a significant impact. Finally, potential avenues for the Federal government to encourage use of this tool are identified.

  10. A case study of potential human health impacts from petroleum coke transfer facilities.

    Science.gov (United States)

    Dourson, Michael L; Chinkin, Lyle R; MacIntosh, David L; Finn, Jennifer A; Brown, Kathleen W; Reid, Stephen B; Martinez, Jeanelle M

    2016-11-01

    Petroleum coke or "petcoke" is a solid material created during petroleum refinement and is distributed via transfer facilities that may be located in densely populated areas. The health impacts from petcoke exposure to residents living in proximity to such facilities were evaluated for a petcoke transfer facilities located in Chicago, Illinois. Site-specific, margin of safety (MOS) and margin of exposure (MOE) analyses were conducted using estimated airborne and dermal exposures. The exposure assessment was based on a combined measurement and modeling program that included multiyear on-site air monitoring, air dispersion modeling, and analyses of soil and surfaces in residential areas adjacent to two petcoke transfer facilities located in industrial areas. Airborne particulate matter less than 10 microns (PM10) were used as a marker for petcoke. Based on daily fence line monitoring, the average daily PM10 concentration at the KCBX Terminals measured on-site was 32 μg/m(3), with 89% of 24-hr average PM10 concentrations below 50 μg/m(3) and 99% below 100 μg/m(3). A dispersion model estimated that the emission sources at the KCBX Terminals produced peak PM10 levels attributed to the petcoke facility at the most highly impacted residence of 11 μg/m(3) on an annual average basis and 54 μg/m(3) on 24-hr average basis. Chemical indicators of petcoke in soil and surface samples collected from residential neighborhoods adjacent to the facilities were equivalent to levels in corresponding samples collected at reference locations elsewhere in Chicago, a finding that is consistent with limited potential for off-site exposure indicated by the fence line monitoring and air dispersion modeling. The MOE based upon dispersion model estimates ranged from 800 to 900 for potential inhalation, the primary route of concern for particulate matter. This indicates a low likelihood of adverse health effects in the surrounding community. Implications: Handling of petroleum coke at

  11. Challenges that Hinder Parturients to Deliver in Health Facilities: A Qualitative Analysis in Two Districts of Indonesia

    Directory of Open Access Journals (Sweden)

    Sudirman Nasir

    2016-12-01

    Full Text Available Background: There are many challenges women face to be able to give birth in health facilities in many parts of Indonesia. This study explores the roles and observations of close-to-community maternal health providers and other community members on potential barriers faced by women to deliver in health facilities in two districts within The Archipelago. Methods: Employing an explorative qualitative approach, 110 semi-structured interviews and 7 focus group discussions were conducted in 8 villages in Southwest Sumba, in the East Nusa Tenggara province, and in 8 villages in Cianjur, in the West Java province. The participants included village midwives, Posyandu kader (village health volunteers, traditional birth attendants (TBAs, mothers, men, village heads and district health officials. Results: The main findings were mostly similar in the two study areas. However, there were some key differences. Preference for TBA care, traditional beliefs, a lack of responsiveness of health providers to local traditions, distance, cost of travel and indirect costs of accompanying family members were all barriers to patients attending health facilities for the birth of their child. TBAs were the preferred health providers in most cases due to their close proximity at the time of childbirth and their adherence to traditional practices during pregnancy and delivery. Conclusions: Improving collaborations between midwives and TBAs, and responsiveness to traditional practices within health facilities and effective health promotion campaigns about the benefits of giving birth in health facilities may increase the use of health facilities in both study areas.

  12. The Mistreatment of Women during Childbirth in Health Facilities Globally: A Mixed-Methods Systematic Review

    Science.gov (United States)

    Bohren, Meghan A.; Vogel, Joshua P.; Hunter, Erin C.; Lutsiv, Olha; Makh, Suprita K.; Souza, João Paulo; Aguiar, Carolina; Saraiva Coneglian, Fernando; Diniz, Alex Luíz Araújo; Tunçalp, Özge; Javadi, Dena; Oladapo, Olufemi T.; Khosla, Rajat; Hindin, Michelle J.; Gülmezoglu, A. Metin

    2015-01-01

    Background Despite growing recognition of neglectful, abusive, and disrespectful treatment of women during childbirth in health facilities, there is no consensus at a global level on how these occurrences are defined and measured. This mixed-methods systematic review aims to synthesize qualitative and quantitative evidence on the mistreatment of women during childbirth in health facilities to inform the development of an evidence-based typology of the phenomenon. Methods and Findings We searched PubMed, CINAHL, and Embase databases and grey literature using a predetermined search strategy to identify qualitative, quantitative, and mixed-methods studies on the mistreatment of women during childbirth across all geographical and income-level settings. We used a thematic synthesis approach to synthesize the qualitative evidence and assessed the confidence in the qualitative review findings using the CERQual approach. In total, 65 studies were included from 34 countries. Qualitative findings were organized under seven domains: (1) physical abuse, (2) sexual abuse, (3) verbal abuse, (4) stigma and discrimination, (5) failure to meet professional standards of care, (6) poor rapport between women and providers, and (7) health system conditions and constraints. Due to high heterogeneity of the quantitative data, we were unable to conduct a meta-analysis; instead, we present descriptions of study characteristics, outcome measures, and results. Additional themes identified in the quantitative studies are integrated into the typology. Conclusions This systematic review presents a comprehensive, evidence-based typology of the mistreatment of women during childbirth in health facilities, and demonstrates that mistreatment can occur at the level of interaction between the woman and provider, as well as through systemic failures at the health facility and health system levels. We propose this typology be adopted to describe the phenomenon and be used to develop measurement tools

  13. [Airport related air pollution and health effects].

    Science.gov (United States)

    Iavicoli, Ivo; Fontana, Luca; Ancona, Carla; Forastiere, Francesco

    2014-01-01

    Airport is an extremely complex emission source of airborne pollutants that can have a significant impact on the environment. Indeed, several airborne chemicals emitted during airport activities may significantly get worse air quality and increase exposure level of both airport workers and general population living nearby the airports. In recent years airport traffic has increased and consequently several studies investigated the association between airport-related air pollution and occurrence of adverse health effects, particularly on respiratory system, in exposed workers and general population resident nearby. In this context, we carried out a critical evaluation of the studies that investigated this correlation in order to obtain a deeper knowledge of this issue and to identify the future research needs. Results show that the evidence of association between airport-related air pollution and health effects on workers and residents is still limited.

  14. Using public relations to promote health: a framing analysis of public relations strategies among health associations.

    Science.gov (United States)

    Park, Hyojung; Reber, Bryan H

    2010-01-01

    This study explored health organizations' public relations efforts to frame health issues through their press releases. Content analysis of 316 press releases from three health organizations-the American Heart Association, the American Cancer Society, and the American Diabetes Association-revealed that they used the medical research frame most frequently and emphasized societal responsibility for health issues. There were differences, however, among the organizations regarding the main frames and health issues: the American Diabetes Association was more likely to focus on the issues related to social support and education, while the American Heart Association and the American Cancer Society were more likely to address medical research and scientific news. To demonstrate their initiatives for public health, all the organizations employed the social support/educational frame most frequently. Researchers and medical doctors frequently were quoted as trusted sources in the releases.

  15. Torsion pendulum facility for direct force measurements of LISA GRS related disturbances

    CERN Document Server

    Carbone, L; Ciani, G; Dolesi, R; Hüller, M; Tombolato, D; Vitale, S; Weber, W J

    2007-01-01

    A four mass torsion pendulum facility for testing of the LISA GRS is under development in Trento. With a LISA-like test mass suspended off-axis with respect to the pendulum fiber, the facility allows for a direct measurement of surface force disturbances arising in the GRS. We present here results with a prototype pendulum integrated with very large-gap sensors, which allows an estimate of the intrinsic pendulum noise floor in the absence of sensor related force noise. The apparatus has shown a torque noise near to its mechanical thermal noise limit, and would allow to place upper limits on GRS related disturbances with a best sensitivity of 300 fN/Hz^(1/2) at 1mHz, a factor 50 from the LISA goal. Also, we discuss the characterization of the gravity gradient noise, one environmental noise source that could limit the apparatus performances, and report on the status of development of the facility.

  16. Reproductive health and access to healthcare facilities: risk factors for depression and anxiety in women with an earthquake experience

    Directory of Open Access Journals (Sweden)

    Shadoul Ahmed

    2011-06-01

    Full Text Available Abstract Background The reproductive and mental health of women contributes significantly to their overall well-being. Three of the eight Millennium Development Goals are directly related to reproductive and sexual health while mental disorders make up three of the ten leading causes of disease burden in low and middle-income countries. Among mental disorders, depression and anxiety are two of the most prevalent. In the context of slower progress in achieving Millennium Development Goals in developing countries and the ever-increasing man-made and natural disasters in these areas, it is important to understand the association between reproductive health and mental health among women with post-disaster experiences. Methods This was a cross-sectional study with a sample of 387 women of reproductive age (15-49 years randomly selected from the October 2005 earthquake affected areas of Pakistan. Data on reproductive health was collected using the Centers for Disease Control reproductive health assessment toolkit. Depression and anxiety were measured using the Hopkins Symptom Checklist-25, while earthquake experiences were captured using the Harvard Trauma Questionnaire. The association of either depression or anxiety with socio-demographic variables, earthquake experiences, reproductive health and access to health facilities was estimated using multivariate logistic regression. Results Post-earthquake reproductive health events together with economic deprivation, lower family support and poorer access to health care facilities explained a significant proportion of differences in the experiencing of clinical levels of depression and anxiety. For instance, women losing resources for subsistence, separation from family and experiencing reproductive health events such as having a stillbirth, having had an abortion, having had abnormal vaginal discharge or having had genital ulcers, were at significant risk of depression and anxiety. Conclusion The

  17. [Determinant factors encouraging work motivation: a study of care staff working in health services facilities for elderly people].

    Science.gov (United States)

    Hotta, Kazushi; Okuno, Junko; Tomura, Sigeo; Yanagi, Hisako

    2009-12-01

    Work motivation among care workers influences the quality of care for facility residents. The purpose of this study was to identify related factors in care staff. Sixty hundred and seven care staff working at 25 health services facilities for elderly people participated in this study. We applied a theoretically derived model of specific relationships among work motivation, jobsatisfaction, profession identity, job competence, interprofessional working and profession image. These factor relationships were then tested using a structural equation modeling technique. Profession identity, job competence and the profession image of caring were shown to have direct influences on work motivation. In addition, job satisfaction, inter professional working, profession images of nursing and rehabilitation responsibilities were shown to have indirect influences. These data suggest that improving profession identity, job competence and the profession image of caring are important to enhance work motivation of care staff.

  18. Availability of Youth Services in U.S. Mental Health Treatment Facilities.

    Science.gov (United States)

    Cummings, Janet R; Case, Brady G; Ji, Xu; Marcus, Steven C

    2016-09-01

    Despite concern about access to mental health (MH) services for youth, little is known about the specialty treatment infrastructure serving this population. We used national data to examine which types of MH treatment facilities (hospital- and community-based) were most likely to offer youth services and which types of communities were most likely to have this infrastructure. Larger (p < 0.001) and privately owned (p < 0.001) facilities were more likely to offer youth services. Rural counties, counties in which a majority of residents were nonwhite, and/or counties with a higher percentage of uninsured residents were less likely to have a community-based MH treatment facility that served youth (p < 0.001).

  19. Progress towards implementation of ACT malaria case-management in public health facilities in the Republic of Sudan: a cluster-sample survey

    Directory of Open Access Journals (Sweden)

    Abdelgader Tarig M

    2012-01-01

    Full Text Available Abstract Background Effective malaria case-management based on artemisinin-based combination therapy (ACT and parasitological diagnosis is a major pillar within the 2007-2012 National Malaria Strategic Plan in the Sudan. Three years after the launch of the strategy a health facility survey was undertaken to evaluate case-management practices and readiness of the health facilities and health workers to implement a new malaria case-management strategy. Methods A cross-sectional, cluster sample survey was undertaken at public health facilities in 15 states of Sudan. Data were collected using quality-of-care assessment methods. The main outcomes were the proportions of facilities with ACTs and malaria diagnostics; proportions of health workers exposed to malaria related health systems support activities; and composite and individual indicators of case-management practices for febrile outpatients stratified by age, availability of ACTs and diagnostics, use of malaria diagnostics, and test result. Results We evaluated 244 facilities, 294 health workers and 1,643 consultations for febrile outpatients (425 Conclusions Five years following change of the policy from chloroquine to ACTs and 3 years before the end of the new malaria strategic plan chloroquine was successfully phased out from public facilities in Sudan, however, an important gap remained in the availability of ACTs, diagnostic capacities and coverage with malaria case-management activities. The national scale-up of diagnostics, using the findings of this survey as well as future qualitative research, should present an opportunity not only to expand existing testing capacities but also to implement effective support interventions to bridge the health systems gaps and support corrective case-management measures, including the discontinuation of artemether monotherapy treatment.

  20. Antimalarial drug prescribing practice in private and public health facilities in South-east Nigeria: a descriptive study

    Directory of Open Access Journals (Sweden)

    Okebe Joseph

    2007-05-01

    Full Text Available Abstract Background Nigeria's national standard has recently moved to artemisinin combination treatments for malaria. As clinicians in the private sector are responsible for attending a large proportion of the population ill with malaria, this study compared prescribing in the private and public sector in one State in Nigeria prior to promoting ACTs. Objective To assess prescribing for uncomplicated malaria in government and private health facilities in Cross River State. Method Audit of 665 patient records at six private and seven government health facilities in 2003. Results Clinicians in the private sector were less likely to record history or physical examination than those in public facilities, but otherwise practice and prescribing were similar. Overall, 45% of patients had a diagnostic blood slides; 77% were prescribed monotherapy, either chloroquine (30.2%, sulphadoxine-pyrimethamine (22.7% or artemisinin derivatives alone (15.8%. Some 20.8% were prescribed combination therapy; the commonest was chloroquine with sulphadoxine-pyrimethamine. A few patients (3.5% were prescribed sulphadoxine-pyrimethamine-mefloquine in the private sector, and only 3.0% patients were prescribed artemisinin combination treatments. Conclusion Malaria treatments were varied, but there were not large differences between the public and private sector. Very few are following current WHO guidelines. Monotherapy with artemisinin derivatives is relatively common.

  1. Experiences of Fast Queue health care users in primary health care facilities in eThekwini district, South AfricaExperiences of Fast Queue health care users in primary health care facilities in eThekwini district, South Africa

    Directory of Open Access Journals (Sweden)

    Dudu G. Sokhela

    2013-07-01

    Full Text Available Background: Comprehensive Primary Health Care (PHC, based on the principles of accessibility, availability, affordability, equity and acceptability, was introduced in South Africa to address inequalities in health service provision. Whilst the Fast Queue was instrumental in the promotion of access to health care, a major goal of the PHC approach, facilities were not prepared for the sudden influx of clients. Increased access resulted in long waiting times and queues contributing to dissatisfaction with the service which could lead to missed appointments and non-compliance with established treatment plans.Objectives: Firstly to describe the experiences of clients using the Fast Queue strategy to access routine healthcare services and secondly, to determine how the clients’ experiences led to satisfaction or dissatisfaction with the Fast Queue service.Method: A descriptive qualitative survey using content analysis explored the experiences of the Fast Queue users in a PHC setting. Setting was first identified based on greatest number using the Fast Queue and geographic diversity and then a convenience sample of health care users of the Fast Queue were sampled individually along with one focus group of users who accessed the Queue monthly for medication refills. The same interview guide questions were used for both individual interviews and the one focus group discussion. Five clinics with the highest number of attendees during a three month period and a total of 83 health care users of the Fast Queue were interviewed. The average participant was female, 31 years old, single and unemployed.Results: Two themes with sub-themes emerged: health care user flow and communication, which highlights both satisfaction and dissatisfaction with the fast queue and queue marshals, could assist in directing users to the respective queues, reduce waiting time and keep users satisfied with the use of sign posts where there is a lack of human resources

  2. A systematic review of waterborne infections from nontuberculous mycobacteria in health care facility water systems.

    Science.gov (United States)

    Li, Trudy; Abebe, Lydia S; Cronk, Ryan; Bartram, Jamie

    2017-05-01

    Healthcare-acquired infections are an increasing problem for health care providers and policy makers. Water is an overlooked source of infectious microorganisms in health care facilities. Waterborne nontuberculous mycobacteria (NTM) are ubiquitous, and particularly problematic in health care facility water systems, and cause a variety of diseases. The purpose of this review is to assess health care associated NTM infections from health care facility water systems. We documented susceptible populations, modes of transmission, and the median attack rate (e.g. patients infected per patients exposed). We aimed to identify transmission risk factors and inform evidence-based policies for infection control and prevention. We searched Embase, PubMed, Web of Science and clinicaltrials.gov without date restrictions. English language articles with original data on NTM waterborne infections in health care settings were included. Randomized controlled trials, descriptive studies (case reports, case series), case-control studies, cohort studies, cross-sectional surveys, and quasi-experimental studies on nosocomial waterborne infections were included. Three investigators independently screened titles and abstracts for relevant articles, and one screened full-text articles. Data were extracted by one investigator, and a second confirmed accuracy for 10% of results. We included 22 observational studies. Immunocompromised, post-surgical, and hemodialysis patients were commonly affected populations. A range of exposure routes such as uncovered central venous catheters (CVCs), wound exposure, and contamination during surgical procedures was reported. The median attack rate was 12.1% (interquartile range, 11-27.2). Waterborne NTM infection affects susceptible patients through common, preventable exposure routes. Effective prevention strategies will require both medical and environmental health expertise, and inter-professional cooperation will optimize these efforts. Copyright © 2016

  3. A toolbox for health risk related decisions

    Energy Technology Data Exchange (ETDEWEB)

    Easterly, C.E.; Jones, T.D.

    1996-10-01

    Development efforts since the late 1970s have resulted in a generalized method for ranking health hazards. This method provides the basis for a wide range of applications where decisions are needed for allocating resources on the basis of health risk considerations. It has been used for more than a decade to solve real problems, and it is supported by 23 publications in the open literature. The diversity of this generalized methodology allows us to provide support in a great number of problem areas. we give four examples in this manuscript: the relative toxicities of petroleum mixtures; a method to derive Emergency Response Planning Guides; an estimate of the possible carcinogenic potency of tungsten, an alternative material to depleted uranium for heavy armor penetrators; and an approach to low dose extrapolation. Our experience suggests that many more applications of the original concept and variations on it can be of utility in military situations. Some potentially fruitful areas may be in the: development of a health-risk-ranking system for alternative solutions to manufacturing, waste management, and remediation; provision of a basis for identifying levels of hazardous agents which are below health concerns, or which should be of concern; development of a framework for evaluating chemicals and radioactive materials on the same basis, and in the development of a battery of in vitro bioassays which could take the place of long-term whole animal tests.

  4. Relative tropospheric photolysis rates of acetaldehyde and formaldehyde measured at the European Photoreactor Facility

    DEFF Research Database (Denmark)

    Nilsson, Elna Johanna Kristina; Bache-Andreassen, Lihn; Johnson, Matthew Stanley;

    2009-01-01

    The photolysis rates of HCHO, DCDO, CH3CHO, and CH3CDO are studied by long-path FTIR spectroscopy in natural tropospheric conditions at the European Photoreactor Facility (EUPHORE) in Valencia, Spain. Average relative photolysis rates jHCHO/jDCDO ) 3.15 ( 0.08 and jCH3CHO/jCH3CDO ) 1.26 ( 0...

  5. "Doing" diversity. Holy Cross Health System facilities honor differences in different ways.

    Science.gov (United States)

    Burnside, G

    1994-12-01

    Holy Cross Health System (HCHS), a South Bend, IN-based organization that stretches from coast to coast, has instituted a diversity initiative to take advantage of demographic changes in its facilities' work forces and the communities they are serving. Launched by Holy Cross's corporate headquarters, the program is carried out by the member facilities, each of which had added its own ideas. HCHS's diversity program has three major components: Consciousness-raising among employees. Activities range from "transcultural rounds" for nursing students to fashion shows in which employees wear costumes from their places of national origin. Educating the larger community. HCHS facilities have been urged to increase awareness of diversity among physicians, patients, vendors, and local business and civic leaders. Strategic thinking. The leaders of HCHS facilities have been advised to integrate diversity into their strategic planning. Leaders are familiarizing themselves with the different cultural, ethnic, and religious groups in the community and preparing their facilities to take full advantage of those groups' contributions.

  6. Facility type and primary care performance in sub-district health promotion hospitals in Northern Thailand.

    Science.gov (United States)

    Kitreerawutiwong, Nithra; Jordan, Sue; Hughes, David

    2017-01-01

    Poor and middle-income Thai people rely heavily on primary care health services. These are staffed by a range of professionals. However, it is unknown whether the performance of primary care varies according to the staffing and organization of local service delivery units. Tambon (sub-district) health promotion hospitals (THPHs) were introduced in 2009 to upgrade the services offered by the previous health centres, but were faced with continuing shortages of doctors and nurses. The Ministry of Public Health (MoPH) designated three categories of THPH, defined according to whether they were regularly staffed by a medical practitioner, a qualified nurse or non-clinical public health officers. This study aimed to compare the performance of primary care offered by the three different types of primary care facilities in one public health region of Northern Thailand (Public Health Region 2). A cross-sectional survey was undertaken in 2013. Data were collected on accessibility, continuity, comprehensiveness, co-ordination and community orientation of care from 825 patients attending 23 primary care facilities. These were selected to include the three officially-designated types of Tambon (sub-district) health promotion hospitals (THPHs) led by medical, nursing or public health personnel. Survey scores were compared in unadjusted and adjusted analyses. THPHs staffed only by public health officers achieved the highest performance score (Mean = 85.14, SD. = 7.30), followed by THPHs staffed by qualified nurses (Mean = 82.86, SD. = 7.06). THPHs staffed by a doctor on rotation returned the lowest scores (Mean = 81.63, SD. = 7.22). Differences in overall scores resulted mainly from differences in reported accessibility, continuity, and comprehensiveness of care, rather than staff skill-mix per se. Policy on quality improvement should therefore focus on improving performance in these areas.

  7. Facility type and primary care performance in sub-district health promotion hospitals in Northern Thailand

    Science.gov (United States)

    Kitreerawutiwong, Nithra; Jordan, Sue; Hughes, David

    2017-01-01

    Background Poor and middle-income Thai people rely heavily on primary care health services. These are staffed by a range of professionals. However, it is unknown whether the performance of primary care varies according to the staffing and organization of local service delivery units. Tambon (sub-district) health promotion hospitals (THPHs) were introduced in 2009 to upgrade the services offered by the previous health centres, but were faced with continuing shortages of doctors and nurses. The Ministry of Public Health (MoPH) designated three categories of THPH, defined according to whether they were regularly staffed by a medical practitioner, a qualified nurse or non-clinical public health officers. This study aimed to compare the performance of primary care offered by the three different types of primary care facilities in one public health region of Northern Thailand (Public Health Region 2). Methods A cross-sectional survey was undertaken in 2013. Data were collected on accessibility, continuity, comprehensiveness, co-ordination and community orientation of care from 825 patients attending 23 primary care facilities. These were selected to include the three officially-designated types of Tambon (sub-district) health promotion hospitals (THPHs) led by medical, nursing or public health personnel. Survey scores were compared in unadjusted and adjusted analyses. Results THPHs staffed only by public health officers achieved the highest performance score (Mean = 85.14, SD. = 7.30), followed by THPHs staffed by qualified nurses (Mean = 82.86, SD. = 7.06). THPHs staffed by a doctor on rotation returned the lowest scores (Mean = 81.63, SD. = 7.22). Conclusions Differences in overall scores resulted mainly from differences in reported accessibility, continuity, and comprehensiveness of care, rather than staff skill-mix per se. Policy on quality improvement should therefore focus on improving performance in these areas. PMID:28339494

  8. Wheelchair cleaning and disinfection in Canadian health care facilities: "That's wheelie gross!".

    Science.gov (United States)

    Gardner, Paula; Muller, Matthew P; Prior, Betty; So, Ken; Tooze, Jane; Eum, Linda; Kachur, Oksana

    2014-11-01

    Wheelchairs are complex equipment that come in close contact with individuals at increased risk of transmitting and acquiring antibiotic-resistant organisms and health care-associated infection. The purpose of this study was to determine the status of wheelchair cleaning and disinfection in Canadian health care facilities. Acute care hospitals (ACHs), chronic care hospitals (CCHs), and long-term care facilities (LTCFs) were contacted and the individual responsible for oversight of wheelchair cleaning and disinfection was identified. A structured interview was conducted that focused on current practices and concerns, barriers to effective wheelchair cleaning and disinfection, and potential solutions. Interviews were completed at 48 of the 54 facilities contacted (89%), including 18 ACHs, 16 CCHs, and 14 LTCFs. Most (n = 24) facilities had 50-200 in-house wheelchairs. Respondents were very concerned about wheelchair cleaning as an infection control issue. Specific concerns included the lack of reliable systems for tracking and identifying dirty and clean wheelchairs (71%, 34/48), failure to clean and disinfect wheelchairs between patients (52%, 25/48), difficulty cleaning cushions (42%, 20/48), lack of guidelines (35%, 27/48), continued use of visibly soiled wheelchairs (29%, 14/48) and lack of resources (25%, 12/48). Our results suggest that wheelchair cleaning and disinfection is not optimally performed at many Canadian hospitals and LTCFs. Specific guidance on wheelchair cleaning and disinfection is necessary. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  9. Decision-making factors affecting different family members regarding the placement of relatives in long-term care facilities

    OpenAIRE

    Huang, Ying-Chia; Chu, Chiao-Lee; Ho, Ching-Sung; Lan, Shou-Jen; Hsieh, Chen-Hsi; Hsieh, Yen-Ping

    2014-01-01

    Background The aim of this research was to investigate factors affecting different family members’ decisions regarding the placement of relatives in long-term car (LTC) facilities in Taiwan. The objective was to investigate the correlations between family members’ personal traits, the living conditions of residents in the LTC facilities, and family members’ experiences with LTC facilities. Methods This study selected family members visiting residents in LTC facilities as research subjects and...

  10. Measuring client satisfaction and the quality of family planning services: A comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana

    Directory of Open Access Journals (Sweden)

    Agha Sohail

    2011-08-01

    Full Text Available Abstract Background Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana, to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Methods Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs conducted in Tanzania (2006, Kenya (2004 and Ghana (2002 using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Results Private health facilities appear to be of higher (interpersonal process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Conclusions Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public

  11. HealtH facility and HealtH worker readiness to deliver new national ...

    African Journals Online (AJOL)

    2008-05-01

    May 1, 2008 ... six months, presence of al wall charts, health worker's exposure to ... East African Medical Journal Vol. 85 No. ... and development, Boston university school of public health, 85 East concord street, 5th floor, Boston, Ma 02118,.

  12. Charging for Ambulatory Care in Military Health Care Facilities: An Evaluation and Analysis

    Science.gov (United States)

    1983-04-25

    health care facilities, with resulting income used to subsidize CHAMPUS. This proposal, calling for $5.00 per visit as submitted by Senator Daniel...Analysis of Current Methods and Their Development," Inquiry, 16, Fall 1979, 230-246. 32 Jack Hadley, John Holahan , and William Scanlon, "Can Fee-for...other) were combined into a single category called "commercial insurance". An additional category, "Do Not Know", was added to reflect those

  13. Experiences of Fast Queue health care users in primary health care facilities in eThekwini district, South Africa

    Directory of Open Access Journals (Sweden)

    Dudu G. Sokhela

    2013-01-01

    Full Text Available Background: Comprehensive Primary Health Care (PHC, based on the principles of accessibility, availability, affordability, equity and acceptability, was introduced in South Africa to address inequalities in health service provision. Whilst the Fast Queue was instrumental in the promotion of access to health care, a major goal of the PHC approach, facilities were not prepared for the sudden influx of clients. Increased access resulted in long waiting times and queues contributing to dissatisfaction with the service which could lead to missed appointments and non-compliance with established treatment plans. Objectives: Firstly to describe the experiences of clients using the Fast Queue strategy to access routine healthcare services and secondly, to determine how the clients’ experiences led to satisfaction or dissatisfaction with the Fast Queue service.Method: A descriptive qualitative survey using content analysis explored the experiences of the Fast Queue users in a PHC setting. Setting was first identified based on greatest number using the Fast Queue and geographic diversity and then a convenience sample of health care users of the Fast Queue were sampled individually along with one focus group of users who accessed the Queue monthly for medication refills. The same interview guide questions were used for both individual interviews and the one focus group discussion. Five clinics with the highest number of attendees during a three month period and a total of 83 health care users of the Fast Queue were interviewed. The average participant was female, 31 years old, single and unemployed.Results: Two themes with sub-themes emerged: health care user flow and communication, which highlights both satisfaction and dissatisfaction with the fast queue and queue marshals, could assist in directing users to the respective queues, reduce waiting time and keep users satisfied with the use of sign posts where there is a lack of human resources

  14. Post abortion care quality status in health facilities of Guraghe zone, Ethiopia.

    Science.gov (United States)

    Tesfaye, Gezahegn; Oljira, Lemessa

    2013-07-23

    Unsafe abortion in the developing world accounts for 13% of all maternal deaths. Ethiopia is one of the developing countries with the highest maternal mortality ratio (673 per 100,000 live births) in the world. Unsafe abortion was estimated to account for 32% of all maternal deaths in Ethiopia. To assess post abortion care quality status in health facilities of Guraghe zone. A facility based cross-sectional study design with both quantitative and qualitative methods was conducted. Patient interview, direct service observation, provider self administered questionnaire and inventory of equipment and supplies were used for the assessment. Six health centers, two hospitals and 422 post-abortion patients were included in the study. Patient-provider interaction was generally satisfactory from the patient's perspective. The majority of the respondents (93.5%) said that they were treated with politeness and respect. More than half 226(56.5%) of the clients have received post abortion family planning. Overall, 83.5% of the patients were satisfied with the services. Those who said waiting time was long were less satisfied and unemployed women were more satisfied than others. The study has revealed several improvements as well as problems in the provision of post-abortion care service in the studied health facilities.

  15. The legal regulation of seclusion and restraint in mental health facilities.

    Science.gov (United States)

    McSherry, Bernadette

    2013-12-01

    A recent report submitted to the United Nations Human Rights Council by the United Nations Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, has called for "an absolute ban" on the use of seclusion and restraint in mental health facilities. In Australia, seclusion and some, but not all, forms of restraint are regulated either by legislation or guidelines. This column explores some of the issues raised by the lack of national reporting requirements for these practices and moves by the National Mental Health Commission towards their reduction or elimination.

  16. Risk Factors for Birth Asphyxia in an Urban Health Facility in Cameroon

    OpenAIRE

    Chiabi, Andreas; Nguefack, Seraphin; Evelyne MAH; NODEM, Sostenne; Mbuagbaw, Lawrence; Mbonda, Elie; TCHOKOTEU, Pierre-Fernand; Anderson DOH

    2013-01-01

    How to Cite This Article: Chiabi A, Nguefack S, Mah E, Nodem S, Mbuagbaw L, Mbonda E, Tchokoteu PF, Doh A. Risk Factors for Birth Asphyxia in an Urban Health Facility in Cameroon. Iran J Child Neurol. 2013 Summer; 7(3):46-54.ObjectiveThe World Health Organization (WHO) estimates that 4 million children are born with asphyxia every year, of which 1 million die and an equal number survive with severe neurologic sequelae. The purpose of this study was to identify the risk factors of birth asphyx...

  17. Factors associated with health facility childbirth in districts of Kenya, Tanzania and Zambia

    DEFF Research Database (Denmark)

    Phiri, Selia Ng'anjo; Kiserud, Torvid; Kvåle, Gunnar;

    2014-01-01

    BACKGROUND: Maternal mortality continues to be a heavy burden in low and middle income countries where half of all deliveries take place in homes without skilled attendance. The study aimed to investigate the underlying and proximate determinants of health facility childbirth in rural and urban...... of delivery and factors that might influence health care seeking behaviour. A total of 1800 women who had childbirth in the previous five years were analysed. The distal and proximate conceptual framework for analysing determinants of maternal mortality was modified for studying factors associated with place...

  18. Baseline results of the first malaria indicator survey in Iran at the health facility level

    Directory of Open Access Journals (Sweden)

    Taghizadeh-Asl Rahim

    2011-10-01

    Full Text Available Abstract Background Malaria continues to be a global public health challenge, particularly in developing countries. Delivery of prompt and effective diagnosis and treatment of malaria cases, detection of malaria epidemics within one week of onset and control them in less than a month, regular disease monitoring and operational classification of malaria are among the major responsibilities of the national malaria programme. The study was conducted to determine these indicators at the different level of primary health care facilities in malaria-affected provinces of Iran Methods In this survey, data was collected from 223 health facilities including health centres, malaria posts, health houses and hospitals as well as the profile of all 5, 836 recorded malaria cases in these facilities during the year preceding the survey. Descriptive statistics (i.e. frequencies, percentages were used to summarize the results and Chi square test was used to analyse data. Results All but one percent of uncomplicated cases took appropriate and correctly-dosed of anti-malarial drugs in accordance to the national treatment guideline. A larger proportion of patients [85.8%; 95% CI: 84.8 - 86.8] were also given complete treatment including anti-relapse course, in line with national guidelines. About one third [35.0%; 95% CI: 33.6 - 36.4] of uncomplicated malaria cases were treated more than 48 hours after first symptoms onset. Correspondingly, half of severe malaria cases took recommended anti-malarial drugs for severe or complicated disease more than 48 hours of onset of first symptoms. The latter cases had given regular anti-malarial drugs promptly. The majority of malaria epidemics [97%; 95% CI: 90.6 - 100] in study areas were detected within one week of onset, but only half of epidemics were controlled within four weeks of detection. Just half of target districts had at least one health facility/emergency site with adequate supply and equipment stocks. Nevertheless

  19. Baseline results of the first malaria indicator survey in Iran at the health facility level.

    Science.gov (United States)

    Raiesi, Ahmad; Nikpour, Fatemeh; Ansari-Moghaddam, Alireza; Ranjbar, Mansoor; Rakhshani, Fatemeh; Mohammadi, Mahdi; Haghdost, Aliakbar; Taghizadeh-Asl, Rahim; Sakeni, Mohammad; Safari, Reza; Saffari, Mehdi

    2011-10-27

    Malaria continues to be a global public health challenge, particularly in developing countries. Delivery of prompt and effective diagnosis and treatment of malaria cases, detection of malaria epidemics within one week of onset and control them in less than a month, regular disease monitoring and operational classification of malaria are among the major responsibilities of the national malaria programme. The study was conducted to determine these indicators at the different level of primary health care facilities in malaria-affected provinces of Iran In this survey, data was collected from 223 health facilities including health centres, malaria posts, health houses and hospitals as well as the profile of all 5, 836 recorded malaria cases in these facilities during the year preceding the survey. Descriptive statistics (i.e. frequencies, percentages) were used to summarize the results and Chi square test was used to analyse data. All but one percent of uncomplicated cases took appropriate and correctly-dosed of anti-malarial drugs in accordance to the national treatment guideline. A larger proportion of patients [85.8%; 95% CI: 84.8 - 86.8] were also given complete treatment including anti-relapse course, in line with national guidelines. About one third [35.0%; 95% CI: 33.6 - 36.4] of uncomplicated malaria cases were treated more than 48 hours after first symptoms onset. Correspondingly, half of severe malaria cases took recommended anti-malarial drugs for severe or complicated disease more than 48 hours of onset of first symptoms. The latter cases had given regular anti-malarial drugs promptly.The majority of malaria epidemics [97%; 95% CI: 90.6 - 100] in study areas were detected within one week of onset, but only half of epidemics were controlled within four weeks of detection. Just half of target districts had at least one health facility/emergency site with adequate supply and equipment stocks. Nevertheless, only one-third of them [33% (95% CI: 0.00 - 67.8)] had

  20. Physical Exposure to Seismic Hazards of Health Facilities in Mexico City, Mexico

    Science.gov (United States)

    Rodriguez, S. M.; Novelo Casanova, D.

    2010-12-01

    Although health facilities are essential infrastructure during disasters and emergencies, they are also usually highly vulnerable installations in the case of the occurrence of large and major earthquakes. Hospitals are one of the most complex critical facilities in modern cities and they are used as first response in emergency situations. The operability of a hospital must be maintained after the occurrence of a local strong earthquake in order to satisfy the need for medical care of the affected population. If a health facility is seriously damaged, it cannot fulfill its function when most is needed. In this case, hospitals become a casualty of the disaster. To identify the level of physical exposure of hospitals to seismic hazards in Mexico City, we analyzed their geographic location with respect to the seismic response of the different type of soils of the city from past earthquakes, mainly from the events that occurred on September 1985 (Ms= 8.0) and April 1989 (Ms= 6.9). Seismic wave amplification in this city is the result of the interaction of the incoming seismic waves with the soft and water saturated clay soils, on which a large part of Mexico City is built. The clay soils are remnants of the lake that existed in the Valley of Mexico and which has been drained gradually to accommodate the growing urban sprawl. Hospital facilities were converted from a simple database of names and locations into a map layer of resources. This resource layer was combined with other map layers showing areas of seismic microzonation in Mexico City. This overlay was then used to identify those hospitals that may be threatened by the occurrence of a large or major seismic event. We analyzed the public and private hospitals considered as main health facilities. Our results indicate that more than 50% of the hospitals are highly exposed to seismic hazards. Besides, in most of these health facilities we identified the lack of preventive measures and preparedness to reduce their

  1. Review of Sodium and Plutonium related Technical Standards in Trans-Uranium Fuel Fabrication Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Misuk; Jeon, Jong Seon; Kang, Hyun Sik; Kim, Seoung Rae [NESS, Daejeon (Korea, Republic of)

    2016-10-15

    In this paper, we would introduce and review technical standards related to sodium fire and plutonium criticality safety. This paper may be helpful to identify considerations in the development of equipment, standards, and etc., to meet the safety requirements in the design, construction and operating of TFFF, KAPF and SFR. The feasibility and conceptual designs are being examined on related facilities, for example, TRU Fuel Fabrication Facilities (TFFF), Korea Advanced Pyro-process Facility (KAPF), and Sodium Cooled Fast Reactor (SFR), in Korea. However, the safety concerns of these facilities have been controversial in part because of the Sodium fire accident and Plutonium related radiation safety caused by transport and handling accident. Thus, many researches have been performed to ensure safety and various documents including safety requirements have been developed. In separating and reducing the long-lived radioactive transuranic(TRU) in the spent nuclear fuel, reusing as the potential energy of uranium fuel resources and reducing the high level wastes, TFFF would be receiving the attention of many people. Thus, people would wonder whether compliance with technical standards that ensures safety. For new facility design, one of the important tasks is to review of technical standards, especially for sodium and Plutonium because of water related highly reactive characteristics and criticality hazard respectively. We have introduced and reviewed two important technical standards for TFFF, which are sodium fire and plutonium criticality safety, in this paper. This paper would provide a brief guidance, about how to start and what is important, to people who are responsible for the initial design to operation of TFFF.

  2. Collaboration with behavioral health care facilities to implement systemwide tobacco control policies--California, 2012.

    Science.gov (United States)

    Gordon, Lauren; Modayil, Mary V; Pavlik, Jim; Morris, Chad D

    2015-02-05

    The California Tobacco Control Program (CTCP) administered 4 regional trainings in 2012 to staffers at CTCP-funded projects, tobacco control coalitions, several county departments of mental health and alcohol and drug, and administrators and providers from behavioral health care facilities. These trainings focused on the special tobacco use cessation needs and opportunities for cessation among persons with mental illness or substance abuse disorders, and they provided information about cessation and smoke-free policies. CTCP surveyed county and private behavioral health care programs to assess their readiness for adopting tobacco control strategies at treatment facilities. Between baseline and follow-up we found a decrease in the proportion of organizations at the precontemplation or contemplation stages of change and twice as many organizations at the action and maintenance stages of change. Significant obstacles remain to implementing policy: many agencies have concerns about going tobacco-free. But significant progress has been made, as evidenced by new policies and a growing number of tobacco-free coalitions consisting of public health agencies, behavioral health care agencies, and local hospitals.

  3. Collaboration With Behavioral Health Care Facilities to Implement Systemwide Tobacco Control Policies — California, 2012

    Science.gov (United States)

    Gordon, Lauren; Modayil, Mary V.; Pavlik, Jim

    2015-01-01

    The California Tobacco Control Program (CTCP) administered 4 regional trainings in 2012 to staffers at CTCP-funded projects, tobacco control coalitions, several county departments of mental health and alcohol and drug, and administrators and providers from behavioral health care facilities. These trainings focused on the special tobacco use cessation needs and opportunities for cessation among persons with mental illness or substance abuse disorders, and they provided information about cessation and smoke-free policies. CTCP surveyed county and private behavioral health care programs to assess their readiness for adopting tobacco control strategies at treatment facilities. Between baseline and follow-up we found a decrease in the proportion of organizations at the precontemplation or contemplation stages of change and twice as many organizations at the action and maintenance stages of change. Significant obstacles remain to implementing policy: many agencies have concerns about going tobacco-free. But significant progress has been made, as evidenced by new policies and a growing number of tobacco-free coalitions consisting of public health agencies, behavioral health care agencies, and local hospitals. PMID:25654218

  4. Health facility service availability and readiness for intrapartum and immediate postpartum care in Malawi: A cross-sectional survey

    Science.gov (United States)

    Oseni, Lolade; Mtimuni, Angella; Sethi, Reena; Rashidi, Tambudzai; Kachale, Fannie; Rawlins, Barbara; Gupta, Shivam

    2017-01-01

    This analysis seeks to identify strengths and gaps in the existing facility capacity for intrapartum and immediate postpartum fetal and neonatal care, using data collected as a part of Malawi’s Helping Babies Breath program evaluation. From August to September 2012, the Maternal and Child Health Integrated Program (MCHIP) conducted a cross-sectional survey in 84 Malawian health facilities to capture current health facility service availability and readiness and health worker capacity and practice pertaining to labor, delivery, and immediate postpartum care. The survey collected data on availability of equipment, supplies, and medications, and health worker knowledge and performance scores on intrapartum care simulation and actual management of real clients at a subset of facilities. We ran linear regression models to identify predictors of high simulation performance of routine delivery care and management of asphyxiated newborns across all facilities surveyed. Key supplies for infection prevention and thermal care of the newborn were found to be missing in many of the surveyed facilities. At the health center level, 75% had no clinician trained in basic emergency obstetric care or newborn care and 39% had no midwife trained in the same. We observed that there were no proportional increases in available transport and staff at a facility as catchment population increased. In simulations of management of newborns with breathing problems, health workers were able to complete a median of 10 out of 16 tasks for a full-term birth case scenario and 20 out of 30 tasks for a preterm birth case scenario. Health workers who had more years of experience appeared to perform worse. Our study provides a benchmark and highlights gaps for future evaluations and studies as Malawi continues to make strides in improving facility-based care. Further progress in reducing the burden of neonatal and fetal death in Malawi will be partly predicated on guaranteeing properly equipped and

  5. Understanding the relationship between access to care and facility-based delivery through analysis of the 2008 Ghana Demographic Health Survey.

    Science.gov (United States)

    Moyer, Cheryl A; McLaren, Zoë M; Adanu, Richard M; Lantz, Paula M

    2013-09-01

    To determine the types of access to care most strongly associated with facility-based delivery among women in Ghana. Data relating to the "5 As of Access" framework were extracted from the 2008 Ghana Demographic Health Survey and analyzed using multivariate logistic regression. In all, 55.5% of a weighted sample of 1102 women delivered in a healthcare facility, whereas 45.5% delivered at home. Affordability was the strongest access factor associated with delivery location, with health insurance coverage tripling the odds of facility delivery. Availability, accessibility (except urban residence), acceptability, and social access variables were not significant factors in the final models. Social access variables, including needing permission to seek healthcare and not being involved in decisions regarding healthcare, were associated with a reduced likelihood of facility-based delivery when examined individually. Multivariate analysis suggested that these variables reflected maternal literacy, health insurance coverage, and household wealth, all of which attenuated the effects of social access. Affordability was an important determinant of facility delivery in Ghana-even among women with health insurance-but social access variables had a mediating role. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  6. Relationship between Health Literacy, Health-Related Behaviors and Health Status: A Survey of Elderly Chinese

    Directory of Open Access Journals (Sweden)

    Yong-Bing Liu

    2015-08-01

    Full Text Available Background: Despite the large volume of research dedicated to health-related behavior change, chronic disease costs continue to rise, thus creating a major public health burden. Health literacy, the ability to seek, understand, and utilize health information, has been identified as an important factor in the course of chronic conditions. Little research has been conducted on the relationship between health literacy and health-related behaviors and health status in elderly Chinese. The aim of this study was to elucidate the relationship between health literacy and health-related behaviors and health status in China. Methods: The subjects enrolled in this study were selected based on a stratified cluster random sampling design. Information involving >4500 older adults in 44 pension institutions in Urumqi, Changji, Karamay, and Shihezi of Xinjiang between September 2011 and June 2012 was collected. The Chinese Citizen Health Literacy Questionnaire (China Health Education Centre, 2008 and a Scale of the General Status were administered and the information was obtained through face-to-face inquiries by investigators. A total of 1452 respondents met the inclusion criteria. A total of 1452 questionnaires were issued and the valid response rate was 96.14% (1396 of 1452. Factors affecting health literacy and the relationship to health literacy were identified by one-way ANOVA and a multiple linear regression model. Results: The average health literacy level of the elderly in nursing homes was relatively low (71.74 ± 28.35 points. There were significant differences in the health literacy score among the factors of age, gender, race, education level, household income, marital conditions, and former occupation (p < 0.001. The health literacy score was significantly associated with smoking, drinking, physical exercise, and health examination (p < 0.001. The elderly with higher health literacy scores were significantly less likely to have risky behaviors

  7. Effect of geographical access to health facilities on child mortality in rural Ethiopia: a community based cross sectional study.

    Directory of Open Access Journals (Sweden)

    Yemisrach B Okwaraji

    Full Text Available BACKGROUND: There have been few studies that have examined associations between access to health care and child health outcomes in remote populations most in need of health services. This study assessed the effect of travel time and distance to health facilities on mortality in children under five years in a remote area of rural north-western Ethiopia. METHODS AND FINDINGS: This study involved a randomly selected cross sectional survey of 2,058 households. Data were collected during home visits to all resident women of reproductive age (15-49 years. A geographic information system (GIS was used to map all households and the only health centre in the district. The analysis was restricted to 2,206 rural children who were under the age of five years during the five years before the survey. Data were analysed using random effects Poisson regression. 90.4% (1,996/2,206 of children lived more than 1.5 hours walk from the health centre. Children who lived ≥1.5 hrs from the health centre had a two to three fold greater risk of death than children who lived <1.5 hours from the health centre (children with travel time 1.5-<2.5 hrs adjusted relative risk [adjRR] 2.3[0.95-5.6], travel time 2.5-<3.5 hrs adjRR 3.1[1.3-7.4] and travel time 3.5-<6.5 hrs adjRR 2.5[1.1-6.2]. CONCLUSION: Distance to a health centre had a marked influence on under five mortality in a poor, rural, remote area of Ethiopia. This study provides important information for policy makers on the likely impact of new health centres and their most effective location in remote areas.

  8. Health system changes under pay-for-performance: the effects of Rwanda's national programme on facility inputs.

    Science.gov (United States)

    Ngo, Diana K L; Sherry, Tisamarie B; Bauhoff, Sebastian

    2017-02-01

    Pay-for-performance (P4P) programmes have been introduced in numerous developing countries with the goal of increasing the provision and quality of health services through financial incentives. Despite the popularity of P4P, there is limited evidence on how providers achieve performance gains and how P4P affects health system quality by changing structural inputs. We explore these two questions in the context of Rwanda's 2006 national P4P programme by examining the programme's impact on structural quality measures drawn from international and national guidelines. Given the programme's previously documented success at increasing institutional delivery rates, we focus on a set of delivery-specific and more general structural inputs. Using the programme's quasi-randomized roll-out, we apply multivariate regression analysis to short-run facility data from the 2007 Service Provision Assessment. We find positive programme effects on the presence of maternity-related staff, the presence of covered waiting areas and a management indicator and a negative programme effect on delivery statistics monitoring. We find no effects on a set of other delivery-specific physical resources, delivery-specific human resources, delivery-specific operations, general physical resources and general human resources. Using mediation analysis, we find that the positive input differences explain a small and insignificant fraction of P4P's impact on institutional delivery rates. The results suggest that P4P increases provider availability and facility operations but is only weakly linked with short-run structural health system improvements overall.

  9. The effectiveness of introducing Group Prenatal Care (GPC) in selected health facilities in a district of Bangladesh: study protocol.

    Science.gov (United States)

    Sultana, Marufa; Mahumud, Rashidul Alam; Ali, Nausad; Ahmed, Sayem; Islam, Ziaul; Khan, Jahangir A M; Sarker, Abdur Razzaque

    2017-01-31

    Despite high rates of antenatal care and relatively good access to health facilities, maternal and neonatal mortality remain high in Bangladesh. There is an immediate need for implementation of evidence-based, cost-effective interventions to improve maternal and neonatal health outcomes. The aim of the study is to assess the effect of the intervention namely Group Prenatal Care (GPC) on utilization of standard number of antenatal care, post natal care including skilled birth attendance and institutional deliveries instead of usual care. The study is quasi-experimental in design. We aim to recruit 576 pregnant women (288 interventions and 288 comparisons) less than 20 weeks of gestational age. The intervention will be delivered over around 6 months. The outcome measure is the difference in maternal service coverage including ANC and PNC coverage, skilled birth attendance and institutional deliveries between the intervention and comparison group. Findings from the research will contribute to improve maternal and newborn outcome in our existing health system. Findings of the research can be used for planning a new strategy and improving the health outcome for Bangladeshi women. Finally addressing the maternal health goal, this study is able to contribute to strengthening health system.

  10. Tamarindus indica and its health related effects

    Directory of Open Access Journals (Sweden)

    Pinar Kuru

    2014-09-01

    Full Text Available Tamarindus [Tamarindus indica L. (T. indica], belongs to the family Leguminosae (Fabaceae, commonly known as Tamarind tree, is one of the fruit tree species that is used as traditional medicine. The aim of this article is to review the current literatue on health related effect of T. indica. Literature review about this plant was conducted between 2003 and 2014 through Pubmed and Google. The keywords Tamarind, T. indica were used for search. Only the health related articles selected. Tamarind tree is found especially in the Indian subcontinent, Africa, Pakistan, Bangladesh, Nigeria and most of the tropical countries. It is preferred to be used for abdominal pain, diarrhea and dysentery, some bacterial infections and parasitic infestations, wound healing, constipation and inflammation. It is a rich source of most of the essential amino acids and phytochemicals, and hence the plant is reported to possess antidiabetic, antimicrobial, antivenomic, antioxidant, antimalarial, cardioprotective, hepatoprotective, antiasthmatic, laxative and anti-hyperlipidemic activity. T. indica has ameliorative effects on many diseases. It can also be preferred as a nutritious support for malnourished patients as it is cheap and easy to access. Those effects should be clarified with further research.

  11. Tamarindus indica and its health related effects

    Institute of Scientific and Technical Information of China (English)

    Pinar Kuru

    2014-01-01

    Tamarindus [Tamarindus indica L. (T. indica)], belongs to the family Leguminosae (Fabaceae), commonly known as Tamarind tree, is one of the fruit tree species that is used as traditional medicine. The aim of this article is to review the current literatue on health related effect of T. indica. Literature review about this plant was conducted between 2003 and 2014 through Pubmed and Google. The keywords Tamarind, T. indica were used for search. Only the health related articles selected. Tamarind tree is found especially in the Indian subcontinent, Africa, Pakistan, Bangladesh, Nigeria and most of the tropical countries. It is preferred to be used for abdominal pain, diarrhea and dysentery, some bacterial infections and parasitic infestations, wound healing, constipation and inflammation. It is a rich source of most of the essential amino acids and phytochemicals, and hence the plant is reported to possess antidiabetic, antimicrobial, antivenomic, antioxidant, antimalarial, cardioprotective, hepatoprotective, antiasthmatic, laxative and anti-hyperlipidemic activity. T. indica has ameliorative effects on many diseases. It can also be preferred as a nutritious support for malnourished patients as it is cheap and easy to access. Those effects should be clarified with further research.

  12. Tamarindus indica and its health related effects

    Institute of Scientific and Technical Information of China (English)

    Pinar; Kuru

    2014-01-01

    Tamarindus[Tamarindus indica L.(T.Indira)],belongs to the family Leguminosae(Fabaceae),commonly known as Tamarind tree,is one of the fruit tree species that is used as traditional medicine.The aim of this article is to review the current literatue on health related effect of T.indir.a.Literature review about this plant was conducted between 2003 and 2014 through Pubmed and Google.The keywords Tamarind,T.indica were used for search.Only the health related articles selected.Tamarind tree is found especially in the Indian subcontinent,Africa,Pakistan,Bangladesh,Nigeria and most of the tropical countries.It is preferred to be used for abdominal pain,diarrhea and dysentery,some bacterial infections and parasitic infestations,wound healing,constipation and inflammation.It is a rich source of most of the essential amino acids and phytochemicals,and hence the plant is reported to possess antidiabetic,antimicrobial,antivenomic,antioxidant,antimalarial,cardioprotective,hepatoprotective,antiasthmatic,laxative and anti-hyperlipidemir activity.T.indica has ameliorative effects on many diseases.It can also be preferred as a nutritious support for malnourished patients as it is cheap and easy to access.Those effects should be clarified with further research.

  13. Understanding Health and Health-Related Behavior of Users of Internet Health Information.

    Science.gov (United States)

    Wimble, Matt

    2016-10-01

    Little is known about how actual use of Internet health-related information is associated with health or health-related behavior. Using a nationally representative sample of 34,525 from 2012, this study examined the demographics of users of Internet health-related information (users), reports estimates of association with several health and behavioral outcomes adjusting for demographic factors, and analyzed the sample by education level, race, gender, and age. Analysis of a large nationally representative sample shows evidence that users of health-related information (users) on the Internet are younger, more educated, more likely to be insured, more likely to be female, and less likely to be African American. After adjusting for demographic differences, users are more likely to have been diagnosed with hypertension, cancer, stroke, and high cholesterol, but no evidence of current hypertension, weight-related issues, or being in fair or poor health. Users are less likely to smoke and among smokers are more likely to attempt quitting. Users are more likely to exercise, get a flu shot, pap smear, mammogram, HIV test, colon cancer screening, blood pressure check, and cholesterol check, but likely to be heavy drinkers. With few exceptions, results appear robust across gender, age groups, level of education, and ethnicity. Use is generally positively associated with prior diagnosis for several conditions and behaviors related to improved health, but I find no relationship with existing health status. The association between use of health-related Internet information and health-related behavior seems robust across levels of education, age, gender, and race.

  14. Mixed and low-level waste treatment project: Appendix C, Health and safety criteria for the mixed and low-level waste treatment facility at the Idaho National Engineering Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Neupauer, R.M.; Thurmond, S.M.

    1992-09-01

    This report contains health and safety information relating to the chemicals that have been identified in the mixed waste streams at the Waste Treatment Facility at the Idaho National Engineering Laboratory. Information is summarized in two summary sections--one for health considerations and one for safety considerations. Detailed health and safety information is presented in material safety data sheets (MSDSs) for each chemical.

  15. Mixed and low-level waste treatment project: Appendix C, Health and safety criteria for the mixed and low-level waste treatment facility at the Idaho National Engineering Laboratory. Part 2, Chemical constituents

    Energy Technology Data Exchange (ETDEWEB)

    Neupauer, R.M.; Thurmond, S.M.

    1992-09-01

    This report contains health and safety information relating to the chemicals that have been identified in the mixed waste streams at the Waste Treatment Facility at the Idaho National Engineering Laboratory. Information is summarized in two summary sections--one for health considerations and one for safety considerations. Detailed health and safety information is presented in material safety data sheets (MSDSs) for each chemical.

  16. [Activities and awareness of public health nurses working at local government facilities and health centers regarding potential nuclear accidents].

    Science.gov (United States)

    Kitamiya, Chiaki

    2011-05-01

    The purpose was to study public health service activities developed during non-emergency periods to respond to potential nuclear accidents and to contribute to an understanding of public health nurses' awareness of the possibility of such accidents. For the purpose of this study, we chose prefectural health centers located in a prefecture with a nuclear power plant and in two adjacent prefectures, along with all local administrative bodies (cities, towns, and villages) in these prefectures. For each one of 124 entities, we selected one public health nurse in charge of health crisis management from among the personnel to be targeted for a questionnaire survey conducted by mail. The survey period was from October to November 2009, and the questionnaire contained questions on the following: whether there had been any disasters over the past ten years; whether the respondent had received training in public health services regarding nuclear accidents; and public health service activities developed during non-emergency periods to respond to potential nuclear accidents (and the amount of work done in this regard). The response rate for our survey was 71.8%. Of the total of 124 entities chosen, 9 were aware of the possibility of radiation accidents and 12 had manuals on radiation accidents. Two local governments and five health centers had participated in accident drills, and at both of two local governments, public health nurses were expected to act as guides during resident evacuation in the event of a nuclear accident. Public health nurses were sent to participate in workshops on radiation at four facilities located in the prefecture with a nuclear power plant. Our analysis revealed a lack of knowledge (beta = -0.404, P manuals, provision of opportunities to gain knowledge of materials regarding past damage to the health of residents and how such damage can be coped with is likely to be effective in developing effective measures in response to disasters.

  17. Assets for policy making in health promotion: overcoming political barriers inhibiting women in difficult life situations to access sport facilities.

    Science.gov (United States)

    Rütten, Alfred; Abu-Omar, Karim; Frahsa, Annika; Morgan, Antony

    2009-12-01

    Although the need for intersectoral policy making in health promotion has been commonplace and a high priority for several decades, there is still a lack of appropriate methods available to assess the inputs, processes, and outcomes associated with the effectiveness of such approaches, particularly in relation to sectors outside of health. This paper demonstrates how asset based models to intersectoral policy making in health promotion can improve the effectiveness of projects aiming to improve health and related outcomes. In particular, it summarises how asset based approaches to the planning and implementation of health promotion programmes can be used to develop our methods for assessing intersectorial actions. The paper is based on the findings from a local neighbourhood project based in Erlangen, Germany, aiming to improve the opportunities for physical activity among women in difficult life situations. The neighbourhood was characterised by high rates of unemployment, social welfare recipients, and migrants. Ethnographic methods enabled us to highlight the range of health related assets available in the neighbourhood which could be activated to improve access to and uptake of physical activity amongst the target population. Results indicate that intersectoral policies seeking to improve health outcomes, are more likely to be successful if they maximise the opportunities for making the most of the assets that exist in individuals, communities and organisations. This study demonstrates how the asset model was used to create the supportive environments which facilitated women from the target population to work with policy makers on an equal footing. Their involvement in project planning and implementation helped to achieve the structural changes required to achieve the aims of the project. These included the establishment of a new job position at the city office for sports and improved access to sport facilities for women in difficult life situations.

  18. DOE standard: Integration of environment, safety, and health into facility disposition activities. Volume 2: Appendices

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-05-01

    This volume contains the appendices that provide additional environment, safety, and health (ES and H) information to complement Volume 1 of this Standard. Appendix A provides a set of candidate DOE ES and H directives and external regulations, organized by hazard types that may be used to identify potentially applicable directives to a specific facility disposition activity. Appendix B offers examples and lessons learned that illustrate implementation of ES and H approaches discussed in Section 3 of Volume 1. Appendix C contains ISMS performance expectations to guide a project team in developing and implementing an effective ISMS and in developing specific performance criteria for use in facility disposition. Appendix D provides guidance for identifying potential Applicable or Relevant and Appropriate Requirements (ARARs) when decommissioning facilities fall under the Comprehensive Environmental Response, Compensation, Liability Act (CERCLA) process. Appendix E discusses ES and H considerations for dispositioning facilities by privatization. Appendix F is an overview of the WSS process. Appendix G provides a copy of two DOE Office of Nuclear Safety Policy and Standards memoranda that form the bases for some of the guidance discussed within the Standard. Appendix H gives information on available hazard analysis techniques and references. Appendix I provides a supplemental discussion to Sections 3.3.4, Hazard Baseline Documentation, and 3.3.6, Environmental Permits. Appendix J presents a sample readiness evaluation checklist.

  19. Social Factors Related to the Utilization of Health Care Among Prison Inmates.

    Science.gov (United States)

    Nowotny, Kathryn M

    2016-04-01

    This study examines the demographic and social factors related to health care utilization in prisons using the 2004 Survey of Inmates in State Correctional Facilities. The findings show that education and employment, strong predictors of health care in the community, are not associated with health care in prisons. Although female inmates have a higher disease burden than male inmates, there are no sex differences in health care usage. The factors associated with health care, however, vary for women and men. Notably, Black men are significantly more likely to utilize health care compared to White and Latino men. The findings suggest that, given the constitutionally mandated health care for inmates, prisons can potentially minimize racial disparities in care and that prisons, in general, are an important context for health care delivery in the United States.

  20. Social and cultural dimensions of hygiene in Cambodian health care facilities

    Directory of Open Access Journals (Sweden)

    Faurand-Tournaire Anne-Laure

    2011-02-01

    Full Text Available Abstract Background The frequency of bloodborne pathogen healthcare-associated infections is thought to be high in developing Southeast Asian Countries. The underlying social-cultural logics contributing to the risks of transmission are rarely studied. This report provides some insights on the social and cultural factors that shape hygiene practices in Cambodian health care settings. Methods We conducted qualitative surveys in various public and private health facilities in Phnom Penh, the capital city and in provinces. We observed and interviewed 319 participants, health care workers and patients, regarding hygiene practices and social relationships amongst the health care staff and with patients. We also examined the local perceptions of hygiene, their impact on the relationships between the health care staff and patients, and perceptions of transmission risks. Data collection stem from face to face semi-structured and open-ended interviews and focus group discussions with various health care staffs (i.e. cleaners, nurses, midwives and medical doctors and with patients who attended the study health facilities. Results Overall responses and observations indicated that hygiene practices were burdened by the lack of adequate materials and equipements. In addition, many other factors were identified to influence and distort hygiene practices which include (1 informal and formal social rapports in hospitals, (2 major infection control roles played by the cleaners in absence of professional acknowledgment. Moreover, hygiene practices are commonly seen as an unessential matter to be devoted to low-ranking staff. Conclusion Our anthropological findings illustrate the importance of comprehensive understanding of hygiene practices; they need to be considered when designing interventions to improve infection control practices in a Cambodian medical setting.

  1. Newborn Care in the Home and Health Facility: Formative Findings for Intervention Research in Cambodia.

    Science.gov (United States)

    Bazzano, Alessandra N; Taub, Leah; Oberhelman, Richard A; Var, Chivorn

    2016-12-21

    Global coverage and scale up of interventions to reduce newborn mortality remains low, though progress has been achieved in improving newborn survival in many low-income settings. An important factor in the success of newborn health interventions, and moving to scale, is appropriate design of community-based programs and strategies for local implementation. We report the results of formative research undertaken to inform the design of a newborn health intervention in Cambodia. Information was gathered on newborn care practices over a period of three months using multiple qualitative methods of data collection in the primary health facility and home setting. Analysis of the data indicated important gaps, both at home and facility level, between recommended newborn care practices and those typical in the study area. The results of this formative research have informed strategies for behavior change and improving referral of sick infants in the subsequent implementation study. Collection and dissemination of data on newborn care practices from settings such as these can contribute to efforts to advance survival, growth and development of newborns for intervention research, and for future newborn health programming.

  2. Multilevel examination of facility characteristics, social integration, and health for older adults living in nursing homes.

    Science.gov (United States)

    Leedahl, Skye N; Chapin, Rosemary K; Little, Todd D

    2015-01-01

    Testing a model based on past research and theory, this study assessed relationships between facility characteristics (i.e., culture change efforts, social workers) and residents' social networks and social support across nursing homes; and examined relationships between multiple aspects of social integration (i.e., social networks, social capital, social engagement, social support) and mental and functional health for older adults in nursing homes. Data were collected at nursing homes using a planned missing data design with random sampling techniques. Data collection occurred at the individual-level through in-person structured interviews with older adult nursing home residents (N = 140) and at the facility-level (N = 30) with nursing home staff. The best fitting multilevel structural equation model indicated that the culture change subscale for relationships significantly predicted differences in residents' social networks. Additionally, social networks had a positive indirect relationship with mental and functional health among residents primarily via social engagement. Social capital had a positive direct relationship with both health outcomes. To predict better social integration and mental and functional health outcomes for nursing homes residents, study findings support prioritizing that close relationships exist among staff, residents, and the community as well as increased resident social engagement and social trust. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Newborn Care in the Home and Health Facility: Formative Findings for Intervention Research in Cambodia

    Directory of Open Access Journals (Sweden)

    Alessandra N. Bazzano

    2016-12-01

    Full Text Available Global coverage and scale up of interventions to reduce newborn mortality remains low, though progress has been achieved in improving newborn survival in many low-income settings. An important factor in the success of newborn health interventions, and moving to scale, is appropriate design of community-based programs and strategies for local implementation. We report the results of formative research undertaken to inform the design of a newborn health intervention in Cambodia. Information was gathered on newborn care practices over a period of three months using multiple qualitative methods of data collection in the primary health facility and home setting. Analysis of the data indicated important gaps, both at home and facility level, between recommended newborn care practices and those typical in the study area. The results of this formative research have informed strategies for behavior change and improving referral of sick infants in the subsequent implementation study. Collection and dissemination of data on newborn care practices from settings such as these can contribute to efforts to advance survival, growth and development of newborns for intervention research, and for future newborn health programming.

  4. A retrospective audit of antibiotic prescriptions in primary health-care facilities in Eastern Region, Ghana.

    Science.gov (United States)

    Ahiabu, Mary-Anne; Tersbøl, Britt P; Biritwum, Richard; Bygbjerg, Ib C; Magnussen, Pascal

    2016-03-01

    Resistance to antibiotics is increasing globally and is a threat to public health. Research has demonstrated a correlation between antibiotic use and resistance development. Developing countries are the most affected by resistance because of high infectious disease burden, limited access to quality assured antibiotics and more optimal drugs and poor antibiotic use practices. The appropriate use of antibiotics to slow the pace of resistance development is crucial. The study retrospectively assessed antibiotic prescription practices in four public and private primary health-care facilities in Eastern Region, Ghana using the WHO/International Network for the Rational Use of Drugs rational drug use indicators. Using a systematic sampling procedure, 400 prescriptions were selected per facility for the period April 2010 to March 2011. Rational drug use indicators were assessed in the descriptive analysis and logistic regression was used to explore for predictors of antibiotic prescription. Average number of medicines prescribed per encounter was 4.01, and 59.9% of prescriptions had antibiotics whilst 24.2% had injections. In total, 79.2% and 88.1% of prescribed medicines were generics and from the national essential medicine list, respectively. In the multivariate analysis, health facility type (odds ratio [OR] = 2.05; 95% confidence interval [CI]: 1.42, 2.95), patient age (OR = 0.97; 95% CI: 0.97, 0.98), number of medicines on a prescription (OR = 1.85; 95% CI: 1.63, 2.10) and 'no malaria drug' on prescription (OR = 5.05; 95% CI: 2.08, 12.25) were associated with an antibiotic prescription. A diagnosis of upper respiratory tract infection was positively associated with antibiotic use. The level of antibiotic use varied depending on the health facility type and was generally high compared with the national average estimated in 2008. Interventions that reduce diagnostic uncertainty in illness management should be considered. The National Health Insurance

  5. A Healthy Investment: Building the Facilities to Train the Next Generation of Nursing and Allied Health Professionals

    Science.gov (United States)

    Woods, Bob

    2013-01-01

    A growing number of community colleges are investing in new facilities and programs to train health care workers in a variety of professions, including nursing, radiology, health information technology, physical therapy, dentistry, and surgical technology. Community colleges have historically offered job training programs in health care, but with…

  6. A Healthy Investment: Building the Facilities to Train the Next Generation of Nursing and Allied Health Professionals

    Science.gov (United States)

    Woods, Bob

    2013-01-01

    A growing number of community colleges are investing in new facilities and programs to train health care workers in a variety of professions, including nursing, radiology, health information technology, physical therapy, dentistry, and surgical technology. Community colleges have historically offered job training programs in health care, but with…

  7. Indian public health standards for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy facilities: An assessment

    Directory of Open Access Journals (Sweden)

    Janmejaya Samal

    2014-10-01

    Full Text Available Background: Indian Public Health Standards (IPHS are the prescribed quality norms for health care services in India. For the first time this set of standards was introduced with the initiation of National Rural Health Mission in India. The first set of standards was released in 2007 and the second revised set was released in 2012. Among various services Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy (AYUSH is one of the components and certain standards have also been prescribed for AYUSH facilities in concerned health institutions. Materials and Methods: A review was made based on the prescribed IPHS documents obtained from the web portal of Directorate of Health Services, Ministry of Health and Family Welfare, Government of India, New Delhi. Results and Discussion: Human resources and drugs have been dealt in detail in all the health institutions. Treatment of common ailments with AYUSH drugs as per the local need, training of health worker in AYUSH drugs and promotion of medicinal plants are some of the services prescribed at sub center level. Description regarding the drugs is only found in primary and Community Health Centers. Manpower under AYUSH has been categorized under essential services in all the institutions except Primary Health Center in which the same has been categorized in desirable services. Conclusion: Mainstreaming of AYUSH and prescribing IPHS standards are some of the important initiatives under NRHM as a substantial portion of rural India is still dependent upon the AYUSH systems of medicine as a way of availing health care services. However, a more detailed prescription for this sector would always be of significance for the society and the sector itself.

  8. Digital Health: Tracking Physiomes and Activity Using Wearable Biosensors Reveals Useful Health-Related Information.

    Science.gov (United States)

    Li, Xiao; Dunn, Jessilyn; Salins, Denis; Zhou, Gao; Zhou, Wenyu; Schüssler-Fiorenza Rose, Sophia Miryam; Perelman, Dalia; Colbert, Elizabeth; Runge, Ryan; Rego, Shannon; Sonecha, Ria; Datta, Somalee; McLaughlin, Tracey; Snyder, Michael P

    2017-01-01

    A new wave of portable biosensors allows frequent measurement of health-related physiology. We investigated the use of these devices to monitor human physiological changes during various activities and their role in managing health and diagnosing and analyzing disease. By recording over 250,000 daily measurements for up to 43 individuals, we found personalized circadian differences in physiological parameters, replicating previous physiological findings. Interestingly, we found striking changes in particular environments, such as airline flights (decreased peripheral capillary oxygen saturation [SpO2] and increased radiation exposure). These events are associated with physiological macro-phenotypes such as fatigue, providing a strong association between reduced pressure/oxygen and fatigue on high-altitude flights. Importantly, we combined biosensor information with frequent medical measurements and made two important observations: First, wearable devices were useful in identification of early signs of Lyme disease and inflammatory responses; we used this information to develop a personalized, activity-based normalization framework to identify abnormal physiological signals from longitudinal data for facile disease detection. Second, wearables distinguish physiological differences between insulin-sensitive and -resistant individuals. Overall, these results indicate that portable biosensors provide useful information for monitoring personal activities and physiology and are likely to play an important role in managing health and enabling affordable health care access to groups traditionally limited by socioeconomic class or remote geography.

  9. Digital Health: Tracking Physiomes and Activity Using Wearable Biosensors Reveals Useful Health-Related Information

    Science.gov (United States)

    Zhou, Gao; Zhou, Wenyu; Schüssler-Fiorenza Rose, Sophia Miryam; Perelman, Dalia; Colbert, Elizabeth; Runge, Ryan; Rego, Shannon; Sonecha, Ria; Datta, Somalee; McLaughlin, Tracey; Snyder, Michael P.

    2017-01-01

    A new wave of portable biosensors allows frequent measurement of health-related physiology. We investigated the use of these devices to monitor human physiological changes during various activities and their role in managing health and diagnosing and analyzing disease. By recording over 250,000 daily measurements for up to 43 individuals, we found personalized circadian differences in physiological parameters, replicating previous physiological findings. Interestingly, we found striking changes in particular environments, such as airline flights (decreased peripheral capillary oxygen saturation [SpO2] and increased radiation exposure). These events are associated with physiological macro-phenotypes such as fatigue, providing a strong association between reduced pressure/oxygen and fatigue on high-altitude flights. Importantly, we combined biosensor information with frequent medical measurements and made two important observations: First, wearable devices were useful in identification of early signs of Lyme disease and inflammatory responses; we used this information to develop a personalized, activity-based normalization framework to identify abnormal physiological signals from longitudinal data for facile disease detection. Second, wearables distinguish physiological differences between insulin-sensitive and -resistant individuals. Overall, these results indicate that portable biosensors provide useful information for monitoring personal activities and physiology and are likely to play an important role in managing health and enabling affordable health care access to groups traditionally limited by socioeconomic class or remote geography. PMID:28081144

  10. Identification of Vehicle Health Assurance Related Trends

    Science.gov (United States)

    Phojanamongkolkij, Nipa; Evans, Joni K.; Barr, Lawrence C.; Leone, Karen M.; Reveley, Mary S.

    2014-01-01

    Trend analysis in aviation as related to vehicle health management (VHM) was performed by reviewing the most current statistical and prognostics data available from the National Transportation Safety Board (NTSB) accident, the Federal Aviation Administration (FAA) incident, and the NASA Aviation Safety Reporting System (ASRS) incident datasets. In addition, future directions in aviation technology related to VHM research areas were assessed through the Commercial Aviation Safety Team (CAST) Safety Enhancements Reserved for Future Implementations (SERFIs), the National Transportation Safety Board (NTSB) Most-Wanted List and recent open safety recommendations, the National Research Council (NRC) Decadal Survey of Civil Aeronautics, and the Future Aviation Safety Team (FAST) areas of change. Future research direction in the VHM research areas is evidently strong as seen from recent research solicitations from the Naval Air Systems Command (NAVAIR), and VHM-related technologies actively being developed by aviation industry leaders, including GE, Boeing, Airbus, and UTC Aerospace Systems. Given the highly complex VHM systems, modifications can be made in the future so that the Vehicle Systems Safety Technology Project (VSST) technical challenges address inadequate maintenance crew's trainings and skills, and the certification methods of such systems as recommended by the NTSB, NRC, and FAST areas of change.

  11. Environmental Health And Building Related Illnesses

    Directory of Open Access Journals (Sweden)

    Li-Li Chan

    2008-12-01

    Full Text Available Malaysia has good environmental laws toprotect the outdoor environment and public health.However there are no laws governing indoor air quality(IAQ and the knowledge among the public about itsimportance is also lacking. Environmental professionalsthink it is not a priority and this influences the policydecisions in the country. Therefore there is a need tocreate awareness by way of research, education andother promotional activities. What is much needed atthis time is the establishment of standards for theconduct of risk assessment studies. To establishstandards we need reliable data which can be used todevelop appropriate guidelines for the purpose ofmitigation and adaptation programmes. IAQ can havesignificant influence on health resulting in drop inproductivity and economy of a country. It has beenestimated that in the US, building related illnesses(BRI symptoms have a relationship with decrease (3 to5% in work performance in an affected populationresulting in an annual loss of US$60 billion in revenue.However, based on efficient management programmesthey have also projected that the potential annualsavings can be in the region of US$10 to 30 billion. Thisestablishes that fact that good management programmesbased on efficient guidelines is of economic value to acountry and wellbeing of the population. The IMU hasembarked on a research programme to collect themuch-needed data for the framing of a good IAQguideline for Malaysia.

  12. Ecological studies related to construction of the Defense Waste Processing Facility on the Savannah River Site

    Energy Technology Data Exchange (ETDEWEB)

    Scott, D.E.; Pechmann, J.H.K.; Knox, J.N.; Estes, R.A.; McGregor, J.H.; Bailey, K. (ed.)

    1988-12-01

    The Savannah River Ecology Laboratory has completed 10 years of ecological studies related to the construction of the Defense Waste Processing Facility (DWPF) on the Savannah River Site. This progress report examines water quality studies on streams peripheral to the DWPF construction site and examines the effectiveness of refuge ponds'' in ameliorating the effects of construction on local amphibians. Individual papers on these topics are indexed separately. 93 refs., 15 figs., 15 tabs. (MHB)

  13. The influences of Taiwan's National Health Insurance on women's choice of prenatal care facility: Investigation of differences between rural and non-rural areas

    Directory of Open Access Journals (Sweden)

    Chen Chi-Liang

    2008-03-01

    Full Text Available Abstract Background Taiwan's National Health Insurance (NHI, implemented in 1995, substantially increased the number of health care facilities that can deliver free prenatal care. Because of the increase in such facilities, it is usually assumed that women would have more choices regarding prenatal care facilities and thus experience reduction in travel cost. Nevertheless, there has been no research exploring these issues in the literature. This study compares how Taiwan's NHI program may have influenced choice of prenatal care facility and perception regarding convenience in transportation for obtaining such care for women in rural and non-rural areas in Taiwan. Methods Based on data collected by a national survey conducted by Taiwan's National Health Research Institutes (NHRI in 2000, we tried to compare how women chose prenatal care facility before and after Taiwan's National Health Insurance program was implemented. Basing our analysis on how women answered questionnaire items regarding "the type of major health care facility used and convenience of transportation to and from prenatal care facility," we investigated whether there were disparities in how women in rural and non-rural areas chose prenatal care facilities and felt about the transportation, and whether the NHI had different influences for the two groups of women. Results After NHI, women in rural areas were more likely than before to choose large hospitals for prenatal care services. For women in rural areas, the relative probability of choosing large hospitals to choosing non-hospital settings in 1998–1999 was about 6.54 times of that in 1990–1992. In contrast, no such change was found in women in non-rural areas. For a woman in a non-rural area, she was significantly more likely to perceive the transportation to and from prenatal care facilities to be very convenient between 1998 and 1999 than in the period between 1990 and 1992. No such improvement was found for women in

  14. Predictors of the quality of health worker treatment practices for uncomplicated malaria at government health facilities in Kenya.

    Science.gov (United States)

    Zurovac, D; Rowe, A K; Ochola, S A; Noor, A M; Midia, B; English, M; Snow, R W

    2004-10-01

    When replacing failing drugs for malaria with more effective drugs, an important step towards reducing the malaria burden is that health workers (HW) prescribe drugs according to evidence-based guidelines. Past studies have shown that HW commonly do not follow guidelines, yet few studies have explored with appropriate methods why such practices occur. We analysed data from a survey of government health facilities in four Kenyan districts in which HW consultations were observed, caretakers and HW were interviewed, and health facility assessments were performed. The analysis was limited to children 2-59 months old with uncomplicated malaria. Treatment was defined as recommended (antimalarial recommended by national guidelines), a minor error (effective, but non-recommended antimalarial), or inappropriate (no effective antimalarial). We evaluated 1006 consultations performed by 135 HW at 81 facilities: 567 children received recommended treatment, 314 had minor errors, and 125 received inappropriate treatment (weighted percentages: 56.9%, 30.4%, and 12.7%). Multivariate logistic regression analysis revealed that programmatic interventions such as in-service malaria training, provision of guidelines and wall charts, and more frequent supervision were significantly associated with better treatment quality. However, neither in-service training nor possession of the guideline document showed an effect by itself. More qualified HW made more errors: both major and minor errors (but generally more minor errors) when second-line drugs were in stock, and more major errors when second-line drugs were not in stock. Child factors such as age and a main complaint of fever were also associated with treatment quality. Our results support the use of several programmatic strategies that can redress HW deficiencies in malaria treatment. Targeted cost-effectiveness trials would help refine these strategies and provide more precise guidance on affordable and effective ways to strengthen

  15. Designing health care environments: Part I. Basic concepts, principles, and issues related to evidence-based design.

    Science.gov (United States)

    Cesario, Sandra K

    2009-06-01

    A 2001 Institute of Medicine report captured the nation's attention regarding the dangers that can result from the health care environment. This report, fueled by the need for new facilities to be constructed, led to an explosion of research that now links the physical structure and design of health care facilities to the health and well-being of patients, nurses, other health care workers, and visitors. Continuing nursing education that highlights the importance of evidence-based design has been associated with measurable improvement in health care facilities' clinical outcomes, economic performance, employee productivity, customer satisfaction, and cultural congruency. Three major categories of outcomes can be impacted by evidence-based design: stress reduction, safety, and overall health care quality and ecology. In this article, Part I of a two-part series, the basic concepts, principles, and issues related to evidence-based design are introduced. Part II will describe continuing education programs available for nurses.

  16. 75 FR 33821 - Recovery Policy RP9524.10; Direct Disaster-Related Damage to Eligible Facilities

    Science.gov (United States)

    2010-06-15

    ... SECURITY Federal Emergency Management Agency Recovery Policy RP9524.10; Direct Disaster-Related Damage to Eligible Facilities AGENCY: Federal Emergency Management Agency, DHS. ACTION: Notice of availability... Recovery Policy RP9524.10, Direct Disaster-Related Damage to Eligible Facilities. The purpose of this...

  17. District decision-making for health in low-income settings: a qualitative study in Uttar Pradesh, India, on engaging the private health sector in sharing health-related data.

    Science.gov (United States)

    Gautham, Meenakshi; Spicer, Neil; Subharwal, Manish; Gupta, Sanjay; Srivastava, Aradhana; Bhattacharyya, Sanghita; Avan, Bilal Iqbal; Schellenberg, Joanna

    2016-09-01

    Health information systems are an important planning and monitoring tool for public health services, but may lack information from the private health sector. In this fourth article in a series on district decision-making for health, we assessed the extent of maternal, newborn and child health (MNCH)-related data sharing between the private and public sectors in two districts of Uttar Pradesh, India; analysed barriers to data sharing; and identified key inputs required for data sharing. Between March 2013 and August 2014, we conducted 74 key informant interviews at national, state and district levels. Respondents were stakeholders from national, state and district health departments, professional associations, non-governmental programmes and private commercial health facilities with 3-200 beds. Qualitative data were analysed using a framework based on a priori and emerging themes. Private facilities registered for ultrasounds and abortions submitted standardized records on these services, which is compulsory under Indian laws. Data sharing for other services was weak, but most facilities maintained basic records related to institutional deliveries and newborns. Public health facilities in blocks collected these data from a few private facilities using different methods. The major barriers to data sharing included the public sector's non-standardized data collection and utilization systems for MNCH and lack of communication and follow up with private facilities. Private facilities feared information disclosure and the additional burden of reporting, but were willing to share data if asked officially, provided the process was simple and they were assured of confidentiality. Unregistered facilities, managed by providers without a biomedical qualification, also conducted institutional deliveries, but were outside any reporting loops. Our findings suggest that even without legislation, the public sector could set up an effective MNCH data sharing strategy with private

  18. Implementation of artemether-lumefantrine treatment policy for malaria at health facilities in Tanzania

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    Mugoyela V

    2011-09-01

    Full Text Available V Mugoyela1, O Minzi21Department of Medicinal Chemistry, 2Unit of Pharmacology and Therapeutics, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, TanzaniaBackground: The purpose of this study was to compare knowledge on the part of health workers in public and private health facilities about prescribing and dispensing of an artemether-lumefantrine combination, 3 years after moving from sulfadoxine-pyrimethamine to artemether-lumefantrine as a first-line treatment for nonsevere malaria in Tanzania.Methods: A cross-sectional survey of a convenience sample of 306 dispensaries and pharmacies was conducted in Dar Es Salaam and the Coast region of Tanzania. Of these, 122 were community pharmacies, 143 were private dispensaries, and 41 were public dispensaries. Specific outcome measures were health workers’ knowledge of the new malaria treatment guidelines, recommended doses of artemether-lumefantrine, and food requirements.Results: A total of 489 health workers were included in the study. The respondents were prescribers in private dispensaries, public dispensaries, and community pharmacies. Participants included medical officers (3.7%, clinical officers (38%, pharmacists (5.7%, and pharmaceutical technicians (3.9%. Nearly all workers in the public dispensaries and about 50% of workers in private dispensaries and community pharmacies were aware of recommended first-line malaria treatment. The difference in the proportion of health workers with adequate knowledge about the new recommended antimalarial medicine in public and private dispensaries was statistically significant (P < 0.0001. There was a higher proportion of workers in public dispensaries who had adequate knowledge about doses of artemether-lumefantrine for adults compared with workers in private dispensaries (P = 0.001. Only 58.0% of respondents were able to state correctly the recommended doses in private dispensaries as compared with 77.0% in public

  19. Induced Abortion and Associated Factors in Health Facilities of Guraghe Zone, Southern Ethiopia

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    Gezahegn Tesfaye

    2014-01-01

    Full Text Available Unsafe abortion is one of the major medical and public health problems in developing countries including Ethiopia. However, there is a lack of up-to-date and reliable information on induced abortion distribution and its determinant factors in the country. This study was intended to assess induced abortion and associated factors in health facilities of Guraghe zone, Southern Ethiopia. Institution based cross-sectional study was conducted in eight health facilities in Guraghe zone. Client exit interview was conducted on 400 patients using a structured questionnaire. Bivariate and multivariate logistic regression analysis was performed to identify factors associated with induced abortion. Out of 400 women, 75.5% responded that the current pregnancy that ended in abortion is unwanted. However, only 12.3% of the respondents have admitted interference to the current pregnancy. Having more than four pregnancies (AOR = 4.28, CI: (1.24–14.71, age of 30–34 years (AOR = 0.15, CI: (0.04–0.55, primary education (AOR = 0.26, CI: (0.13–0.88, and wanted pregnancy (AOR = 0.44, CI: (0.14–0.65 were found to have association with induced abortion. The study revealed high level of induced abortion which is underpinned by high magnitude of unwanted pregnancy. There is requirement for widespread expansion of increased access to high quality family planning service and post-abortion care.

  20. Ready, aim fire! Mental health nurses under siege in acute inpatient facilities.

    Science.gov (United States)

    Ward, Louise

    2013-04-01

    It has been clearly acknowledged and well-documented that physical, emotional, and psychological violence is a central theme and an expected workplace hazard for registered nurses working in acute inpatient mental health care facilities. Limited research, however, has focused on how registered nurses have been able to cope within this environment and adequately protect themselves from harm. A critical feminist research project recently explored the lived experience of 13 Australian, female, registered nurses working in a busy metropolitan acute inpatient mental health care facility. "Fear" was exposed as the precursor to violence and aggression, both "fear as experienced by the nurse" and "fear as experienced by the patient." The participants reported experiencing a sense of fear when they could not accurately or confidently anticipate a patient response or reaction. They identified this relationship with fear as being "part of the job" and part of the unpredictable nature of caring for people experiencing complex distortions in thinking and behavior. The participants believed, however, that additional workplace pressures complicated the therapeutic environment, resulting in a distraction from patient care and observation. This distraction could lead to nurse-patient miscommunication and the potential for violence. This article discusses a major theme to emerge from this study, "Better the devil you know!" The theme highlights how mental health nurses cope with violence and why they choose to continue working in this complex care environment.

  1. Induced abortion and associated factors in health facilities of Guraghe zone, southern Ethiopia.

    Science.gov (United States)

    Tesfaye, Gezahegn; Hambisa, Mitiku Teshome; Semahegn, Agumasie

    2014-01-01

    Unsafe abortion is one of the major medical and public health problems in developing countries including Ethiopia. However, there is a lack of up-to-date and reliable information on induced abortion distribution and its determinant factors in the country. This study was intended to assess induced abortion and associated factors in health facilities of Guraghe zone, Southern Ethiopia. Institution based cross-sectional study was conducted in eight health facilities in Guraghe zone. Client exit interview was conducted on 400 patients using a structured questionnaire. Bivariate and multivariate logistic regression analysis was performed to identify factors associated with induced abortion. Out of 400 women, 75.5% responded that the current pregnancy that ended in abortion is unwanted. However, only 12.3% of the respondents have admitted interference to the current pregnancy. Having more than four pregnancies (AOR = 4.28, CI: (1.24-14.71)), age of 30-34 years (AOR = 0.15, CI: (0.04-0.55)), primary education (AOR = 0.26, CI: (0.13-0.88)), and wanted pregnancy (AOR = 0.44, CI: (0.14-0.65)) were found to have association with induced abortion. The study revealed high level of induced abortion which is underpinned by high magnitude of unwanted pregnancy. There is requirement for widespread expansion of increased access to high quality family planning service and post-abortion care.

  2. An Examination of the Determinants of The Mode of Transport to Primary Health Facilities in A Developing Region

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    Olayinka Otun

    2014-12-01

    Full Text Available Access to primary health facilities is a key determinant of the overall well being of the population in an area.   In rural regions were distances to public facilities are usually longer compared to urban areas, it is not clear if people are still willing to walk to use these facilities. It is pertinent therefore to clarify such uncertainty since walking distance is a standard measure used to plan such public facilities particularly in rural regions. The objective  of this study therefore is to provide a framework to determine the factors that will influence a health care service seeker in a developing region to walk or use other means of transport to a primary health facility.  The case study for this research is Ijebu North Local Government Area of Ogun state made up of eleven urban and rural wards. One hundred and fifty households were selected at random for interview. Logit regression was used to describe how some predictor variables were used to explain the likelihood of a particular household walking to a primary health facility. The predicting model  in this study was able to classify 80.0% of the cases correctly.   This simply shows that the predictors (independent variables contribute to the predicting power of the logistic regression model.   The  pseudo R-squares of Cox and Snell’s R-square and Nagelkerke’s R also show that our logistic model is relevant to predicting whether a household will walk or use a vehicle while attending a health facility.   In our study, we noted that settlement status (p=0.00  and transport cost to health facility (p=0.00 contributed significantly to the prediction.  This study also reveals that the odds for household members in an urban area to walk to the health facility often used  is 88.1%  lower than the odds for a household in a rural area.   It was revealed that households that are poor are 49% times more likely to walk to the health facility they frequently used. The knowledge

  3. [Supply and demand of medical specialists in the health facilities of the Ministry of Health: national, regional and by type of specialty gaps].

    Science.gov (United States)

    Zevallos, Leslie; Pastor, Reyna; Moscoso, Betsy

    2011-06-01

    To characterize the supply, demand and the gap of medical specialists in facilities of the Ministry of Health of Peru (MINSA) at the national, regional and specialty type levels. Observational, descriptive study through which we calculated the supply of medical specialists using secondary sources of MINSA. The analysis of the demand for medical specialists was based on two methodologies: the need for specialists according to the guidelines of classification of the health facilities and according to the epidemiological and demographic profile. The arithmetic difference between the estimated demand and the supply was the procedure used to calculate the gap of medical specialists. The Ministry of Health has a total supply at the national level of 6,074 medical specialists of which 61.5% belong to the clinical specialties, 33.2% to the surgical specialties, 4.9% specialities related to aid to diagnosis and treatment and 0.4% to public health specialties. According to the categorization guideline there is a total demand of 11,176 medical specialists and according to the epidemiological and demographic profile of 11,738. The national estimated gaps found are similar in both methods, although they differ widely across regions and by type of specialty. At the regional level, the gaps are greater in Loreto, Piura, Puno and Madre de Dios when estimating the defficit in relation to the supply. Regarding the speciality, the gap is greater in the four basic specialties: gynecology and obstetrics, pediatrics, internal medicine and general surgery. There is a waid gap between supply and demand of medical specialists at the national and regional levels, as a whole representing approximately 45% of the current offer, regardless of the estimation method.

  4. Utility of health facility-based malaria data for malaria surveillance.

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    Yaw A Afrane

    Full Text Available BACKGROUND: Currently, intensive malaria control programs are being implemented in Africa to reduce the malaria burden. Clinical malaria data from hospitals are valuable for monitoring trends in malaria morbidity and for evaluating the impacts of these interventions. However, the reliability of hospital-based data for true malaria incidence is often questioned because of diagnosis accuracy issues and variation in access to healthcare facilities among sub-groups of the population. This study investigated how diagnosis and treatment practices of malaria cases in hospitals affect reliability of hospital malaria data. METHODOLOGY/PRINCIPAL FINDINGS: The study was undertaken in health facilities in western Kenya. A total of 3,569 blood smears were analyzed after being collected from patients who were requested by clinicians to go to the hospital's laboratory for malaria testing. We applied several quality control measures for clinical malaria diagnosis. We compared our slide reading results with those from the hospital technicians. Among the 3,390 patients whose diagnoses were analyzed, only 36% had clinical malaria defined as presence of any level of parasitaemia and fever. Sensitivity and specificity of clinicians' diagnoses were 60.1% (95% CI: 61.1-67.5 and 75.0% (95% CI: 30.8-35.7, respectively. Among the 980 patients presumptively treated with an anti-malarial by the clinicians without laboratory diagnosis, only 47% had clinical malaria. CONCLUSIONS/SIGNIFICANCE: These findings revealed substantial over-prescription of anti-malarials and misdiagnosis of clinical malaria. More than half of the febrile cases were not truly clinical malaria, but were wrongly diagnosed and treated as such. Deficiency in malaria diagnosis makes health facility data unreliable for monitoring trends in malaria morbidity and for evaluating impacts of malaria interventions. Improving malaria diagnosis should be a top priority in rural African health centers.

  5. Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana.

    Science.gov (United States)

    Alhassan, Robert Kaba; Duku, Stephen Opoku; Janssens, Wendy; Nketiah-Amponsah, Edward; Spieker, Nicole; van Ostenberg, Paul; Arhinful, Daniel Kojo; Pradhan, Menno; Rinke de Wit, Tobias F

    2015-01-01

    Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients' decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will help determine more effective quality improvement interventions and health insurance sustainability strategies, especially in resource constrained countries in Africa where universal access to good quality care remains a challenge. To examine the differences in perceptions of clients and health staff on quality healthcare and determine if these perceptions are associated with technical quality proxies in health facilities. Implications of the findings for a sustainable National Health Insurance Scheme (NHIS) in Ghana are also discussed. This is a cross-sectional study in two southern regions in Ghana involving 64 primary health facilities: 1,903 households and 324 health staff. Data collection lasted from March to June, 2012. A Wilcoxon-Mann-Whitney test was performed to determine differences in client and health staff perceptions of quality healthcare. Spearman's rank correlation test was used to ascertain associations between perceived and technical quality care proxies in health facilities, and ordered logistic regression employed to predict the determinants of client and staff-perceived quality healthcare. Negative association was found between technical quality and client-perceived quality care (coef. = -0.0991, pperception differences were found in all healthcare quality proxies, suggesting some level of unbalanced commitment to quality improvement and potential information asymmetry between clients and service providers. Overall, the findings suggest that increased efforts towards technical quality care alone will not necessarily translate into better client-perceived quality care and willingness to utilize health services in NHIS-accredited health facilities. There is the

  6. Consumer and carer perspectives in the development of a mental health research, treatment and teaching facility: A thematic analysis.

    Science.gov (United States)

    Katsikitis, M; Lane, B R; Ozols, I; Statham, D

    2017-09-01

    WHAT IS KNOWN ON THE SUBJECT?: Around the world, recovery has become a focus in mental health policy. The participation of people accessing mental health services (consumers) and carers of such individuals in decision-making related to services forms part of this recovery orientation and studies suggest positive outcomes following such participation. However, little is known about consumer and carer desires at the earliest stages of development of new services. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Consumers and carers desire changes to how mental health services are provided. Many factors affect consumer and carer experiences, including language use, physical design of spaces, accessibility, consideration of individual needs, practical help and how well care is continued from hospital to community settings. Carers may feel sidelined in treatment and be distressed as a result. They wish to be respected and involved in recovery. Consumers and carers wish for focus on broader health, with care taken to address physical health, psychological needs, social needs and treatment of the whole person rather than just an illness. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Consumers and carers desire partnership with professionals in recovery. Tokenistic participation should be avoided. Flexibility in how services are provided and less formality may help engage consumers and carers. Specifically, professionals may help by linking consumers and carers to services that address practical needs. Professionals should communicate with carers to draw on their expertise about the individual accessing the mental health service and help carers understand how they can assist the individual's recovery. Introduction Recovery-oriented mental health policies recognize consumer and carer participation in service decision-making as essential, but little is known about the views of these individuals in the earliest stages of service development. Aim This study sought consumer and carer

  7. How much malaria occurs in urban Luanda, Angola? A health facility-based assessment.

    Science.gov (United States)

    Thwing, Julie I; Mihigo, Jules; Fernandes, Alexandra Pataca; Saute, Francisco; Ferreira, Carolina; Fortes, Filomeno; de Oliveira, Alexandre Macedo; Newman, Robert D

    2009-03-01

    We conducted a health facility-based survey of patients with fever during malaria transmission season to determine the proportion with laboratory-confirmed malaria in Luanda, Angola. We enrolled 864 patients at 30 facilities; each underwent a blood film for malaria and a questionnaire. Only 3.6% had a positive blood film. When stratified by distance of the facility to city center ( or = 15 km), the proportions were 1.5% (9/615) and 8.8% (22/249), respectively (P < 0.0001). Of patients traveling outside Luanda in the preceding 3 months, 6.8% (6/88) had malaria, compared with 3.2% (26/776) not traveling (P = 0.13). Children < 5 years of age were less likely to have malaria (2.4%; 12/510) than children ages 5-14 (8.7%; 9/104) and adults (4.0%; 10/250) (P = 0.03). The prevalence of laboratory-confirmed malaria in febrile patients in Luanda is very low, but increases with distance from the urban center. Prevention and treatment should be focused in surrounding rural areas.

  8. 42 CFR 413.118 - Payment for facility services related to covered ASC surgical procedures performed in hospitals...

    Science.gov (United States)

    2010-10-01

    ... ASC surgical procedures performed in hospitals on an outpatient basis. 413.118 Section 413.118 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM... PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Specific Categories of Costs §...

  9. Why give birth in health facility? Users’ and providers’ accounts of poor quality of birth care in Tanzania

    Science.gov (United States)

    2013-01-01

    Background In Tanzania, half of all pregnant women access a health facility for delivery. The proportion receiving skilled care at birth is even lower. In order to reduce maternal mortality and morbidity, the government has set out to increase health facility deliveries by skilled care. The aim of this study was to describe the weaknesses in the provision of acceptable and adequate quality care through the accounts of women who have suffered obstetric fistula, nurse-midwives at both BEmOC and CEmOC health facilities and local community members. Methods Semi-structured interviews involving 16 women affected by obstetric fistula and five nurse-midwives at maternity wards at both BEmOC and CEmOC health facilities, and Focus Group Discussions with husbands and community members were conducted between October 2008 and February 2010 at Comprehensive Community Based Rehabilitation in Tanzania and Temeke hospitals in Dar es Salaam, and Mpwapwa district in Dodoma region. Results Health care users and health providers experienced poor quality caring and working environments in the health facilities. Women in labour lacked support, experienced neglect, as well as physical and verbal abuse. Nurse-midwives lacked supportive supervision, supplies and also seemed to lack motivation. Conclusions There was a consensus among women who have suffered serious birth injuries and nurse midwives staffing both BEmOC and CEmOC maternity wards that the quality of care offered to women in birth was inadequate. While the birth accounts of women pointed to failure of care, the nurses described a situation of disempowerment. The bad birth care experiences of women undermine the reputation of the health care system, lower community expectations of facility birth, and sustain high rates of home deliveries. The only way to increase the rate of skilled attendance at birth in the current Tanzanian context is to make facility birth a safer alternative than home birth. The findings from this study

  10. Health worker perspectives on the possible use of intramuscular artesunate for the treatment of severe malaria at lower-level health facilities in settings with poor access to referral facilities in Nigeria: a qualitative study.

    Science.gov (United States)

    Adesoro, Olatunde; Shumba, Constance; Kpamor, John; Achan, Jane; Kivumbi, Harriet; Dada, John; Maxwell, Kolawole; Tibenderana, James; Marasciulo, Madeline; Hamade, Prudence; Oresanya, Olusola; Nankabirwa, Joanita; Baba, Ebenezer

    2016-10-12

    Innovative strategies are needed to reduce malaria mortality in high burden countries like Nigeria. Given that one of the important reasons for this high malaria mortality is delay in receiving effective treatment, improved access to such treatment is critical. Intramuscular artesunate could be used at lower-level facilities given its proven efficacy, ease of use and excellent safety profile. The objective of this study was therefore to explore health workers' perspectives on the possible use of intramuscular artesunate as definitive treatment for severe malaria at lower-level facilities, especially when access to referral facilities is challenging. The study was to provide insight as a formative step into the conduct of future experimental studies to ascertain the feasibility of the use of intramuscular artesunate for definitive treatment of severe malaria in lower level facilities where access to referral care is limited. This qualitative study was done across three southern States in Nigeria (Oyo, Cross River and Enugu). Key informant interviews were conducted over a period of three months between October and December 2014 among 90 purposively selected health workers with different roles in malaria case management from primary care to policy level. A thematic content analysis was used to analyse data. Overall, most of health workers and other key informant groups thought that the use of intramuscular artesunate for definitive treatment of severe malaria at lower-level facilities was possible. They however reported human resource and infrastructure constraints as factors affecting the feasibility of intramuscular artesunate use as definitive treatment for severe malaria in lower-level facilities.. Specifically identified barriers included limited numbers of skilled health workers available to manage potential complications of severe malaria and poorly equipped facilities for supportive treatment. Intramuscular artesunate was considered easy to administer and the

  11. Factors affecting acceptance of provider-initiated HIV testing and counseling services among outpatient clients in selected health facilities in Harar Town, Eastern Ethiopia

    Directory of Open Access Journals (Sweden)

    Abdurahman S

    2015-05-01

    partners, a fear of the results, a shortage of staff, a busy work environment, a lack of private rooms, and a lack of refresher training, which were identified as the main barriers for PITC. Conclusion: There is evidence of the relatively increased acceptability of PITC services by outpatient department clients. A program needs to be strengthened to enhance the use of PITC; the Ministry of Health, Regional Health Bureau, and other responsible bodies – including health facilities – should design and strengthen information education and communication/behavioral change and communication interventions and promote activities related to PITC and HIV counseling and testing in both health facilities and the community at large. Keywords: PITC, outpatient clients, Harar town, Eastern Ethiopia

  12. 60 Million non-facility births: who can deliver in community settings to reduce intrapartum-related deaths?

    Science.gov (United States)

    Darmstadt, Gary L; Lee, Anne C C; Cousens, Simon; Sibley, Lynn; Bhutta, Zulfiqar A; Donnay, France; Osrin, Dave; Bang, Abhay; Kumar, Vishwajeet; Wall, Steven N; Baqui, Abdullah; Lawn, Joy E

    2009-10-01

    For the world's 60 million non-facility births, addressing who is currently attending these births and what effect they have on birth outcomes is a key starting point toward improving care during childbirth. We present a systematic review of evidence for the effect of community-based cadres-community-based skilled birth attendants (SBAs), trained traditional birth attendants (TBAs), and community health workers (CHWs)-in improving perinatal and intrapartum-related outcomes. The evidence for providing skilled birth attendance in the community is low quality, consisting of primarily before-and-after and quasi-experimental studies, with a pooled 12% reduction in all cause perinatal mortality (PMR) and a 22%-47% reduction in intrapartum-related neonatal mortality (IPR-NMR). Low/moderate quality evidence suggests that TBA training may improve linkages with facilities and improve perinatal outcomes. A randomized controlled trial (RCT) of TBA training showed a 30% reduction in PMR, and a meta-analysis demonstrated an 11% reduction in IPR-NMR. There is moderate evidence that CHWs have a positive impact on perinatal-neonatal outcomes. Meta-analysis of CHW packages (2 cluster randomized controlled trials, 2 quasi-experimental studies) showed a 28% reduction in PMR and a 36% reduction in early neonatal mortality rate; one quasi-experimental study showed a 42% reduction in IPR-NMR. Skilled childbirth care is recommended for all pregnant women, and community strategies need to be linked to prompt, high-quality emergency obstetric care. CHWs may play a promising role in providing pregnancy and childbirth care, mobilizing communities, and improving perinatal outcomes in low-income settings. While the role of the TBA is still controversial, strategies emphasizing partnerships with the health system should be further considered. Innovative community-based strategies combined with health systems strengthening may improve childbirth care for the rural poor, help reduce gross

  13. A qualitative analysis of oral health care needs in arkansas nursing facilities: the professional role of the dental hygienist.

    Science.gov (United States)

    Hardgraves, Virginia M; Mitchell, Tanya Villalpando; Hanson, Carrie-Carter; Simmer-Beck, Melanie

    2014-12-01

    Frail elders and nursing home residents are vulnerable to poor oral health and frequently lack access to dental care. The purpose of this study was to determine why residents in Arkansas skilled nursing facilities have limited access to oral health care. This study utilized qualitative research methodology. Data was collected from oral health care personnel through open-ended responses in a written survey (n=23) and through telephone interviews (n=21). The investigators applied the constant comparative method to analyze and unitize the data and ultimately reach consensus. Data analysis resulted in consensus on 2 emergent themes: policy and access. This qualitative case study suggests access to oral health care for residents living in both long-term care (LTC) and assisted living I and II facilities in Arkansas is affected by public and facility policies and access to oral health care as a function of the patient's health status and availability of oral health care providers. Access for residents residing in assisted living I and II facilities is also limited by the residents' inability to assume responsibility for accessing oral health care. The outcomes from this study may serve to inform policymakers and advocates for access to oral health care as they develop new policies to address this growing need. Copyright © 2014 The American Dental Hygienists’ Association.

  14. Site specific risk assessment of an energy-from-waste thermal treatment facility in Durham Region, Ontario, Canada. Part A: Human health risk assessment.

    Science.gov (United States)

    Ollson, Christopher A; Knopper, Loren D; Whitfield Aslund, Melissa L; Jayasinghe, Ruwan

    2014-01-01

    The regions of Durham and York in Ontario, Canada have partnered to construct an energy-from-waste thermal treatment facility as part of a long term strategy for the management of their municipal solid waste. This paper presents the results of a comprehensive human health risk assessment for this facility. This assessment was based on extensive sampling of baseline environmental conditions (e.g., collection and analysis of air, soil, water, and biota samples) as well as detailed site specific modeling to predict facility-related emissions of 87 identified contaminants of potential concern. Emissions were estimated for both the approved initial operating design capacity of the facility (140,000 tonnes per year) and for the maximum design capacity (400,000 tonnes per year). For the 140,000 tonnes per year scenario, this assessment indicated that facility-related emissions are unlikely to cause adverse health risks to local residents, farmers, or other receptors (e.g., recreational users). For the 400,000 tonnes per year scenarios, slightly elevated risks were noted with respect to inhalation (hydrogen chloride) and infant consumption of breast milk (dioxins and furans), but only during predicted 'upset conditions' (i.e. facility start-up, shutdown, and loss of air pollution control) that represent unusual and/or transient occurrences. However, current provincial regulations require that additional environmental screening would be mandatory prior to expansion of the facility beyond the initial approved capacity (140,000 tonnes per year). Therefore, the potential risks due to upset conditions for the 400,000 tonnes per year scenario should be more closely investigated if future expansion is pursued.

  15. Using geographical information systems for defining the accessibility to health care facilities in Jeddah City, Saudi Arabia

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    Abdulkader A. Murad

    2014-12-01

    Full Text Available Spatial data play an important role in the planning of health care facilities and their allocation. Today, geographical information systems (GIS provide useful techniques for capturing, maintaining and analysing health care spatial data; indeed health geoinformatics is an emerging discipline that uses innovative geospatial technology to investigate health issues. The purpose of this paper is to define how GIS can be used for assessing the level of accessibility to health care. The paper identifies the advantages of using GIS in health care planning and covers GIS-based international accessibility with a focus on GIS applications for health care facilities in Jeddah city, Saudi Arabia. A geodatabase that includes location of health services, road networks, health care demand and population districts was created using ArcGIS software. The geodatabase produced is based on collected data and covers issues, such as defining the spatial distribution of health care facilities, evaluating health demand types and modelling health service areas based on analysis of driving-time and straight-line distances.

  16. Diagnosis and treatment of malaria in peripheral health facilities in Uganda

    DEFF Research Database (Denmark)

    Ndyomugyenyi, Richard; Magnussen, Pascal; Clarke, Siân

    2007-01-01

    Background Early recognition of symptoms and signs perceived as malaria are important for effective case management, as few laboratories are available at peripheral health facilities. The validity and reliability of clinical signs and symptoms used by health workers to diagnose malaria were...... villages. A malaria case was defined as any slide-confirmed parasitaemia in a person with an axillary temperature = 37.5°C or a history of fever within the last 24 hrs and no signs suggestive of other diseases. Results Cases of malaria were significantly more likely to report joint pains, headache......, vomiting and abdominal pains. However, due to the low prevalence of malaria, the predictive values of these individual signs alone, or in combination, were poor. Only 24.8% of 1627 patients had malaria according to case definition and > 75% of patients were unnecessarily treated for malaria and few slide...

  17. Comparison of knowledge of and attitudes toward dementia between health-related and non-health-related university students

    OpenAIRE

    Yong, Mi-hyun; Yoo, Chan-uk; Yang, Yeong-ae

    2015-01-01

    [Purpose] This study compared the knowledge of and attitudes toward dementia between health-related and non-health-related students. [Subjects] The subjects consisted of a total of 416 people, 213 health-related students and 203 non-health-related students, at K University, which is located in Gyeongsangbuk-do, Republic of Korea, between May 1 and 14, 2014. [Methods] The subjects answered a self-administered questionnaire about their knowledge of and attitudes toward dementia. [Results] There...

  18. Quality of malaria case management at outpatient health facilities in Angola

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    Santelli Ana

    2009-12-01

    Full Text Available Abstract Background Angola's malaria case-management policy recommends treatment with artemether-lumefantrine (AL. In 2006, AL implementation began in Huambo Province, which involved training health workers (HWs, supervision, delivering AL to health facilities, and improving malaria testing with microscopy and rapid diagnostic tests (RDTs. Implementation was complicated by a policy that was sometimes ambiguous. Methods Fourteen months after implementation began, a cross-sectional survey was conducted in 33 outpatient facilities in Huambo Province to assess their readiness to manage malaria and the quality of malaria case-management for patients of all ages. Consultations were observed, patients were interviewed and re-examined, and HWs were interviewed. Results Ninety-three HWs and 177 consultations were evaluated, although many sampled consultations were missed. All facilities had AL in-stock and at least one HW trained to use AL and RDTs. However, anti-malarial stock-outs in the previous three months were common, clinical supervision was infrequent, and HWs had important knowledge gaps. Except for fever history, clinical assessments were often incomplete. Although testing was recommended for all patients with suspected malaria, only 30.7% of such patients were tested. Correct testing was significantly associated with caseloads Conclusion By late-2007, substantial progress had been made to implement the malaria case-management policy in a setting with weak infrastructure. However, policy ambiguities, under-use of malaria testing, and distrust of negative test results led to many incorrect malaria diagnoses and treatments. In 2009, Angola published a policy that clarified many issues. As problems identified in this survey are not unique to Angola, better strategies for improving HW performance are urgently needed.

  19. Oral health care in older people in long term care facilities : A systematic review of implementation strategies

    NARCIS (Netherlands)

    Weening-Verbree, L.; Huisman-de Waal, G.; van Dusseldorp, L.; van Achterberg, T.; Schoonhoven, L.

    2013-01-01

    Objectives: Oral hygiene is necessary to maintain oral health and quality of life. However, the oral hygiene and the oral health care of older people in long term care facilities are poor. This indicates that care is not in compliance with the available guidelines and protocols, and stresses the imp

  20. Oral health care in older people in long term care facilities: A systematic review of implementation strategies

    NARCIS (Netherlands)

    Weening-Verbree, L.; Huisman-de Waal, G.J.; Dusseldorp, L. van; Achterberg, T. van; Schoonhoven, L.

    2013-01-01

    OBJECTIVES: Oral hygiene is necessary to maintain oral health and quality of life. However, the oral hygiene and the oral health care of older people in long term care facilities are poor. This indicates that care is not in compliance with the available guidelines and protocols, and stresses the

  1. Oral health care in older people in long term care facilities : A systematic review of implementation strategies

    NARCIS (Netherlands)

    Weening-Verbree, L.; Huisman-de Waal, G.; van Dusseldorp, L.; van Achterberg, T.; Schoonhoven, L.

    Objectives: Oral hygiene is necessary to maintain oral health and quality of life. However, the oral hygiene and the oral health care of older people in long term care facilities are poor. This indicates that care is not in compliance with the available guidelines and protocols, and stresses the

  2. Morbidity profile of elderly outpatients attending selected sub-district Siddha health facilities in Tamil Nadu, India

    Directory of Open Access Journals (Sweden)

    Kalaiselvi Selvaraj

    2016-01-01

    Conclusion: Elderly constitute more than one fourth of outpatients load from siddha health facilities. Degenerative diseases like arthritis and non-communicable diseases were the common morbidities in this age group. Geriatric clinics and mobile clinics under siddha system may help in improving health care services.

  3. Quality of antimalarial drugs and antibiotics in Papua New Guinea: a survey of the health facility supply chain.

    Directory of Open Access Journals (Sweden)

    Manuel W Hetzel

    Full Text Available BACKGROUND: Poor-quality life-saving medicines are a major public health threat, particularly in settings with a weak regulatory environment. Insufficient amounts of active pharmaceutical ingredients (API endanger patient safety and may contribute to the development of drug resistance. In the case of malaria, concerns relate to implications for the efficacy of artemisinin-based combination therapies (ACT. In Papua New Guinea (PNG, Plasmodium falciparum and P. vivax are both endemic and health facilities are the main source of treatment. ACT has been introduced as first-line treatment but other drugs, such as primaquine for the treatment of P. vivax hypnozoites, are widely available. This study investigated the quality of antimalarial drugs and selected antibiotics at all levels of the health facility supply chain in PNG. METHODS AND FINDINGS: Medicines were obtained from randomly sampled health facilities and selected warehouses and hospitals across PNG and analysed for API content using validated high performance liquid chromatography (HPLC. Of 360 tablet/capsule samples from 60 providers, 9.7% (95% CI 6.9, 13.3 contained less, and 0.6% more, API than pharmacopoeial reference ranges, including 29/37 (78.4% primaquine, 3/70 (4.3% amodiaquine, and one sample each of quinine, artemether, sulphadoxine-pyrimethamine and amoxicillin. According to the package label, 86.5% of poor-quality samples originated from India. Poor-quality medicines were found in 48.3% of providers at all levels of the supply chain. Drug quality was unrelated to storage conditions. CONCLUSIONS: This study documents the presence of poor-quality medicines, particularly primaquine, throughout PNG. Primaquine is the only available transmission-blocking antimalarial, likely to become important to prevent the spread of artemisinin-resistant P. falciparum and eliminating P. vivax hypnozoites. The availability of poor-quality medicines reflects the lack of adequate quality control and

  4. Measuring Physical Neighborhood Quality Related to Health

    Directory of Open Access Journals (Sweden)

    Kimberly A. Rollings

    2015-04-01

    Full Text Available Although sociodemographic factors are one aspect of understanding the effects of neighborhood environments on health, equating neighborhood quality with socioeconomic status ignores the important role of physical neighborhood attributes. Prior work on neighborhood environments and health has relied primarily on level of socioeconomic disadvantage as the indicator of neighborhood quality without attention to physical neighborhood quality. A small but increasing number of studies have assessed neighborhood physical characteristics. Findings generally indicate that there is an association between living in deprived neighborhoods and poor health outcomes, but rigorous evidence linking specific physical neighborhood attributes to particular health outcomes is lacking. This paper discusses the methodological challenges and limitations of measuring physical neighborhood environments relevant to health and concludes with proposed directions for future work.

  5. Measuring Physical Neighborhood Quality Related to Health

    Science.gov (United States)

    Rollings, Kimberly A.; Wells, Nancy M.; Evans, Gary W.

    2015-01-01

    Although sociodemographic factors are one aspect of understanding the effects of neighborhood environments on health, equating neighborhood quality with socioeconomic status ignores the important role of physical neighborhood attributes. Prior work on neighborhood environments and health has relied primarily on level of socioeconomic disadvantage as the indicator of neighborhood quality without attention to physical neighborhood quality. A small but increasing number of studies have assessed neighborhood physical characteristics. Findings generally indicate that there is an association between living in deprived neighborhoods and poor health outcomes, but rigorous evidence linking specific physical neighborhood attributes to particular health outcomes is lacking. This paper discusses the methodological challenges and limitations of measuring physical neighborhood environments relevant to health and concludes with proposed directions for future work. PMID:25938692

  6. Water-related environmental control requirements at municipal solid waste-to-energy conversion facilities

    Energy Technology Data Exchange (ETDEWEB)

    Young, J C; Johnson, L D

    1980-09-01

    Water use and waste water production, water pollution control technology requirements, and water-related limitations to their design and commercialization are identified at municipal solid waste-to-energy conversion systems. In Part I, a summary of conclusions and recommendations provides concise statements of findings relative to water management and waste water treatment of each of four municipal solid waste-to-energy conversion categories investigated. These include: mass burning, with direct production of steam for use as a supplemental energy source; mechanical processing to produce a refuse-derived fuel (RDF) for co-firing in gas, coal or oil-fired power plants; pyrolysis for production of a burnable oil or gas; and biological conversion of organic wastes to methane. Part II contains a brief description of each waste-to-energy facility visited during the subject survey showing points of water use and wastewater production. One or more facilities of each type were selected for sampling of waste waters and follow-up tests to determine requirements for water-related environmental controls. A comprehensive summary of the results are presented. (MCW)

  7. University of the Witwatersrand physiotherapy undergraduate curriculum alignment to medical conditions of patients within Gauteng state health facilities

    Directory of Open Access Journals (Sweden)

    Mokgobadibe V. Ntsiea

    2017-02-01

    Full Text Available Background: The healthcare sector requires graduates with the ability to confidently assess and manage the majority of the medical conditions seen in hospitals.Objective: To establish whether the most prevalent medical conditions treated by physiotherapists in Gauteng (South Africa state health facilities align with the University of the Witwatersrand (Wits physiotherapy curriculum.Methods: This was a retrospective review of condition-related statistics from physiotherapy departments within the Gauteng province state health facilities. Data from all Gauteng government hospitals that had submitted at least 75% of their physiotherapy condition–related statistics to the provincial statistics coordinator from January 2012 to December 2014 were considered and compared to medical conditions covered in the Wits 2015 physiotherapy curriculum to check if all conditions listed in the Gauteng statistics appeared within the Wits curriculum document. The number of teaching hours for the common conditions was noted to check the emphasis given to these conditions in the curriculum.Results: Eighty-three per cent of the hospitals submitted 75% of their monthly statistics. Overall, the most common conditions treated were lower limb fractures (13% followed by stroke (7.6% (n = 705 597. Within the neuro-musculoskeletal category, the most common conditions after lower limb fractures were soft tissue injuries (15.1% (n = 330 511. The most common cardiopulmonary conditions were tuberculosis (24.9%, followed by pneumonia (13.8% (n = 94 895. The most common neurological conditions were stroke (30.9% followed by cerebral palsy (17% (n = 174 024. Within the non-specified categories, the number of intensive care unit (ICU patients was the highest (23%, followed by sputum induction (21% (n = 138 187. The most common conditions that were emphasised within the Wits curriculum as indicated by the teaching hours: fractures, 14.5 (66% of 22 third-year orthopaedics hours

  8. An Assessment of the Electric Power Quality and Electrical Installation Impacts on Medical Electrical Equipment Operations at Health Care Facilities

    Directory of Open Access Journals (Sweden)

    Mário C.G. Ramos

    2009-01-01

    Full Text Available Problem statement: Medical electrical equipments at health care facilities presented malfunction and wrong medical information due to poor electric power quality and to inadequate electrical Installations. Some equipment such as X-ray, computerized axial tomography and magnetic resonance imaging are considered as polluting ones due to their high amount of harmonics and voltage transients produced on the electrical power supply when in operation, while other equipments, connected to the same power supply, are considered sensitive or victim ones, presenting failure or producing wrong. Approach: The effects on some sensitive medical electrical equipment were verified in a controlled environment at energy quality technological center of the technical school of the University of Sao Paulo. A heart monitor, pulmonary ventilator and pulse oxymeter equipment types were submitted to a controlled voltage supply with high harmonic content and voltage sags. The test methodology used simulated conditions based on Brazilian NBR standards, ANSI/IEEE Std. 519, IEC 60601 and IEC 61000-4-11 standards. Results: The results of the polluting equipment current consumption measurements as well as the three sensitive equipments tested were presented and discussed. The pulmonary ventilator presented problems that range from stoppage to expiratory valve blockage and alarm system failures. The pulse oxymeter presented display malfunctions and it was extremely sensitive to voltage sags. The heart monitor maintained steady operation in all test cases. Conclusion/Recommendations: In spite of several existing recommendations and standards for testing medical electrical equipments, there is a lack of standard related to test cases considering the effects of high harmonic and voltage sags. The quality of electrical installation in health care facilities needs to be improved to reduce risks to the patients and to provide better health treatment.

  9. Response to cotrimoxazole in the management of childhood pneumonia in first-level health care facilities.

    Science.gov (United States)

    Noorani, Q A; Qazi, S A; Rasmussen, Z A; Rehman, G N; Khan, S S; Muhammadullah, I; Mohammad, Y K; Sher, G A; Munir, N H

    2006-08-01

    Reports of high levels of antimicrobial resistance to cotrimoxazole in children with non-severe pneumonia (NSP) have prompted calls for a change to amoxicillin in the therapeutic guidelines at the first-level health care facility (FLHF). FLHFs lack data about the use of World Health Organization (WHO) acute respiratory infection (ARI) standard case management (SCM). To apply ARI SCM guidelines at the FLHF, assess clinical outcome of NSP with oral cotrimoxazole and determine the risk factors influencing treatment outcome. Health care workers (HCWs) at 14 health centres managed children aged 2-59 months with NSP according to ARI SCM guidelines. The primary outcome was treatment failure, including change of antibiotic therapy and loss to follow-up. Of 949 children enrolled, 110 (11.6%) failed therapy with oral cotrimoxazole. Clinical failure was significantly higher among children presenting with a fast respiratory rate of > or = 15 breaths/min above normal for age and wheezing on examination. To treat children with NSP at the FLHF, oral cotrimoxazole is an acceptable treatment choice in view of the efficacy, cost and ease of use. In children with wheezing and signs of pneumonia, the decision to use antibiotic therapy should be made after a trial of bronchodilator therapy.

  10. Role of Health Insurance Status in Inter-facility Transfers of Patients with ST-Elevation Myocardial Infarction

    Science.gov (United States)

    Ward, Michael J.; Kripalani, Sunil; Zhu, Yuwei; Storrow, Alan B.; Wang, Thomas J.; Speroff, Theodore; Munoz, Daniel; Dittus, Robert S.; Harrell, Frank E.; Self, Wesley H.

    2016-01-01

    Lack of health insurance is associated with inter-facility transfer from emergency departments for several non-emergent conditions, but its association with transfers for ST-elevation myocardial infarction (STEMI), which requires timely definitive care for optimal outcomes, is unknown. Our objective was to determine whether insurance status is a predictor of inter-facility transfer for emergency department visits with STEMI. We analyzed data from the 2006 through 2011 Nationwide Emergency Department Sample examining all emergency department visits for patients age 18 years and older with a diagnosis of STEMI and a disposition of inter-facility transfer or hospitalization at the same institution. For emergency department visits with STEMI, our multivariable logistic regression model included emergency department disposition status (inter-facility transfer vs hospitalization at the same institution) as the primary outcome, and insurance status (none vs. any [including Medicare, Medicaid, and private insurance]) as the primary exposure. We found that among 1,377,827 emergency department STEMI visits, including 249,294 (18.1%) transfers, patients without health insurance (adjusted odds ratio: 1.6, 95% CI: 1.5, 1.7) were more likely to be transferred than those with insurance. Lack of health insurance status was also an independent risk factor for transfer compared to each sub-category of health insurance, including Medicare, Medicaid and private insurance. In conclusion, among patients presenting to United States emergency departments with STEMI, lack of insurance was an independent predictor of inter-facility transfer. In conclusion, because inter-facility transfer is associated with longer delays to definitive STEMI therapy than treatment at the same facility, lack of health insurance may lead to important health disparities among patients with STEMI. PMID:27282834

  11. Abuse and discrimination towards indigenous people in public health care facilities: experiences from rural Guatemala.

    Science.gov (United States)

    Cerón, Alejandro; Ruano, Ana Lorena; Sánchez, Silvia; Chew, Aiken S; Díaz, Diego; Hernández, Alison; Flores, Walter

    2016-05-13

    Health inequalities disproportionally affect indigenous people in Guatemala. Previous studies have noted that the disadvantageous situation of indigenous people is the result of complex and structural elements such as social exclusion, racism and discrimination. These elements need to be addressed in order to tackle the social determinants of health. This research was part of a larger participatory collaboration between Centro de Estudios para la Equidad y Gobernanza en los Servicios de Salud (CEGSS) and community based organizations aiming to implement social accountability in rural indigenous municipalities of Guatemala. Discrimination while seeking health care services in public facilities was ranked among the top three problems by communities and that should be addressed in the social accountability intervention. This study aimed to understand and categorize the episodes of discrimination as reported by indigenous communities. A participatory approach was used, involving CEGSS's researchers and field staff and community leaders. One focus group in one rural village of 13 different municipalities was implemented. Focus groups were aimed at identifying instances of mistreatment in health care services and documenting the account of those who were affected or who witnessed them. All of the 132 obtained episodes were transcribed and scrutinized using a thematic analysis. Episodes described by participants ranged from indifference to violence (psychological, symbolic, and physical), including coercion, mockery, deception and racism. Different expressions of discrimination and mistreatment associated to poverty, language barriers, gender, ethnicity and social class were narrated by participants. Addressing mistreatment in public health settings will involve tackling the prevalent forms of discrimination, including racism. This will likely require profound, complex and sustained interventions at the programmatic and policy levels beyond the strict realm of public

  12. Laboratory testing improves diagnosis and treatment outcomes in primary health care facilities

    Directory of Open Access Journals (Sweden)

    Jane Y. Carter

    2011-12-01

    Full Text Available Objective: To determine if use of basic laboratory tests improves diagnosis and treatment outcomes in outpatients attending rural primary health care facilities.Setting: Six rural health centres in Kenya.Design: Cross-sectional study to observe change in diagnosis and treatment made by clinical officers after laboratory testing in outpatients attending six rural health centres in Kenya.Subject: The diagnosis and treatment of 1134 patients attending outpatient services in six rural health centres were compared before and after basic laboratory testing. Essential clinical diagnostic equipment and laboratory tests were established at each health centre. Clinical officers and laboratory technicians received on-site refresher training in good diagnostic practices and laboratory procedures before the study began.Results: Laboratory tests were ordered on 704 (62.1% patients. Diagnosis and treatment were changed in 45% of tested patients who returned with laboratory results (21% of all patients attending the clinics. 166 (23.5% patients did not return to the clinician for a final diagnosis and management decision after laboratory testing. Blood slide examination for malaria parasites, wet preparations, urine microscopy and stool microscopy resulted in most changes to diagnosis. There was no significant change in drug costs after laboratory testing. The greatest changes in numbers of recorded diseases following laboratory testing was for intestinal worms (53% and malaria (21%.Conclusion: Effective use of basic laboratory tests at primary health care level significantly improves diagnosis and patient treatment. Use of laboratory testing can be readily incorporated into routine clinical practice. On-site refresher training is an effective means of improving the quality of patient care and communication between clinical and laboratory staff.

  13. Quality of labeling on dispensed medicines and associated factors among public health care facilities in Bahir dar city, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Wubante Demilew Nigussie

    2014-03-01

    Full Text Available Purpose: To determine the quality of labeling on dispensed medicines and identify the associated factors among public health facilities in Bahir Dar city. Methods: A cross sectional study was conducted from August 5 to 20, 2013 at selected health care facilities in Bahir Dar city. Simple random sampling and systematic random sampling techniques was used to select health facilities and dispensing encounters respectively. Data was collected from non participatory observations of the drug dispensing process using check list. Data was entered into EPI Info (version 3.5.2 and analyzed using SPSS version 16. Bivariate and multivariate regression analysis was computed to test the strength of association and level of significance. P-value <0.05 was considered as statistical significant. Results: A total of 400 dispensing encounters and 636 drugs dispensed were observed in eight (8 outpatient pharmacies. The percentage of drugs adequately labeled was 32.2%. Drugs adequate labeling score was higher in private health facilities (39.3% compared to government health facilities (25.83%. The name, strength and dosage form of the drugs were labeled in 95.6%, 90% and 85.8% respectively. Differences in dispenser work experiences (AOR = 2.99, CI: 1.67 – 5.37, average dispensing time (AOR = 6.22, CI: 3.08-12.57, average consultation time (AOR=3.42, CI: 1.64-7.13, level of health facility (AOR = 4.31, CI 1.94 – 9.59 and type of health facilities (AOR = 4.29, CI 1.72 – 10.66 were found to be independently associated factors for quality of labeling score. Conclusion: The quality of labeling on dispensed medicines was not adequate. Dispenser work experiences, average dispensing time, average consultation time, level of health facility and type of health facilities were found to be significant factors for quality of labeling score. Therefore, attention should be given to strong skill development, increasing manpower and implementation of regular monitoring for the

  14. Utilisation of health services and geography: deconstructing regional differences in barriers to facility-based delivery in Nepal.

    Science.gov (United States)

    Hodge, Andrew; Byrne, Abbey; Morgan, Alison; Jimenez-Soto, Eliana

    2015-03-01

    While established that geographical inaccessibility is a key barrier to the utilisation of health services, it remains unknown whether disparities are driven only by limited access to these services, or are also attributable to health behaviour. Significant disparities exist in health outcomes and the coverage of many critical health services between the mountains region of Nepal and the rest of the country, yet the principal factors driving these regional disparities are not well understood. Using national representative data from the 2011 Nepal Demographic and Health Survey, we examine the extent to which observable factors explain the overall differences in the utilisation of maternal health services. We apply nonlinear Blinder-Oaxaca-type decomposition methods to quantify the effect that differences in measurable characteristics have on the regional coverage gap in facility-based delivery. The mean coverage of facility-based deliveries was 18.6 and 36.3 % in the mountains region and the rest of Nepal, respectively. Between 54.8 and 74.1 % of the regional coverage gap was explained by differences in observed characteristics. Factors influencing health behaviours (proxied by mothers' education, TV viewership and tobacco use, and household wealth) and subjective distance to the health facility were the major factors, contributing between 52.9 and 62.5 % of the disparity. Mothers' birth history was also noteworthy. Policies simultaneously addressing access and health behaviours appear necessary to achieve greater coverage and better health outcomes for women and children in isolated areas.

  15. A national health facility survey of malaria infection among febrile patients in Kenya, 2014.

    Science.gov (United States)

    Githinji, Sophie; Noor, Abdisalan M; Malinga, Josephine; Macharia, Peter M; Kiptui, Rebecca; Omar, Ahmeddin; Njagi, Kiambo; Waqo, Ejersa; Snow, Robert W

    2016-12-08

    The use of malaria infection prevalence among febrile patients at clinics has a potential to be a valuable epidemiological surveillance tool. However, routine data are incomplete and not all fevers are tested. This study was designed to screen all fevers for malaria infection in Kenya to explore the epidemiology of fever test positivity rates. Random sampling was used within five malaria epidemiological zones of Kenya (i.e., high lake endemic, moderate coast endemic, highland epidemic, seasonal low transmission and low risk zones). The selected sample was representative of the number of hospitals, health centres and dispensaries within each zone. Fifty patients with fever presenting to each sampled health facility during the short rainy season were screened for malaria infection using a rapid diagnostic test (RDT). Details of age, pregnancy status and basic demographics were recorded for each patient screened. 10,557 febrile patients presenting to out-patient clinics at 234 health facilities were screened for malaria infection. 1633 (15.5%) of the patients surveyed were RDT positive for malaria at 124 (53.0%) facilities. Infection prevalence among non-pregnant patients varied between malaria risk zones, ranging from 0.6% in the low risk zone to 41.6% in the high lake endemic zone. Test positivity rates (TPR) by age group reflected the differences in the intensity of transmission between epidemiological zones. In the lake endemic zone, 6% of all infections were among children aged less than 1 year, compared to 3% in the coast endemic, 1% in the highland epidemic zone, less than 1% in the seasonal low transmission zone and 0% in the low risk zone. Test positivity rate was 31% among febrile pregnant women in the high lake endemic zone compared to 9% in the coast endemic and highland epidemic zones, 3.2% in the seasonal low transmission zone and zero in the low risk zone. Malaria infection rates among febrile patients, with supporting data on age and pregnancy status

  16. Perceived health and environment related factors associated with ...

    African Journals Online (AJOL)

    Perceived health and environment related factors associated with urban ... as an important resource for meeting the challenges of rapidly growing cities, such ... to livelihood, it also has health and environmental problems associated with it.

  17. India-EU relations in health services: prospects and challenges

    National Research Council Canada - National Science Library

    Chanda, Rupa

    2011-01-01

    .... This paper examines the opportunities for and constraints to India-EU relations in health services in the context of this agreement, focusing on the EU as a market for India's health services exports and collaboration...

  18. Improvement of the Computing - Related Procurement Process at a Government Research Facility

    Energy Technology Data Exchange (ETDEWEB)

    Gittins, C.

    2000-04-03

    The purpose of the project was to develop, implement, and market value-added services through the Computing Resource Center in an effort to streamline computing-related procurement processes across the Lawrence Livermore National Laboratory (LLNL). The power of the project was in focusing attention on and value of centralizing the delivery of computer related products and services to the institution. The project required a plan and marketing strategy that would drive attention to the facility's value-added offerings and services. A significant outcome of the project has been the change in the CRC internal organization. The realignment of internal policies and practices, together with additions to its product and service offerings has brought an increased focus to the facility. This movement from a small, fractious organization into one that is still small yet well organized and focused on its mission and goals has been a significant transition. Indicative of this turnaround was the sharing of information. One-on-one and small group meetings, together with statistics showing work activity was invaluable in gaining support for more equitable workload distribution, and the removal of blame and finger pointing. Sharing monthly reports on sales and operating costs also had a positive impact.

  19. Design studies related to an in vivo neutron activation analysis facility for measuring total body nitrogen.

    Science.gov (United States)

    Stamatelatos, I E; Chettle, D R; Green, S; Scott, M C

    1992-08-01

    Design studies relating to an in vivo prompt capture neutron activation analysis facility measuring total body nitrogen are presented. The basis of the design is a beryllium-graphite neutron collimator and reflector configuration for (alpha, n) type radionuclide neutron sources (238PuBe or 241AmBe), so as to reflect leaking, or out-scattered, neutrons towards the subject. This improves the ratio of thermal neutron flux to dose and the spatial distribution of thermal flux achieved with these sources, whilst retaining their advantage of long half-lives as compared to 252Cf based systems. The common problem of high count-rate at the detector, and therefore high nitrogen region of interest background due to pile-up, is decreased by using a set of smaller (5.1 cm diameter x 10.2 cm long) NaI(Tl) detectors instead of large ones. The facility described presents a relative error of nitrogen measurement of 3.6% and a nitrogen to background ratio of 2.3 for 0.45 mSv skin dose (assuming ten 5.1 cm x 10.2 cm NaI(Tl) detectors).

  20. Design studies related to an in vivo neutron activation analysis facility for measuring total body nitrogen

    Energy Technology Data Exchange (ETDEWEB)

    Stamatelatos, I.E.M.; Chettle, D.R.; Green, S.; Scott, M.C. (Birmingham Univ. (United Kingdom). School of Physics and Space Research)

    1992-08-01

    Design studies relating to an in vivo prompt capture neutron activation analysis facility measuring total body nitrogen are presented. The basis of the design is a beryllium-graphite neutron collimator and reflector configuration for ({alpha}, n) type radionuclide neutron sources ({sup 238}PuBe or {sup 241}AmBe), so as to reflect leaking, or out-scattered, neutrons towards the subject. This improves the ratio of thermal neutron flux to dose and the spatial distribution of thermal flux achieved with these sources, whilst retaining their advantage of long half-lives as compared to {sup 252}Cf based systems. The common problem of high count-rate at the detector, and therefore high nitrogen region of interest background due to pile-up, is decreased by using a set of smaller (5.1 cm diameter x 10.2 cm long) NaI(Tl) detectors instead of large ones. The facility described presents a relative error of nitrogen measurement of 3.6% and a nitrogen to background ratio of 2.3 for 0.45 mSv skin dose (assuming ten 5.1 cm x 10.2 cm NaI(Tl) detectors). (author).

  1. Integrating Health Belief Model and Technology Acceptance Model: An Investigation of Health-Related Internet Use

    Science.gov (United States)

    2015-01-01

    Background Today, people use the Internet to satisfy health-related information and communication needs. In Malaysia, Internet use for health management has become increasingly significant due to the increase in the incidence of chronic diseases, in particular among urban women and their desire to stay healthy. Past studies adopted the Technology Acceptance Model (TAM) and Health Belief Model (HBM) independently to explain Internet use for health-related purposes. Although both the TAM and HBM have their own merits, independently they lack the ability to explain the cognition and the related mechanism in which individuals use the Internet for health purposes. Objective This study aimed to examine the influence of perceived health risk and health consciousness on health-related Internet use based on the HBM. Drawing on the TAM, it also tested the mediating effects of perceived usefulness of the Internet for health information and attitude toward Internet use for health purposes for the relationship between health-related factors, namely perceived health risk and health consciousness on health-related Internet use. Methods Data obtained for the current study were collected using purposive sampling; the sample consisted of women in Malaysia who had Internet access. The partial least squares structural equation modeling method was used to test the research hypotheses developed. Results Perceived health risk (β=.135, t 1999=2.676) and health consciousness (β=.447, t 1999=9.168) had a positive influence on health-related Internet use. Moreover, perceived usefulness of the Internet and attitude toward Internet use for health-related purposes partially mediated the influence of health consciousness on health-related Internet use (β=.025, t 1999=3.234), whereas the effect of perceived health risk on health-related Internet use was fully mediated by perceived usefulness of the Internet and attitude (β=.029, t 1999=3.609). These results suggest the central role of

  2. Delivery Practices and Associated Factors among Mothers Seeking Child Welfare Services in Selected Health Facilities in Nyandarua South District, Kenya

    Directory of Open Access Journals (Sweden)

    Wanjira Carol

    2011-05-01

    Full Text Available Abstract Background A measure of the proportion of deliveries assisted by skilled attendants is one of the indicators of progress towards achieving Millennium Development Goal (MDG 5, which aims at improving maternal health. This study aimed at establishing delivery practices and associated factors among mothers seeking child welfare services at selected health facilities in Nyandarua South district, Kenya to determine whether mothers were receiving appropriate delivery care. Methods A hospital-based cross-sectional survey among women who had recently delivered while in the study area was carried out between August and October 2009. Binary Logistic regression was used to identify factors that predicted mothers' delivery practice. Results Among the 409 mothers who participated in the study, 1170 deliveries were reported. Of all the deliveries reported, 51.8% were attended by unskilled birth attendants. Among the deliveries attended by unskilled birth attendants, 38.6% (452/1170 were by neighbors and/or relatives. Traditional Birth Attendants attended 1.5% (17/1170 of the deliveries while in 11.7% (137/1170 of the deliveries were self administered. Mothers who had unskilled birth attendance were more likely to have Conclusion Among the mothers interviewed, utilization of skilled delivery attendance services was still low with a high number of deliveries being attended by unqualified lay persons. There is need to implement cost effective and sustainable measures to improve the quality of maternal health services with an aim of promoting safe delivery and hence reducing maternal mortality.

  3. Quality of life, health status, and health service utilization related to a new measure of health literacy: FLIGHT/VIDAS.

    Science.gov (United States)

    Ownby, Raymond L; Acevedo, Amarilis; Jacobs, Robin J; Caballero, Joshua; Waldrop-Valverde, Drenna

    2014-09-01

    Researchers have identified significant limitations in some currently used measures of health literacy. The purpose of this paper is to present data on the relation of health-related quality of life, health status, and health service utilization to performance on a new measure of health literacy in a nonpatient population. The new measure was administered to 475 English- and Spanish-speaking community-dwelling volunteers along with existing measures of health literacy and assessments of health-related quality of life, health status, and healthcare service utilization. Relations among measures were assessed via correlations and health status and utilization was tested across levels of health literacy using ANCOVA models. The new health literacy measure is significantly related to existing measures of health literacy as well as to participants' health-related quality of life. Persons with lower levels of health literacy reported more health conditions, more frequent physical symptoms, and greater healthcare service utilization. The new measure of health literacy is valid and shows relations to measures of conceptually related constructs such as quality of life and health behaviors. FLIGHT/VIDAS may be useful to researchers and clinicians interested in a computer administered and scored measure of health literacy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. [Dependent relative: Effects on family health].

    Science.gov (United States)

    Estrada Fernández, M Eugenia; Gil Lacruz, Ana I; Gil Lacruz, Marta; Viñas López, Antonio

    2017-04-18

    The purpose of this work is to analyse the effects on informal caregiver's health and lifestyle when living with a dependent person at home. A comparison will be made between this situation and other situations involving commitment of time and energy, taking into account gender and age differences in each stage of the life cycle. Cross-sectional study analysing secondary data. The method used for collecting information is the computer assisted personal interview carried out in selected homes by the Ministry of Health, Social Services and Equality. The study included 19,351 participants aged over 25 years who completed the 2011-2012 Spanish National Health Survey. This research is based on demographic information obtained from a Spanish National Health Survey (2011/12). Using an empirical framework, the Logit model was select and the data reported as odds ratio. The estimations were repeated independently by sub-groups of age and gender. The study showed that the health of people who share their lives with a dependent person is worse than those who do not have any dependent person at home (they are 5 times at higher risk of developing health problems). The study found that being a woman, advance age, low educational level and does not work, also has an influence. Being a caregiver reduces the likelihood of maintaining a healthy lifestyle through physical exercise, relaxation, or eating a balanced diet. Living with a dependent person reduces the likelihood of maintaining healthy lifestyles and worsens the state of health of family members. Significant differences in gender and age were found. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  5. Absolute and Relative Socioeconomic Health Inequalities across Age Groups.

    Directory of Open Access Journals (Sweden)

    Sander K R van Zon

    Full Text Available The magnitude of socioeconomic health inequalities differs across age groups. It is less clear whether socioeconomic health inequalities differ across age groups by other factors that are known to affect the relation between socioeconomic position and health, like the indicator of socioeconomic position, the health outcome, gender, and as to whether socioeconomic health inequalities are measured in absolute or in relative terms. The aim is to investigate whether absolute and relative socioeconomic health inequalities differ across age groups by indicator of socioeconomic position, health outcome and gender.The study sample was derived from the baseline measurement of the LifeLines Cohort Study and consisted of 95,432 participants. Socioeconomic position was measured as educational level and household income. Physical and mental health were measured with the RAND-36. Age concerned eleven 5-years age groups. Absolute inequalities were examined by comparing means. Relative inequalities were examined by comparing Gini-coefficients. Analyses were performed for both health outcomes by both educational level and household income. Analyses were performed for all age groups, and stratified by gender.Absolute and relative socioeconomic health inequalities differed across age groups by indicator of socioeconomic position, health outcome, and gender. Absolute inequalities were most pronounced for mental health by household income. They were larger in younger than older age groups. Relative inequalities were most pronounced for physical health by educational level. Gini-coefficients were largest in young age groups and smallest in older age groups.Absolute and relative socioeconomic health inequalities differed cross-sectionally across age groups by indicator of socioeconomic position, health outcome and gender. Researchers should critically consider the implications of choosing a specific age group, in addition to the indicator of socioeconomic position and

  6. Herbal therapy and quality of life in hypertension patients at health facilities providing complementary therapy

    Directory of Open Access Journals (Sweden)

    Nurhayati Nurhayati

    2016-07-01

    -sectional study used a of data from medical records in hypertension subjects health care facilities in provinces of: DKI Jakarta, Central Java, West Java, East Java, Bali, Banten, and South Sumatra which used complementary medicine for treatment patients. The interview and recording of patient medical records was done by 77 medical doctors who practicing herbal medicine. The quality of life based on Short Form 36 WHO questionnaire for getting data quality of life of hypertension patients. Risk factors that related to quality of life in hypertension patients were analyzed using Cox regression. Results: Total patients had been collected were 189 subjects. The proportion of those who had good quality of life were 51.9% (97/187. Dominant risk factors related to quality of life in hypertension patients were level of education and type of treatment. Compared with those who had low education level, those who had middle and high education level had 83% more risk to be good quality of life. Furthermore, in terms of type of treatment, those who had pharmaceutical and herbal/traditional had 29% more risk to be good quality of life. Conclusion: Hypertension subjects who had higher level of education and had pharmaceutical and herbal/traditional had more risk to be good quality of life. Keywords: quality of life, hypertension patients 

  7. Coverage and quality of antenatal care provided at primary health care facilities in the 'Punjab' province of 'Pakistan'.

    Directory of Open Access Journals (Sweden)

    Muhammad Ashraf Majrooh

    Full Text Available BACKGROUND: Antenatal care is a very important component of maternal health services. It provides the opportunity to learn about risks associated with pregnancy and guides to plan the place of deliveries thereby preventing maternal and infant morbidity and mortality. In 'Pakistan' antenatal services to rural population are being provided through a network of primary health care facilities designated as 'Basic Health Units and Rural Health Centers. Pakistan is a developing country, consisting of four provinces and federally administered areas. Each province is administratively subdivided in to 'Divisions' and 'Districts'. By population 'Punjab' is the largest province of Pakistan having 36 districts. This study was conducted to assess the coverage and quality antenatal care in the primary health care facilities in 'Punjab' province of 'Pakistan'. METHODS: Quantitative and Qualitative methods were used to collect data. Using multistage sampling technique nine out of thirty six districts were selected and 19 primary health care facilities of public sector (seventeen Basic Health Units and two Rural Health Centers were randomly selected from each district. Focus group discussions and in-depth interviews were conducted with clients, providers and health managers. RESULTS: The overall enrollment for antenatal checkup was 55.9% and drop out was 32.9% in subsequent visits. The quality of services regarding assessment, treatment and counseling was extremely poor. The reasons for low coverage and quality were the distant location of facilities, deficiency of facility resources, indifferent attitude and non availability of the staff. Moreover, lack of client awareness about importance of antenatal care and self empowerment for decision making to seek care were also responsible for low coverage. CONCLUSION: The coverage and quality of the antenatal care services in 'Punjab' are extremely compromised. Only half of the expected pregnancies are enrolled and

  8. Traffic-related air pollution - the health effects scrutinized

    OpenAIRE

    Nijland, M.E.

    2013-01-01

    Numerous studies have been published on the health effects associated with exposure to air pollution. Air pollution is acknowledged as a public health risk and air quality regulations are set for specific air pollutants to protect human health. A major pollutant, well known for its adverse health impact, is particulate matter (PM) of which road traffic is a major source. Therefore, the health effects of traffic-related air pollution have been under considerable scrutiny. We examined in vivo t...

  9. Setting an Example: The Health, Medical Care, and Health-Related Behavior of American Parents.

    Science.gov (United States)

    Zill, Nicholas

    This report details a national survey study of parents, age 54 or younger, living with children under age 18. The study examined parents' physical health status, stress levels and negative feelings, health habits, and access to health care. Findings indicated that one in eight parents reported health problems, with health related to education,…

  10. Differential utilisation of health facilities and services for childbirth in Peninsula Malaysia--the ethnic factor.

    Science.gov (United States)

    Arhsat, H; Tan Boon Ann; Tey Nai Peng

    1985-12-01

    The ethnic factor in the differential utilization of the health facilities in Peninsular Malaysia is examined. Data from the Malaysian Population and Family Survey 1984/85 show that about 45% of the births were delivered in the government hospitals, 15% in the private hospitals/clinics and the remaining 40% were delivered at home. Utilisation of these facilities varies greatly by ethnicity. The Malays have the greatest tendency to choose home delivery (60%), as opposed to institutional delivery (40%). Although urbanization and better socioeconomic conditions have led to an increase in institutional delivery, social customs continue to exert an influence on their behavior in favor of home delivery. Almost all Chinese babies are delivered in hospitals or clinics, with those from the higher social class showing a tendency to resort to the use of private hospitals/clinics for delivery. Indians were the most frequent users of government hospital across nearly all the social strata. While institutional deliveries were all attended by trained personnel, about 71% of the home deliveries were attended by government midwives and 24% by village midwives or other untrained persons, and only 5% were delivered by a doctor or a nurse.

  11. DOE standard: Integration of environment, safety, and health into facility disposition activities. Volume 1: Technical standard

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-05-01

    This Department of Energy (DOE) technical standard (referred to as the Standard) provides guidance for integrating and enhancing worker, public, and environmental protection during facility disposition activities. It provides environment, safety, and health (ES and H) guidance to supplement the project management requirements and associated guidelines contained within DOE O 430.1A, Life-Cycle Asset Management (LCAM), and amplified within the corresponding implementation guides. In addition, the Standard is designed to support an Integrated Safety Management System (ISMS), consistent with the guiding principles and core functions contained in DOE P 450.4, Safety Management System Policy, and discussed in DOE G 450.4-1, Integrated Safety Management System Guide. The ISMS guiding principles represent the fundamental policies that guide the safe accomplishment of work and include: (1) line management responsibility for safety; (2) clear roles and responsibilities; (3) competence commensurate with responsibilities; (4) balanced priorities; (5) identification of safety standards and requirements; (6) hazard controls tailored to work being performed; and (7) operations authorization. This Standard specifically addresses the implementation of the above ISMS principles four through seven, as applied to facility disposition activities.

  12. Why some women fail to give birth at health facilities: a qualitative study of women’s perceptions of perinatal care from rural Southern Malawi

    Directory of Open Access Journals (Sweden)

    Kumbani Lily

    2013-02-01

    Full Text Available Abstract Background Despite Malawi government’s policy to support women to deliver in health facilities with the assistance of skilled attendants, some women do not access this care. Objective The study explores the reasons why women delivered at home without skilled attendance despite receiving antenatal care at a health centre and their perceptions of perinatal care. Methods A descriptive study design with qualitative data collection and analysis methods. Data were collected through face-to-face in-depth interviews using a semi- structured interview guide that collected information on women’s perception on perinatal care. A total of 12 in- depth interviews were conducted with women that had delivered at home in the period December 2010 to March 2011. The women were asked how they perceived the care they received from health workers before, during, and after delivery. Data were manually analyzed using thematic analysis. Results Onset of labor at night, rainy season, rapid labor, socio-cultural factors and health workers’ attitudes were related to the women delivering at home. The participants were assisted in the delivery by traditional birth attendants, relatives or neighbors. Two women delivered alone. Most women went to the health facility the same day after delivery. Conclusions This study reveals beliefs about labor and delivery that need to be addressed through provision of appropriate perinatal information to raise community awareness. Even though, it is not easy to change cultural beliefs to convince women to use health facilities for deliveries. There is a need for further exploration of barriers that prevent women from accessing health care for better understanding and subsequently identification of optimal solutions with involvement of the communities themselves.

  13. ON HEALTH PROTECTION AND HEALTH RELATED PHYSICAL CULTURE TRAININGS OF FIRST YEAR STUDENTS

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    V.G. Fotynyuk

    2017-01-01

    Full Text Available Purpose: to assess health protection and health related physical culture trainings of first year students. Material: in the research first year students (n=121; 86 boys and 35girls of age 16 - 19 years, participated. Results: components of students’ individual health were found. Situation with health related physical culture trainings, ensuring students’ sound health and optimal functional potentials of their organisms were determined. It was found that leading role shall be played by formation of health world vision values, knowledge about formation of practical skills in healthy life style. Motivation tendency for realization of intentions and practicing of health related physical culture trainings were found in students. Conclusions: the received results prove students’ tendency to pay insufficient attention to individual health. It was found that health related physical culture trainings require modern renewal of education’s content, forms and methods of physical education. The basis of such trainings shall be health related orientation.

  14. Health related quality of life among insulin-dependent diabetics

    DEFF Research Database (Denmark)

    Aalto, A M; Uutela, A; Aro, A R

    1997-01-01

    This crossectional questionnaire study examined the associations of health factors and psychosocial factors with Health Related Quality of Life (HRQOL) in a sample of adult type I diabetic patients (n = 385). Health related quality of life was measured by the Finnish version of MOS SF-20....... Psychosocial measures were general social support, diabetes-specific social support, diabetes locus of control (DCL), self-efficacy, diabetes health beliefs and self-care practices. In multivariate analyses, limitations in physical functioning showed strong associations with perceived health (beta = -0.33, P...... diabetes and glycemic control were not related to HRQOL...

  15. Why is polypharmacy increasing in aged care facilities? The views of Australian health care professionals.

    Science.gov (United States)

    Jokanovic, Natali; Tan, Edwin C K; Dooley, Michael J; Kirkpatrick, Carl M; Elliott, Rohan A; Bell, J Simon

    2016-10-01

    The prevalence of polypharmacy in residential aged care facilities (RACFs) is high and increasing. Although not necessarily inappropriate, polypharmacy has been associated with drug interactions, adverse drug events, geriatric syndromes and hospital admissions. The aim of this study was to identify and prioritize factors contributing to the increasing prevalence of polypharmacy in RACFs. Seventeen health care professionals from metropolitan and regional Victoria and South Australia identified and prioritized factors using a modified nominal group technique. The top five factors ranked from most important to fifth most important were 'changes in resident mix', 'increasing numbers of prescribers and the reluctance of one prescriber to discontinue a medicine commenced by another prescriber', 'better adherence to clinical practice guidelines', 'increasing reliance on locums' and 'greater recognition and pharmacological management of pain'. Reasons for the increase in polypharmacy are multifactorial. Understanding the factors contributing to polypharmacy may help to guide future research and develop interventions to manage polypharmacy in RACFs. © 2016 John Wiley & Sons, Ltd.

  16. Building capacity in health facility management: guiding principles for skills transfer in Liberia

    Directory of Open Access Journals (Sweden)

    Dahn Bernice T

    2010-03-01

    Full Text Available Abstract Background Management training is fundamental to developing human resources for health. Particularly as Liberia revives its health delivery system, facility and county health team managers are central to progress. Nevertheless, such management skills are rarely prioritized in health training, and sustained capacity building in this area is limited. We describe a health management delivery program in which a north and south institution collaborated to integrate classroom and field-based training in health management and to transfer the capacity for sustained management development in Liberia. Methods We developed and implemented a 6-month training program in health management skills (i.e. strategic problem solving, financial management, human resource management and leadership delivered by Yale University and Mother Patern College from Liberia, with support from the Clinton HIV/AIDS Initiative. Over three 6-month cycles, responsibility for course instruction was transferred from the north institution to the south institution. A self-administered survey was conducted of all participants completing the course to measure changes in self-rated management skills, the degree to which the course was helpful and met its stated objectives, and faculty members' responsiveness to participant needs as the transfer process occurred. Results Respondents (n = 93, response rate 95.9% reported substantial improvement in self-reported management skills, and rated the helpfulness of the course and the degree to which the course met its objectives highly. Levels of improvement and course ratings were similar over the three cohorts as the course was transferred to the south institution. We suggest a framework of five elements for implementing successful management training programs that can be transferred and sustained in resource-limited settings, including: 1 use a short-course format focusing on four key skill areas with practical tools; 2 include

  17. Characteristics and Factors Associated With Antihypertensive Medication Use in Patients Attending Peruvian Health Facilities

    Science.gov (United States)

    Mejia, Christian R; Failoc-Rojas, Virgilio E; Cervantes, Carmen; Aspajo, Antonio J; Leandro, Jesus Galileo; Cordova-De La Cruz, Jhomar; Charri, Julio C; García-Auqui, Kevin E; Coronel-Chucos, Lelis Gabriela; Justo-Pinto, Luz Delia; Mamani-Apaza, Marisol Stefanie; Paz-Campos, Neil Arón; Correa, Ricardo

    2017-01-01

    Introduction  Hypertension is a very common disease worldwide, and medication is needed to prevent its short-term and long-term complications. Our objective was to determine the characteristics and factors associated with antihypertensive medication use in patients attending Peruvian health facilities. Materials & Methods We performed a multicenter, cross-sectional study with secondary data. We obtained self-reported antihypertensive medication from patients attending health facilities in 10 departments of Peru. We looked for associations of the antihypertensive treatment according to sociopathological factors and obtained p values using generalized linear models. Results Of the 894 patients with hypertension, 61% (547) were women and 60% (503) were on antihypertensive treatment, of which 82% (389) had monotherapy and 52% (258) had recently taken their medication. Antihypertensive treatment was positively correlated with the patient's age (adjusted prevalence ratio [aPR]: 1.01; 95% confidence interval [CI]: 1.007 to 1.017; p value < 0.001), diabetes (aPR: 1.31; 95% CI: 1.11 to 1.55; p value = 0.001) and cardiovascular disease (aPR: 1.38; 95% CI: 1.26 to 1.51; p value < 0.001). Conversely, the frequency of antihypertensive treatment decreases with physical activity (aPR: 0.80; 95% CI: 0.70 to 0.92; p value = 0.001). Conclusion Patients who have comorbidities and advanced age are more likely to be on antihypertensive treatment. In contrast, patients with increased physical activity have a lower frequency of antihypertensive treatment. It is important to consider these factors for future preventive programs and to improve therapeutic compliance. PMID:28331773

  18. Piloting laboratory quality system management in six health facilities in Nigeria.

    Directory of Open Access Journals (Sweden)

    Henry Mbah

    Full Text Available Achieving accreditation in laboratories is a challenge in Nigeria like in most African countries. Nigeria adopted the World Health Organization Regional Office for Africa Stepwise Laboratory (Quality Improvement Process Towards Accreditation (WHO/AFRO- SLIPTA in 2010. We report on FHI360 effort and progress in piloting WHO-AFRO recognition and accreditation preparedness in six health facility laboratories in five different states of Nigeria.Laboratory assessments were conducted at baseline, follow up and exit using the WHO/AFRO- SLIPTA checklist. From the total percentage score obtained, the quality status of laboratories were classified using a zero to five star rating, based on the WHO/AFRO quality improvement stepwise approach. Major interventions include advocacy, capacity building, mentorship and quality improvement projects.At baseline audit, two of the laboratories attained 1- star while the remaining four were at 0- star. At follow up audit one lab was at 1- star, two at 3-star and three at 4-star. At exit audit, four labs were at 4- star, one at 3-star and one at 2-star rating. One laboratory dropped a 'star' at exit audit, while others consistently improved. The two weakest elements at baseline; internal audit (4% and occurrence/incidence management (15% improved significantly, with an exit score of 76% and 81% respectively. The elements facility and safety was the major strength across board throughout the audit exercise.This effort resulted in measurable and positive impact on the laboratories. We recommend further improvement towards a formal international accreditation status and scale up of WHO/AFRO- SLIPTA implementation in Nigeria.

  19. Examining physicians’ preparedness for tobacco cessation services in India: Findings from primary care public health facilities in two Indian states

    Directory of Open Access Journals (Sweden)

    Rajmohan Panda

    2013-03-01

    Full Text Available BackgroundA total of 275 million tobacco users live throughout India and are in need of tobacco cessation services. However, the preparation of physicians to deliver this service at primary care health facilities remains unknown.AimsThe study aimed to examine the primary care physicians’ preparedness to deliver tobacco cessation services in two Indian states.MethodResearchers surveyed physicians working in primary care public health facilities, primarily in rural areas using a semistructured interview schedule. Physicians’ preparedness was defined in the study as those possessing knowledge of tobacco cessation methods and exhibiting a positive attitude towards the benefits of tobacco cessation counselling as well as being willing to be part of tobacco prevention or cessation program.ResultsOverall only 17% of physicians demonstrated adequate preparation to provide tobacco cessation services at primary care health facilities in both the States. The findings revealed minimal tobacco cessation training during formal medical education (21.3% and on-the-job training (18.9%. Factors, like sex and age of service provider, type of health facility, location of health facility and number of patients attended by the service provider, failed to show significance during bivariate and regression analysis. Preparedness was significantly predicted by state health system.ConclusionThe study highlights a lack of preparedness of primary care physicians to deliver tobacco cessation services. Both the curriculum in medical school and on-the-job training require an addition of a learning component on tobacco cessation. The addition of this component will enable existing primary care facilities to deliver tobacco cessation services.

  20. Health-related ad information and health motivation effects on product evaluations

    DEFF Research Database (Denmark)

    Chrysochou, Polymeros; Grunert, Klaus G

    2014-01-01

    This study tests the effect of health-related ad information on perceived product healthfulness and purchase intention. Also, the study investigates whether consumers' health motivation moderates the effects, because of the way health motivation affects processing of health-related information...... in ads. Three types of healthrelated ad elements are distinguished: functional claims, process claims and health imagery. These elements were combined in mock ads and an online experiment was run to test the study hypotheses. Results show that health imagery has the largest impact on consumers' product...... evaluations, while functional claims and process claims have much smaller effects. Health motivation shows significant interaction with process claims on product evaluations....

  1. Parenting style, parenting stress, and children's health-related behaviors.

    Science.gov (United States)

    Park, Hyunjeong; Walton-Moss, Benita

    2012-07-01

    Parental guidance is critical to the development of children's health-related behaviors. The purpose of this study was to look at the relationship between parenting factors, including parenting style and parenting stress, and children's health-related behaviors. In this descriptive, correlational study, 284 parents of preschool children were interviewed using the Child Rearing Questionnaire and the Korean Parenting Stress Index-Short Form. Parent distress, authoritative and permissive parenting styles, family income, and mother's education were significantly associated with children's health-related behaviors. These findings suggest that higher levels of warmth, characteristics of both parenting styles, may be a critical factor in the development of health-related behaviors.

  2. Approaches towards a regional, shared electronic patient record for health care facilities of different health care organizations--IT-strategy and first results.

    Science.gov (United States)

    Schabetsberger, Thomas; Gross, Erich; Haux, Reinhold; Lechleitner, Georg; Pellizzari, Thomas; Schindelwig, Klaus; Stark, Christian; Vogl, Raimund; Wilhelmy, Immanuel

    2004-01-01

    Today, information processing in healthcare facilities is usually primarily directed towards the information needs of the respective institution. This stands in apparent contradiction to the fact that patients may not be solely treated in one general practice or hospital. More information processing towards patient-centered, shared care would better support high quality as well as efficient health care. We developed a stepwise approach transforming trans-institutional information system architectures (TISAs) from an inefficient state caused by redundancy and media cracks towards a state which better supports patient centered, shared care. In a total of three steps we want to establish electronic communication between existing information systems of different healthcare facilities for transmission of discharge summaries and diagnostic results. In further stages we plan to expand this communication solution to a regional comprehensive and consistent electronic patient record for multiple hospitals and general practices in Tyrol, Austria. In addition, two related approaches towards supporting shared care have been compared with our approach. The aim of this paper is to report on our approach and first experiences.

  3. Quality of antenatal and childbirth care in rural health facilities in Burkina Faso, Ghana and Tanzania: an intervention study.

    Science.gov (United States)

    Duysburgh, Els; Temmerman, Marleen; Yé, Maurice; Williams, Afua; Massawe, Siriel; Williams, John; Mpembeni, Rose; Loukanova, Svetla; Haefeli, Walter E; Blank, Antje

    2016-01-01

    To assess the impact of an intervention consisting of a computer-assisted clinical decision support system and performance-based incentives, aiming at improving quality of antenatal and childbirth care. Intervention study in rural primary healthcare (PHC) facilities in Burkina Faso, Ghana and Tanzania. In each country, six intervention and six non-intervention PHC facilities, located in one intervention and one non-intervention rural districts, were selected. Quality was assessed in each facility by health facility surveys, direct observation of antenatal and childbirth care, exit interviews, and reviews of patient records and maternal and child health registers. Findings of pre- and post-intervention and of intervention and non-intervention health facility quality assessments were analysed and assessed for significant (P < 0.05) quality of care differences. Post-intervention quality scores do not show a clear difference to pre-intervention scores and scores at non-intervention facilities. Only a few variables had a statistically significant better post-intervention quality score and when this is the case this is mostly observed in only one study-arm, being pre-/post-intervention or intervention/non-intervention. Post-intervention care shows similar deficiencies in quality of antenatal and childbirth care and in detection, prevention, and management of obstetric complications as at baseline and non-intervention study facilities. Our intervention study did not show a significant improvement in quality of care during the study period. However, the use of new technology seems acceptable and feasible in rural PHC facilities in resource-constrained settings, creating the opportunity to use this technology to improve quality of care. © 2015 John Wiley & Sons Ltd.

  4. Job Burnout, Job Satisfaction, and Related Factors among Health Care Workers in Golestan Province, Iran

    Science.gov (United States)

    Kabir, Mohammad Javad; Heidari, Alireza; Etemad, Koorosh; Gashti, Ashrafi Babazadeh; Jafari, Nahid; Honarvar, Mohammad Reza; Ariaee, Mohammad; Lotfi, Mansureh

    2016-01-01

    Introduction Burnout causes physical and emotional tireness, job dissatisfaction, resulting in reduced efficiency and a feeling of alienation from colleagues. Also, job satisfaction has a major impact on job-related behaviors, such as turnover intention, absenteeism, and job performance. The aim of this study was to determine job burnout, job satisfaction rate, and related factors among health care workers in Golestan Province in Iran. Methods This cross-sectional study was conducted with 1,141 health workers in Golestan Province in northern Iran. Data were collected using a questionnaire that was comprised of four sections. It consisted of socio-economic characteristics, physical environment and facilities of health house (rural health clinic), Maslach burnout inventory, and a satisfaction questionnaire. Multi-nomial Logistic Regression was conducted to analyze the data using SPSS software, version 22. Results There were significant relationships between the intensity of job burnout and age (p education level (p = 0.027), number of children (p = 0.002), dissatisfaction with income (p education level (p = 0.016), number of children (p = 0.003), dissatisfaction with income (p < 0.001), and the physical environment of health houses (p = 0.008). There were significant relationships between job satisfaction and the satisfaction from income (p = 0.001), the physical environment of health houses (p = 0.001), and the facilities of health houses (p = 0.001). Conclusion Burnout was average among health workers, and health workers job satisfaction rate was lower than the average level in health workers. Effective interventions are recommended with regards to the unfavorable condition of job satisfaction and its relationship with job burnout.

  5. School-Based Health Education Programmes, Health-Learning Capacity and Child Oral Health--related Quality of Life

    Science.gov (United States)

    Freeman, Ruth; Gibson, Barry; Humphris, Gerry; Leonard, Helen; Yuan, Siyang; Whelton, Helen

    2016-01-01

    Objective: To use a model of health learning to examine the role of health-learning capacity and the effect of a school-based oral health education intervention (Winning Smiles) on the health outcome, child oral health-related quality of life (COHRQoL). Setting: Primary schools, high social deprivation, Ireland/Northern Ireland. Design: Cluster…

  6. Health-related internet habits and health anxiety in university students.

    Science.gov (United States)

    Singh, Karmpaul; Brown, Richard J

    2014-01-01

    Health-related Internet use has grown rapidly, yet little research has considered how health anxious individuals use the Internet for this purpose. Our aim was to examine the relationships between health anxiety and the extent of, reasons for, and consequences of health-related Internet usage in university students (n = 255). Responses on a purpose-made Internet use questionnaire were correlated with health anxiety scores; multiple regression analyses controlling for depression and anxiety were also conducted. Health anxiety positively correlated with (all ps < .01): frequency of health-related searching (r(s) = .163), proportion of health-related information sought (r(s) = .200), time spent online for health purposes (r(s) = .166), and number of searches for both illness (r(s) = .453) and wellness (r(s) = .208) information. Health anxiety further positively correlated with advantages perceived in health-related Internet use (r(s) = .183), heightened tension (r(s) = .364) and relief (r(s) = .174) post-search, and perceived doctor disadvantages (r(s) = .306), yet a greater likelihood to visit a doctor post-search (r(s) = .217). Health anxiety also correlated with six measures of possible addiction to using the Internet for health purposes (r(s) range = .171 to .366, all ps < .01). Some (including several potentially dysfunctional) aspects of health-related Internet use correlate with health anxiety. Research evaluating the possible role of Internet use in the development and maintenance of health anxiety is warranted.

  7. Status of the implementation of the World Health Organization multimodal hand hygiene strategy in United States of America health care facilities

    Science.gov (United States)

    Allegranzi, Benedetta; Conway, Laurie; Larson, Elaine; Pittet, Didier

    2014-01-01

    Background The World Health Organization (WHO) launched a multimodal strategy and campaign in 2009 to improve hand hygiene practices worldwide. Our objective was to evaluate the implementation of the strategy in United States health care facilities. Methods From July through December 2011, US facilities participating in the WHO global campaign were invited to complete the Hand Hygiene Self-Assessment Framework online, a validated tool based on the WHO multimodal strategy. Results Of 2,238 invited facilities, 168 participated in the survey (7.5%). A detailed analysis of 129, mainly nonteaching public facilities (80.6%), showed that most had an advanced or intermediate level of hand hygiene implementation progress (48.9% and 45.0%, respectively). The total Hand Hygiene Self-Assessment Framework score was 36 points higher for facilities with staffing levels of infection preventionists > 0.75/100 beds than for those with lower ratios (P = .01) and 41 points higher for facilities participating in hand hygiene campaigns (P = .002). Conclusion Despite the low response rate, the survey results are unique and allow interesting reflections. Whereas the level of progress of most participating facilities was encouraging, this may reflect reporting bias, ie, better hospitals more likely to report. However, even in respondents, further improvement can be achieved, in particular by embedding hand hygiene in a stronger institutional safety climate and optimizing staffing levels dedicated to infection prevention. These results should encourage the launch of a coordinated national campaign and higher participation in the WHO global campaign. PMID:24581011

  8. Environmental Management Waste Management Facility (EMWMF) Site-Specific Health and Safety Plan, Oak Ridge, Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    Flynn, N.C. Bechtel Jacobs

    2008-04-21

    The Bechtel Jacobs Company LLC (BJC) policy is to provide a safe and healthy workplace for all employees and subcontractors. The implementation of this policy requires that operations of the Environmental Management Waste Management Facility (EMWMF), located one-half mile west of the U.S. Department of Energy (DOE) Y-12 National Security Complex, be guided by an overall plan and consistent proactive approach to environment, safety and health (ES&H) issues. The BJC governing document for worker safety and health, BJC/OR-1745, 'Worker Safety and Health Program', describes the key elements of the BJC Safety and Industrial Hygiene (IH) programs, which includes the requirement for development and implementation of a site-specific Health and Safety Plan (HASP) where required by regulation (refer also to BJC-EH-1012, 'Development and Approval of Safety and Health Plans'). BJC/OR-1745, 'Worker Safety and Health Program', implements the requirements for worker protection contained in Title 10 Code of Federal Regulations (CFR) Part 851. The EMWMF site-specific HASP requirements identifies safe operating procedures, work controls, personal protective equipment, roles and responsibilities, potential site hazards and control measures, site access requirements, frequency and types of monitoring, site work areas, decontamination procedures, and outlines emergency response actions. This HASP will be available on site for use by all workers, management and supervisors, oversight personnel and visitors. All EMWMF assigned personnel will be briefed on the contents of this HASP and will be required to follow the procedures and protocols as specified. The policies and procedures referenced in this HASP apply to all EMWMF operations activities. In addition the HASP establishes ES&H criteria for the day-to-day activities to prevent or minimize any adverse effect on the environment and personnel safety and health and to meet standards that define acceptable

  9. The state of emergency obstetric care services in Nairobi informal settlements and environs: Results from a maternity health facility survey

    Directory of Open Access Journals (Sweden)

    Saliku Teresa

    2009-03-01

    Full Text Available Abstract Background Maternal mortality in Sub-Saharan Africa remains a challenge with estimates exceeding 1,000 maternal deaths per 100,000 live births in some countries. Successful prevention of maternal deaths hinges on adequate and quality emergency obstetric care. In addition to skilled personnel, there is need for a supportive environment in terms of essential drugs and supplies, equipment, and a referral system. Many household surveys report a reasonably high proportion of women delivering in health facilities. However, the quality and adequacy of facilities and personnel are often not assessed. The three delay model; 1 delay in making the decision to seek care; 2 delay in reaching an appropriate obstetric facility; and 3 delay in receiving appropriate care once at the facility guided this project. This paper examines aspects of the third delay by assessing quality of emergency obstetric care in terms of staffing, skills equipment and supplies. Methods We used data from a survey of 25 maternity health facilities within or near two slums in Nairobi that were mentioned by women in a household survey as places that they delivered. Ethical clearance was obtained from the Kenya Medical Research Institute. Permission was also sought from the Ministry of Health and the Medical Officer of Health. Data collection included interviews with the staff in-charge of maternity wards using structured questionnaires. We collected information on staffing levels, obstetric procedures performed, availability of equipment and supplies, referral system and health management information system. Results Out of the 25 health facilities, only two met the criteria for comprehensive emergency obstetric care (both located outside the two slums while the others provided less than basic emergency obstetric care. Lack of obstetric skills, equipment, and supplies hamper many facilities from providing lifesaving emergency obstetric procedures. Accurate estimation of burden

  10. Crises and Resilience at the Frontline—Public Health Facility Managers under Devolution in a Sub-County on the Kenyan Coast

    Science.gov (United States)

    Nyikuri, Mary; Tsofa, Benjamin; Barasa, Edwine; Okoth, Philip; Molyneux, Sassy

    2015-01-01

    Background Public primary health care (PHC) facilities are for many individuals the first point of contact with the formal health care system. These facilities are managed by professional nurses or clinical officers who are recognised to play a key role in implementing health sector reforms and facilitating initiatives aimed at strengthening community involvement. Little in-depth research exists about the dimensions and challenges of these managers’ jobs, or on the impact of decentralisation on their roles and responsibilities. In this paper, we describe the roles and responsibilities of PHC managers–or ‘in-charges’ in Kenya, and their challenges and coping strategies, under accelerated devolution. Methods The data presented in this paper is part of a wider set of activities aimed at understanding governance changes under devolution in Kenya, under the umbrella of a ‘learning site’. A learning site is a long term process of collaboration between health managers and researchers deciding together on key health system questions and interventions. Data were collected through seven formal in depth interviews and observations at four PHC facilities as well as eight in depth interviews and informal interactions with sub-county managers from June 2013 to July 2014. Drawing on the Aragon framework of organisation capacity we discuss the multiple accountabilities, daily routines, challenges and coping strategies among PHC facility managers. Results PHC in-charges perform complex and diverse roles in a difficult environment with relatively little formal preparation. Their key concerns are lack of job clarity and preparedness, the difficulty of balancing multidirectional accountability responsibilities amidst significant resource shortages, and remuneration anxieties. We show that day-to-day management in an environment of resource constraints and uncertainty requires PHC in-charges who are resilient, reflective, and continuously able to learn and adapt. We

  11. Crises and Resilience at the Frontline-Public Health Facility Managers under Devolution in a Sub-County on the Kenyan Coast.

    Directory of Open Access Journals (Sweden)

    Mary Nyikuri

    Full Text Available Public primary health care (PHC facilities are for many individuals the first point of contact with the formal health care system. These facilities are managed by professional nurses or clinical officers who are recognised to play a key role in implementing health sector reforms and facilitating initiatives aimed at strengthening community involvement. Little in-depth research exists about the dimensions and challenges of these managers' jobs, or on the impact of decentralisation on their roles and responsibilities. In this paper, we describe the roles and responsibilities of PHC managers-or 'in-charges' in Kenya, and their challenges and coping strategies, under accelerated devolution.The data presented in this paper is part of a wider set of activities aimed at understanding governance changes under devolution in Kenya, under the umbrella of a 'learning site'. A learning site is a long term process of collaboration between health managers and researchers deciding together on key health system questions and interventions. Data were collected through seven formal in depth interviews and observations at four PHC facilities as well as eight in depth interviews and informal interactions with sub-county managers from June 2013 to July 2014. Drawing on the Aragon framework of organisation capacity we discuss the multiple accountabilities, daily routines, challenges and coping strategies among PHC facility managers.PHC in-charges perform complex and diverse roles in a difficult environment with relatively little formal preparation. Their key concerns are lack of job clarity and preparedness, the difficulty of balancing multidirectional accountability responsibilities amidst significant resource shortages, and remuneration anxieties. We show that day-to-day management in an environment of resource constraints and uncertainty requires PHC in-charges who are resilient, reflective, and continuously able to learn and adapt. We highlight the importance of

  12. Absolute and Relative Socioeconomic Health Inequalities across Age Groups

    NARCIS (Netherlands)

    van Zon, Sander K. R.; Bultmann, Ute; de Leon, Carlos F. Mendes; Reijneveld, Sijmen A.

    2015-01-01

    Background The magnitude of socioeconomic health inequalities differs across age groups. It is less clear whether socioeconomic health inequalities differ across age groups by other factors that are known to affect the relation between socioeconomic position and health, like the indicator of

  13. Health-Related Quality of Life in HIV Disease.

    Science.gov (United States)

    Hays, Ron D.; And Others

    1995-01-01

    The structure of health-related quality of life (HRQOL) in persons with human immunodeficiency virus (HIV) was studied in 205 symptomatic adults. Confirmatory factor analysis supported a two-factor model of HRQOL, with physical and mental health dimensions. Correlations of HRQOL with other aspects of health and support are discussed. (SLD)

  14. Absolute and Relative Socioeconomic Health Inequalities across Age Groups

    NARCIS (Netherlands)

    van Zon, Sander K. R.; Bultmann, Ute; de Leon, Carlos F. Mendes; Reijneveld, Sijmen A.

    2015-01-01

    Background The magnitude of socioeconomic health inequalities differs across age groups. It is less clear whether socioeconomic health inequalities differ across age groups by other factors that are known to affect the relation between socioeconomic position and health, like the indicator of socioec

  15. A bonnet and fluid jet polishing facility for optics fabrication related to the E-ELT

    Science.gov (United States)

    Vecchi, G.; Basso, S.; Civitani, M.; Ghigo, M.; Pareschi, G.; Riva, M.; Zerbi, F. M.

    A robotic polishing machine has been implemented at INAF-Brera Astronomical Observatory within the T-REX project. The facility, IRP1200 by Zeeko Ltd., consists of a 7-axis computer-controlled polishing/forming machine capable of producing precision surfaces on several optical materials. The machine enables two methods, the bonnet and the fluid jet polishing. We report on the results of the standard bonnet polishing machine acceptance tests that have been completed at our site. We intend to use the machine to support development and production programs related to the European Extremely Large Telescope (E-ELT), in particular, for making part of the optics of the Multi-conjugate Adaptive Optics RelaY (MAORY) module.

  16. HealthPaths: Using functional health trajectories to quantify the relative importance of selected health determinants

    Directory of Open Access Journals (Sweden)

    Michael Wolfson

    2014-10-01

    Full Text Available Background: It is widely known that that there is a significant dispersion in health status, as well as a strong correlation between health status and socio-economic status. But considerable uncertainty remains as to the quantitative importance of the various explanatory factors typically cited in this context. As health status is intrinsically a reflection of co-evolving dynamic processes, it is important to take a lifetime perspective when seeking to understand its determinants. The "bottom line" measure of overall population health is, though, health-adjusted life expectancy (HALE, which is an aggregation of individuals' health-adjusted life lengths (HALLs. Objective: In an exploratory mode, we intend to provide a realistic assessment of the relative importance of selected health determinants of HALE. Methods: This paper first draws on very detailed estimates of the covariates of vector-valued functional health trajectories, using the National Population Health Survey (Statistics Canada. We then use longitudinal microsimulation to draw out their implications by synthesising first a realistic base case -- specifically, a representative longitudinal population sample -- and then a series of exploratory counterfactual populations. Comparisons between and among counterfactuals and the base case are then used to estimate the quantitative importance of various factors in accounting for HALE. Results: Several surprising results emerged. Of the four risk factors explicitly examined, obesity had the smallest impacts on HALE: moving from the fifth to the 95th percentiles of BMI increased HALE 1.5 and 2.5 years for men and women, respectively. Eliminating smoking increased HALE by five and four years, while moving from the lowest to the highest levels of education had similar effects of about five years for both men and women. Perhaps surprisingly, moving from the fifth to the 95th percentiles of the psycho-social factor, Antonovsky's sense of coherence

  17. Perceived relevance and foods with health-related claims

    DEFF Research Database (Denmark)

    Dean, M.; Lampila, P.; Shepherd, R.

    2012-01-01

    consumers’ responses to health claims that either promise to reduce a targeted disease risk or improve well-being in comparison to other types of health-related messages, and how attitudes towards nutritionally healthy eating, functional food and previous experience relating to products with health claims...... affect the consumers’ perceptions of nutrition and health claims. The data (N = 2385) were collected by paper and pencil surveys in Finland, the UK, Germany and Italy on a target group of consumers over 35 year old, solely or jointly responsible for the family’s food shopping. The results showed...... by health claims consumers also need to have a positive attitude towards functional food products....

  18. Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana.

    Directory of Open Access Journals (Sweden)

    Robert Kaba Alhassan

    Full Text Available Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients' decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will help determine more effective quality improvement interventions and health insurance sustainability strategies, especially in resource constrained countries in Africa where universal access to good quality care remains a challenge.To examine the differences in perceptions of clients and health staff on quality healthcare and determine if these perceptions are associated with technical quality proxies in health facilities. Implications of the findings for a sustainable National Health Insurance Scheme (NHIS in Ghana are also discussed.This is a cross-sectional study in two southern regions in Ghana involving 64 primary health facilities: 1,903 households and 324 health staff. Data collection lasted from March to June, 2012. A Wilcoxon-Mann-Whitney test was performed to determine differences in client and health staff perceptions of quality healthcare. Spearman's rank correlation test was used to ascertain associations between perceived and technical quality care proxies in health facilities, and ordered logistic regression employed to predict the determinants of client and staff-perceived quality healthcare.Negative association was found between technical quality and client-perceived quality care (coef. = -0.0991, p<0.0001. Significant staff-client perception differences were found in all healthcare quality proxies, suggesting some level of unbalanced commitment to quality improvement and potential information asymmetry between clients and service providers. Overall, the findings suggest that increased efforts towards technical quality care alone will not necessarily translate into better client-perceived quality care and willingness to utilize health services in

  19. Determinants of stillbirths occurred in health facilities in Zambezia province, Mozambique (2013-2014

    Directory of Open Access Journals (Sweden)

    Germano Pires

    Full Text Available Abstract Objectives: to identify the determinants of stillbirths in Zambezia province, Mozambique. Methods: a retrospective cross-sectional ecological study was carried out in 2013-2014 by using perinatal indicators captured by the health information system in Zambezia. Sequentially perinatal care indicators, bivariate analysis and multiple adjusted regression at a 5% significance level with possible explainable variables of stillbirths were described. Results: a median proportion of stillbirths was 1.6%, low birth weight and preterm birth and obstetric complications were 4.9%, 1.9% and 4.1%, respectively. The bivariate analysis demonstrated association of stillbirths with anemia (p=0.043, antepartum hemorrhage (p=0.009, dystocic delivery (p<0.001, obstructed labor (p=0.004. In the analysis of multiple adjusted regression, the obstructed labor were a predictor (ß=0.435; p=0.03 to stillbirths Conclusions: the most important factor associated to stillbirths in health facilities in Zambezia province in 2013-2014 was the obstructed labor. The strengthening of diagnostic analysis and the attempt to handle obstetric complications is still a priority in Zambezia, in being able to decrease the avoidable perinatal deaths.

  20. Perceived Barriers to Utilizing Maternal and Neonatal Health Services in Contracted-Out Versus Government-Managed Health Facilities in the Rural Districts of Pakistan

    Directory of Open Access Journals (Sweden)

    Atif Riaz

    2015-05-01

    Full Text Available Background A number of developing countries have contracted out public health facilities to the Non-Government Organizations (NGOs in order to improve service utilization. However, there is a paucity of in-depth qualitative information on barriers to access services as a result of contracting from service users’ perspective. The objective of this study was to explore perceived barriers to utilizing Maternal and Neonatal Health (MNH services, in health facilities contracted out by government to NGO for service provision versus in those which are managed by government (non-contracted. Methods A community-based qualitative exploratory study was conducted between April to September 2012 at two contracted-out and four matched non-contracted primary healthcare facilities in Thatta and Chitral, rural districts of Pakistan. Using semi-structured guide, the data were collected through thirty-six Focus Group Discussions (FGDs conducted with mothers and their spouses in the catchment areas of selected facilities. Thematic analysis was performed using NVivo version 10.0 in which themes and sub-themes emerged. Results Key barriers reported in contracted sites included physical distance, user charges and familial influences. Whereas, poor functionality of health centres was the main barrier for non-contracted sites with other issues being comparatively less salient. Decision-making patterns for participants of both catchments were largely similar. Spouses and mother-in-laws particularly influenced the decision to utilize health facilities. Conclusion Contracting out of health facility reduces supply side barriers to MNH services for the community served but distance, user charges and low awareness remain significant barriers. Contracting needs to be accompanied by measures for transportation in remote settings, oversight on user fee charges by contractor, and strong communitybased behavior change strategies.

  1. Health locus of control, acculturation, and health-related Internet use among Latinas.

    Science.gov (United States)

    Roncancio, Angelica M; Berenson, Abbey B; Rahman, Mahbubur

    2012-01-01

    Among individuals residing in the United States, the Internet is the third most used source for obtaining health information. Little is known, however, about its use by Latinas. To understand health-related Internet use among Latinas, the authors examined it within the theoretical frameworks of health locus of control and acculturation. The authors predicted that acculturation would serve as a mediator between health locus of control and health-related Internet use, age and health-related Internet use, income and health-related Internet use, and education and health-related Internet use. Data were collected via a 25-minute self-report questionnaire. The sample consisted of 932 young (M age = 21.27 years), low-income Latinas. Using structural equation modeling, the authors observed that acculturation partially mediated the relation between health locus of control and health-related Internet use and fully mediated the relations among age, income, and Internet use. An internal health locus of control (p Internet use. The Internet is a powerful tool that can be used to effectively disseminate information to Latinas with limited access to health care professionals. These findings can inform the design of Internet-based health information dissemination studies targeting Latinas.

  2. Do Health-Related Feared Possible Selves Motivate Healthy Eating?

    Science.gov (United States)

    Noureddine, Samar; Metzger, Bonnie

    2014-01-13

    The question of what motivates individuals to assume healthy eating habits remains unanswered. The purpose of this descriptive survey is to explore health-related feared possible selves in relation to dietary beliefs and behavior in adults. A convenience sample of 74 middle-aged employees of a health maintenance organization completed self-administered questionnaires. Health-related feared selves, current health perception, knowledge of diet-health association, dietary self-efficacy, dietary intention and intake were measured. Health-related fears were the most frequently reported feared selves, but very few of those represented illnesses and none were related to dietary intake. The number of health and body weight related fears was significantly associated with lower dietary self-efficacy and weaker intention to eat in a healthy manner. Multivariate analysis showed self-efficacy to be the only significant predictor of dietary intention. These adults may not have perceived being at risk for diet-associated illnesses, and so their feared selves did not motivate them to eat in a healthy manner. Research on the effect of hoped for health related possible selves and the perceived effectiveness of diet in reducing health risk are recommended.

  3. Assessing the potential of rural and urban private facilities in implementing child health interventions in Mukono district, central Uganda

    DEFF Research Database (Denmark)

    Rutebemberwa, Elizeus; Buregyeya, Esther; Lal, Sham;

    2016-01-01

    clinicians, less likely to have people with tertiary education (OR 0.34; 95 % CI 0.17-0.66) and less likely to have zinc tablets (OR 0.38; 95 % CI 0.19-0.78). In both urban and rural areas, there was low usage of stock cards and patient registers. About half of the facilities in both rural and urban areas...... keeping, essential drugs for the treatment of malaria, pneumonia and diarrhoea; the sex, level of education, professional and in-service training of the persons found attending to patients in these facilities. A comparison was made between urban and rural facilities. Univariate and bivariate analysis...... attended to at least one sick child in the week prior to the interview. CONCLUSION: There were big gaps between rural and urban private facilities with rural ones having less trained personnel and less zinc tablets' availability. In both rural and urban areas, record keeping was low. Child health...

  4. Women's education level, maternal health facilities, abortion legislation and maternal deaths: a natural experiment in Chile from 1957 to 2007.

    Directory of Open Access Journals (Sweden)

    Elard Koch

    Full Text Available BACKGROUND: The aim of this study was to assess the main factors related to maternal mortality reduction in large time series available in Chile in context of the United Nations' Millennium Development Goals (MDGs. METHODS: Time series of maternal mortality ratio (MMR from official data (National Institute of Statistics, 1957-2007 along with parallel time series of education years, income per capita, fertility rate (TFR, birth order, clean water, sanitary sewer, and delivery by skilled attendants were analysed using autoregressive models (ARIMA. Historical changes on the mortality trend including the effect of different educational and maternal health policies implemented in 1965, and legislation that prohibited abortion in 1989 were assessed utilizing segmented regression techniques. RESULTS: During the 50-year study period, the MMR decreased from 293.7 to 18.2/100,000 live births, a decrease of 93.8%. Women's education level modulated the effects of TFR, birth order, delivery by skilled attendants, clean water, and sanitary sewer access. In the fully adjusted model, for every additional year of maternal education there was a corresponding decrease in the MMR of 29.3/100,000 live births. A rapid phase of decline between 1965 and 1981 (-13.29/100,000 live births each year and a slow phase between 1981 and 2007 (-1.59/100,000 live births each year were identified. After abortion was prohibited, the MMR decreased from 41.3 to 12.7 per 100,000 live births (-69.2%. The slope of the MMR did not appear to be altered by the change in abortion law. CONCLUSION: Increasing education level appears to favourably impact the downward trend in the MMR, modulating other key factors such as access and utilization of maternal health facilities, changes in women's reproductive behaviour and improvements of the sanitary system. Consequently, different MDGs can act synergistically to improve maternal health. The reduction in the MMR is not related to the legal

  5. Women's education level, maternal health facilities, abortion legislation and maternal deaths: a natural experiment in Chile from 1957 to 2007.

    Science.gov (United States)

    Koch, Elard; Thorp, John; Bravo, Miguel; Gatica, Sebastián; Romero, Camila X; Aguilera, Hernán; Ahlers, Ivonne

    2012-01-01

    The aim of this study was to assess the main factors related to maternal mortality reduction in large time series available in Chile in context of the United Nations' Millennium Development Goals (MDGs). Time series of maternal mortality ratio (MMR) from official data (National Institute of Statistics, 1957-2007) along with parallel time series of education years, income per capita, fertility rate (TFR), birth order, clean water, sanitary sewer, and delivery by skilled attendants were analysed using autoregressive models (ARIMA). Historical changes on the mortality trend including the effect of different educational and maternal health policies implemented in 1965, and legislation that prohibited abortion in 1989 were assessed utilizing segmented regression techniques. During the 50-year study period, the MMR decreased from 293.7 to 18.2/100,000 live births, a decrease of 93.8%. Women's education level modulated the effects of TFR, birth order, delivery by skilled attendants, clean water, and sanitary sewer access. In the fully adjusted model, for every additional year of maternal education there was a corresponding decrease in the MMR of 29.3/100,000 live births. A rapid phase of decline between 1965 and 1981 (-13.29/100,000 live births each year) and a slow phase between 1981 and 2007 (-1.59/100,000 live births each year) were identified. After abortion was prohibited, the MMR decreased from 41.3 to 12.7 per 100,000 live births (-69.2%). The slope of the MMR did not appear to be altered by the change in abortion law. Increasing education level appears to favourably impact the downward trend in the MMR, modulating other key factors such as access and utilization of maternal health facilities, changes in women's reproductive behaviour and improvements of the sanitary system. Consequently, different MDGs can act synergistically to improve maternal health. The reduction in the MMR is not related to the legal status of abortion.

  6. Mental health related Internet use among psychiatric patients

    OpenAIRE

    2015-01-01

    Background: The Internet is of great importance in today’s health sector, as most Internet users utilize online functions for health related purposes. Concerning the mental health care sector, little data exist about the Internet use of psychiatric patients. It is the scope of this current study to analyze the quantity and pattern of Internet usage among mental health patients. Methods: Patients from all services of the Department of Psychiatry at a university hospital were surveyed by comple...

  7. The Relation of Socio-Ecological Factors to Adolescents' Health-Related Behaviour: A Literature Review

    Science.gov (United States)

    Aura, Annamari; Sormunen, Marjorita; Tossavainen, Kerttu

    2016-01-01

    Purpose: The purpose of this paper is to identify and describe adolescents' health-related behaviours from a socio-ecological perspective. Socio-ecological factors have been widely shown to be related to health behaviours (smoking, alcohol consumption, physical activity and diet) in adolescence and to affect health. The review integrates evidence…

  8. Controlling alcohol-related global health problems.

    Science.gov (United States)

    Lam, Tai Hing; Chim, David

    2010-07-01

    Alcohol's adverse public health impact includes disease, injury, violence, disability, social problems, psychiatric illness, drunk driving, drug use, unsafe sex, and premature death. Furthermore, alcohol is a confirmed human carcinogen. The International Agency for Research on Cancer concluded that alcohol causes cancer of the oral cavity, pharynx, larynx, esophagus, liver, colon-rectum, and breast. World Cancer Research Fund/American Institute for Cancer Research concluded that the evidence justifies recommending avoidance of consuming any alcohol, even in small quantities. Despite being responsible for 3.8% of global deaths (2,255,000 deaths) and 4.6% of global disability-adjusted life years in 2004, alcohol consumption is increasing rapidly in China and Asia. Contrary to the World Health Assembly's call for global control action, Hong Kong has reduced wine and beer taxes to zero since 2008. An International Framework Convention on Alcohol Control is urgently needed. Increasing alcohol taxation and banning alcohol advertisement and promotion are among the most effective policies.

  9. [Health and health-related behaviors according to sexual attraction and behavior].

    Science.gov (United States)

    Pérez, Glòria; Martí-Pastor, Marc; Gotsens, Mercè; Bartoll, Xavier; Diez, Elia; Borrell, Carme

    2015-01-01

    to Describe perceived health, mental health and certain health-related behaviors according to sexual attraction and behavior in the population residing in Barcelona in 2011. Perceived health, mental health, chronic conditions and health-related behaviors were analyzed in 2675 people aged 15 to 64 years. The Barcelona Health Survey for 2011 was used, which included questions on sexual attraction and behavior. Multivariate robust Poisson regression models were fitted to obtain adjusted prevalence ratios. People feeling same-sex attraction reported a higher prevalence of worse perceived and mental health. These people and those who had had sex with persons of the same sex more frequently reported harmful health-related behaviors. Lesbian, gay, transgender and bisexual people may have health problems that should be explored in depth, prevented, and attended. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  10. Gender relations and health research: a review of current practices

    Directory of Open Access Journals (Sweden)

    Bottorff Joan L

    2011-12-01

    Full Text Available Abstract Introduction The importance of gender in understanding health practices and illness experiences is increasingly recognized, and key to this work is a better understanding of the application of gender relations. The influence of masculinities and femininities, and the interplay within and between them manifests within relations and interactions among couples, family members and peers to influence health behaviours and outcomes. Methods To explore how conceptualizations of gender relations have been integrated in health research a scoping review of the existing literature was conducted. The key terms gender relations, gender interactions, relations gender, partner communication, femininities and masculinities were used to search online databases. Results Through analysis of this literature we identified two main ways gender relations were integrated in health research: a as emergent findings; and b as a basis for research design. In the latter, gender relations are included in conceptual frameworks, guide data collection and are used to direct data analysis. Conclusions Current uses of gender relations are typically positioned within intimate heterosexual couples whereby single narratives (i.e., either men or women are used to explore the influence and/or impact of intimate partner gender relations on health and illness issues. Recommendations for advancing gender relations and health research are discussed. This research has the potential to reduce gender inequities in health.

  11. Accounting for variations in ART program sustainability outcomes in health facilities in Uganda: a comparative case study analysis.

    Science.gov (United States)

    Zakumumpa, Henry; Bennett, Sara; Ssengooba, Freddie

    2016-10-18

    Uganda implemented a national ART scale-up program at public and private health facilities between 2004 and 2009. Little is known about how and why some health facilities have sustained ART programs and why others have not sustained these interventions. The objective of the study was to identify facilitators and barriers to the long-term sustainability of ART programs at six health facilities in Uganda which received donor support to commence ART between 2004 and 2009. A case-study approach was adopted. Six health facilities were purposively selected for in-depth study from a national sample of 195 health facilities across Uganda which participated in an earlier study phase. The six health facilities were placed in three categories of sustainability; High Sustainers (2), Low Sustainers (2) and Non- Sustainers (2). Semi-structured interviews with ART Clinic managers (N = 18) were conducted. Questionnaire data were analyzed (N = 12). Document review augmented respondent data. Based on the data generated, across-case comparative analyses were performed. Data were collected between February and June 2015. Several distinguishing features were found between High Sustainers, and Low and Non-Sustainers' ART program characteristics. High Sustainers had larger ART programs with higher staffing and patient volumes, a broader 'menu' of ART services and more stable program leadership compared to the other cases. High Sustainers associated sustained ART programs with multiple funding streams, robust ART program evaluation systems and having internal and external program champions. Low and Non Sustainers reported similar barriers of shortage and attrition of ART-proficient staff, low capacity for ART program reporting, irregular and insufficient supply of ARV drugs and a lack of alignment between ART scale-up and their for-profit orientation in three of the cases. We found that ART program sustainability was embedded in a complex system involving dynamic interactions

  12. Information technology systems in public sector health facilities in developing countries: the case of South Africa

    Directory of Open Access Journals (Sweden)

    Cline Gregory B

    2013-01-01

    Full Text Available Abstract Background The public healthcare sector in developing countries faces many challenges including weak healthcare systems and under-resourced facilities that deliver poor outcomes relative to total healthcare expenditure. Global references demonstrate that information technology has the ability to assist in this regard through the automation of processes, thus reducing the inefficiencies of manually driven processes and lowering transaction costs. This study examines the impact of hospital information systems implementation on service delivery, user adoption and organisational culture within two hospital settings in South Africa. Methods Ninety-four interviews with doctors, nurses and hospital administrators were conducted in two public sector tertiary healthcare facilities (in two provinces to record end-user perceptions. Structured questionnaires were used to conduct the interviews with both qualitative and quantitative information. Results Noteworthy differences were observed among the three sample groups of doctors, nurses and administrators as well as between our two hospital groups. The impact of automation in terms of cost and strategic value in public sector hospitals is shown to have yielded positive outcomes with regard to patient experience, hospital staff workflow enhancements, and overall morale in the workplace. Conclusion The research provides insight into the reasons for investing in system automation, the associated outcomes, and organisational factors that impact the successful adoption of IT systems. In addition, it finds that sustainable success in these initiatives is as much a function of the technology as it is of the change management function that must accompany the system implementation.

  13. Information technology systems in public sector health facilities in developing countries: the case of South Africa

    Science.gov (United States)

    2013-01-01

    Background The public healthcare sector in developing countries faces many challenges including weak healthcare systems and under-resourced facilities that deliver poor outcomes relative to total healthcare expenditure. Global references demonstrate that information technology has the ability to assist in this regard through the automation of processes, thus reducing the inefficiencies of manually driven processes and lowering transaction costs. This study examines the impact of hospital information systems implementation on service delivery, user adoption and organisational culture within two hospital settings in South Africa. Methods Ninety-four interviews with doctors, nurses and hospital administrators were conducted in two public sector tertiary healthcare facilities (in two provinces) to record end-user perceptions. Structured questionnaires were used to conduct the interviews with both qualitative and quantitative information. Results Noteworthy differences were observed among the three sample groups of doctors, nurses and administrators as well as between our two hospital groups. The impact of automation in terms of cost and strategic value in public sector hospitals is shown to have yielded positive outcomes with regard to patient experience, hospital staff workflow enhancements, and overall morale in the workplace. Conclusion The research provides insight into the reasons for investing in system automation, the associated outcomes, and organisational factors that impact the successful adoption of IT systems. In addition, it finds that sustainable success in these initiatives is as much a function of the technology as it is of the change management function that must accompany the system implementation. PMID:23347433

  14. Perceived job demands relate to self-reported health complaints

    NARCIS (Netherlands)

    Roelen, C.A.M.; Schreuder, K.J.; Koopmans, P.C.; Groothoff, J.W.

    2008-01-01

    Background Illness and illness behaviour are important problems in the Dutch workforce. Illness has been associated with job demands, with high demands relating to poorer health. It has not been reported whether subjective health complaints relate to job demands. Aims To investigate whether perceive

  15. Heritability of health-related quality of life

    DEFF Research Database (Denmark)

    Steenstrup, Troels; Pedersen, Ole Birger; Hjelmborg, Jacob

    2013-01-01

    Aim: The present study aims to estimate the relative importance of genetic and environmental factors for health-related quality of life (HRQL) measured by the 12-item Short-Form Health Survey (SF-12). Methods: The study was based on two Danish twin cohorts (46,417 twin individuals) originating from...

  16. [Confronting the Health-Related Challenges of Climate Change: Nursing Education for the Future].

    Science.gov (United States)

    Wu, Pei-Chih; Lee, Chi-Chen

    2016-08-01

    Climate change is the greatest threat to public health in the 21st century. The increasing health impact of heat waves, the increasing magnitudes and spatial expansions of vector and water-borne diseases epidemics, and the increasing medical burdens of biological allergic illnesses, worsening local air pollution, and other related issues are expected to continue to increase in severity in the near future. All of these issues are global problems that must be faced. Adaptation strategies and action plans related to climate change are needed and emerging. Moreover, integrating the basic concepts, scientific evidences, and new technology into public and professional education systems is already recognized as a priority in the national adaptation program. Nurses stand on the frontlines of medical care and health communication. The integration of climate change and adaptation to climate change into nursing education and training is become increasingly important. This article reviews both the expected health impacts of climate change and the mitigation and adaptation strategies that have been proposed / adopted by medical care facilities around the world. Further, we outline the current, priority needs for action in medical care facilities in Taiwan in order to mitigate and adapt to climate-change-related healthcare issues. Additionally, we present an integrated strategic plan for educating healthcare professionals, including nurse, in the future. We hope that the ideas that are presented in this paper encourage multidisciplinary cooperation and help bridge the gap between technology development and practical application in Taiwan's medical care system.

  17. Classifying substance use disorder treatment facilities with co-located mental health services: A latent class analysis approach.

    Science.gov (United States)

    Mauro, Pia M; Furr-Holden, C Debra; Strain, Eric C; Crum, Rosa M; Mojtabai, Ramin

    2016-06-01

    The Affordable Care Act calls for increased integration and coordination of behavioral health services, as people with co-occurring disorders (CODs), meeting criteria for both substance use and psychiatric disorders, are overrepresented in treatment samples. Nationwide estimates of mental health (MH) service co-location in substance use disorder (SUD) treatment facilities are needed. We empirically derived a multiple-indicator categorization of services for CODs in SUD treatment facilities. We used latent class analysis to categorize 14,037 SUD treatment facilities in the United States and territories included in the 2012 National Survey of Substance Abuse Treatment Services. Latent class indicators included MH screening and diagnosis, MH support services, psychiatric medications, groups for CODs, and psychosocial approaches. Multinomial logistic regression compared facility-identified primary focus (i.e., SUD, MH, mix of SUD-MH, and general/other) and other facility characteristics across classes. A four-class solution was chosen with the following classes: Comprehensive MH/COD Services (25%), MH without COD Services (25%), MH Screening Services (21%), and Limited MH Services (29%). The former two classes with co-located MH services were less likely to report a SUD-primary focus than the latter classes reporting only MH screening or Limited MH Services. Only the Comprehensive MH/COD Services class also had a high probability of providing special groups for CODs. Approximately half of SUD treatment facilities were in classes with co-located mental health services, but only a quarter provided comprehensive COD services. Future studies should assess differences in patient experiences and treatment outcomes across facilities with and without COD services. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Licensed Healthcare Facilities

    Data.gov (United States)

    California Department of Resources — The Licensed Healthcare Facilities point layer represents the locations of all healthcare facilities licensed by the State of California, Department of Health...

  19. Licensed Healthcare Facilities

    Data.gov (United States)

    California Department of Resources — The Licensed Healthcare Facilities point layer represents the locations of all healthcare facilities licensed by the State of California, Department of Health...

  20. Emission Facilities - Erosion & Sediment Control Facilities

    Data.gov (United States)

    NSGIC Education | GIS Inventory — An Erosion and Sediment Control Facility is a DEP primary facility type related to the Water Pollution Control program. The following sub-facility types related to...

  1. Risk Factors for Birth Asphyxia in an Urban Health Facility in Cameroon

    Directory of Open Access Journals (Sweden)

    Andreas CHIABI

    2013-08-01

    Full Text Available How to Cite This Article: Chiabi A, Nguefack S, Mah E, Nodem S, Mbuagbaw L, Mbonda E, Tchokoteu PF, Doh A. Risk Factors for Birth Asphyxia in an Urban Health Facility in Cameroon. Iran J Child Neurol. 2013 Summer; 7(3:46-54.ObjectiveThe World Health Organization (WHO estimates that 4 million children are born with asphyxia every year, of which 1 million die and an equal number survive with severe neurologic sequelae. The purpose of this study was to identify the risk factors of birth asphyxia and the hospital outcome of affected neonates.Materials & MethodsThis study was a prospective case-control study on term neonates in a tertiary hospital in Yaounde, with an Apgar score of < 7 at the 5th minute as the case group, that were matched with neonates with an Apgar score of ≥ 7 at the 5th minute as control group. Statistical analysis of relevant variables of the mother and neonates was carried out to determine the significant risk factors.ResultsThe prevalence of neonatal asphyxia was 80.5 per 1000 live births. Statistically significant risk factors were the single matrimonial status, place of antenatal visits, malaria, pre-eclampsia/eclampsia, prolonged labor, arrest of labour,prolonged rupture of membranes, and non-cephalic presentation. Hospital mortality was 6.7%, that 12.2% of them had neurologic deficits and/or abnormal transfontanellar ultrasound/electroencephalogram on discharge, and 81.1% hada satisfactory outcome.ConclusionThe incidence of birth asphyxia in this study was 80.5% per1000 live birth with a mortality of 6.7%. Antepartum risk factors were: place of antenatal visit, malaria during pregnancy, and preeclampsia/eclampsia. Whereas prolonged labor, stationary labor, and term prolonged rupture of membranes were intrapartum risk faktors. Preventive measures during prenatal  visits through informing and communicating with pregnant women should be reinforced. References1. World Health Organisation. Perinatal mortality: a listingof

  2. Quality of care and its determinants in longer term mental health facilities across Europe; a cross-sectional analysis

    NARCIS (Netherlands)

    Killaspy, Helen; Cardoso, Graca; White, Sarah; Wright, Christine; Caldas de Almeida, Jose Miguel; Turton, Penny; Taylor, Tatiana L.; Schuetzwohl, Matthias; Schuster, Mirjam; Cervilla, Jorge A.; Brangier, Paulette; Raboch, Jiri; Kalisova, Lucie; Onchev, Georgi; Alexiev, Spiridon; Mezzina, Roberto; Ridente, Pina; Wiersma, Durk; Visser, Ellen; Kiejna, Andrzej; Adamowski, Tomasz; Ploumpidis, Dimitris; Gonidakis, Fragiskos; King, Michael

    2016-01-01

    Background: The Quality Indicator for Rehabilitative Care (QuIRC) is an international, standardised quality tool for the evaluation of mental health facilities that provide longer term care. Completed by the service manager, it comprises 145 items that assess seven domains of care: living environmen

  3. Evaluating Potential Human Health Risks Associated with the Development of Utility-Scale Solar Energy Facilities on Contaminated Sites

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, J. -J. [Argonne National Lab. (ANL), Argonne, IL (United States); Chang, Y. -S. [Argonne National Lab. (ANL), Argonne, IL (United States); Hartmann, H. [Argonne National Lab. (ANL), Argonne, IL (United States); Wescott, K. [Argonne National Lab. (ANL), Argonne, IL (United States); Kygeris, C. [Indiana Univ. of Pennsylvania, PA (United States)

    2013-09-01

    This report presents a general methodology for obtaining preliminary estimates of the potential human health risks associated with developing a utility-scale solar energy facility on a contaminated site, based on potential exposures to contaminants in soils (including transport of those contaminants into the air).

  4. Coverage of emergency obstetric care and availability of services in public and private health facilities in Bangladesh.

    Science.gov (United States)

    Alam, Badrul; Mridha, Malay K; Biswas, Taposh K; Roy, Lumbini; Rahman, Maksudur; Chowdhury, Mahbub E

    2015-10-01

    To assess the coverage of emergency obstetric care (EmOC) and the availability of obstetric services in Bangladesh. In a national health facility assessment performed between November 2007 and July 2008, all public EmOC facilities and private facilities providing obstetric services in the 64 districts of Bangladesh were mapped. The performance of EmOC services in these facilities during the preceding month was investigated using a semi-structured questionnaire completed through interviews of managers and service providers, and record review. In total, 8.6 (2.1 public and 6.5 private) facilities per 500000 population offered obstetric care services. Population coverage by obstetric care facilities varied by region. Among 281 public facilities designated for comprehensive EmOC, cesarean delivery was available in only 215 (76.5%) and blood transfusion services in 198 (70.5%). In the private sector (for profit and not for profit), these services were available in more than 80% of facilities. In all facility types, performance of assisted vaginal delivery (range 12.2%-48.4%) and use of parenteral anticonvulsants to treat pre-eclampsia/eclampsia (range 48.6%-80.8%) were low. The main reason for non-availability of EmOC services was a lack of specialist/trained providers. Bangladesh needs to increase the availability of EmOC services through innovative public-private partnerships. In the public sector, additional trained manpower supported by an incentivized package should be deployed. Copyright © 2015. Published by Elsevier Ireland Ltd.

  5. Nurse Practitioner Led Health Facility (Role 1 on Exercise Precision Support, 2011: A nurse practitioners observational report

    Directory of Open Access Journals (Sweden)

    Danny O'Neill

    2013-09-01

    Full Text Available Late in 2011, the Royal Australian Air Force (RAAF deployed a Role One enhanced health facility in support of Exercise Precision Support. The Role One health facility was deployed to the Shoalwater Bay military training area and tasked with providing 24 hour care during the pre-deployment exercise for Australian forces headed to operations overseas. The Precision Support exercise integrates with air operations, large scale logistic movements and austere base establishment elements, to aid in the preparation, training and sustainment of service personnel for operational roles, both in a conflict environment as well as humanitarian aid roles. The Role One provided this medical support with 2 Emergency Nurse Practitioners (ENPs, Registered Nurses (RNs, Medical Assistants (MAs and Radiographers. The ENPs took on the role of the senior clinicians during this exercise, competently managing all of the health complaints that presented during the exercise period. This article will discuss and review the role of the Nurse Practitioner (NP within a Role One, deployed Defence health facility, build on international evidence whilst supporting the utilisation of NPs in the RAAF Health Service and subsequently more widely in the greater Australian Defence Force (ADF. This article will provide some practical evidence enabling health commanders to recognise, deploy and fully utilise NPs, in order to support current and future ADF operations.

  6. Use of facility assessment data to improve reproductive health service delivery in the Democratic Republic of the Congo

    Directory of Open Access Journals (Sweden)

    Aveledi Blandine

    2009-12-01

    Full Text Available Abstract Background Prolonged exposure to war has severely impacted the provision of health services in the Democratic Republic of the Congo (DRC. Health infrastructure has been destroyed, health workers have fled and government support to health care services has been made difficult by ongoing conflict. Poor reproductive health (RH indicators illustrate the effect that the prolonged crisis in DRC has had on the on the reproductive health (RH of Congolese women. In 2007, with support from the RAISE Initiative, the International Rescue Committee (IRC and CARE conducted baseline assessments of public hospitals to evaluate their capacities to meet the RH needs of the local populations and to determine availability, utilization and quality of RH services including emergency obstetric care (EmOC and family planning (FP. Methods Data were collected from facility assessments at nine general referral hospitals in five provinces in the DRC during March, April and November 2007. Interviews, observation and clinical record review were used to assess the general infrastructure, EmOC and FP services provided, and the infection prevention environment in each of the facilities. Results None of the nine hospitals met the criteria for classification as an EmOC facility (either basic or comprehensive. Most facilities lacked any FP services. Shortage of trained staff, essential supplies and medicines and poor infection prevention practices were consistently documented. All facilities had poor systems for routine monitoring of RH services, especially with regard to EmOC. Conclusions Women's lives can be saved and their well-being improved with functioning RH services. As the DRC stabilizes, IRC and CARE in partnership with the local Ministry of Health and other service provision partners are improving RH services by: 1 providing necessary equipment and renovations to health facilities; 2 improving supply management systems; 3 providing comprehensive competency

  7. Use of facility assessment data to improve reproductive health service delivery in the Democratic Republic of the Congo.

    Science.gov (United States)

    Casey, Sara E; Mitchell, Kathleen T; Amisi, Immaculée Mulamba; Haliza, Martin Migombano; Aveledi, Blandine; Kalenga, Prince; Austin, Judy

    2009-12-21

    Prolonged exposure to war has severely impacted the provision of health services in the Democratic Republic of the Congo (DRC). Health infrastructure has been destroyed, health workers have fled and government support to health care services has been made difficult by ongoing conflict. Poor reproductive health (RH) indicators illustrate the effect that the prolonged crisis in DRC has had on the on the reproductive health (RH) of Congolese women. In 2007, with support from the RAISE Initiative, the International Rescue Committee (IRC) and CARE conducted baseline assessments of public hospitals to evaluate their capacities to meet the RH needs of the local populations and to determine availability, utilization and quality of RH services including emergency obstetric care (EmOC) and family planning (FP). Data were collected from facility assessments at nine general referral hospitals in five provinces in the DRC during March, April and November 2007. Interviews, observation and clinical record review were used to assess the general infrastructure, EmOC and FP services provided, and the infection prevention environment in each of the facilities. None of the nine hospitals met the criteria for classification as an EmOC facility (either basic or comprehensive). Most facilities lacked any FP services. Shortage of trained staff, essential supplies and medicines and poor infection prevention practices were consistently documented. All facilities had poor systems for routine monitoring of RH services, especially with regard to EmOC. Women's lives can be saved and their well-being improved with functioning RH services. As the DRC stabilizes, IRC and CARE in partnership with the local Ministry of Health and other service provision partners are improving RH services by: 1) providing necessary equipment and renovations to health facilities; 2) improving supply management systems; 3) providing comprehensive competency-based training for health providers in RH and infection

  8. A retrospective evaluation of the quality of malaria case management at twelve health facilities in four districts in Zambia

    Institute of Scientific and Technical Information of China (English)

    Pascalina Chanda-Kapata; Emmanuel Chanda; Freddie Masaninga; Annette Habluetzel; Felix Masiye; Ibrahima Soce Fall

    2014-01-01

    Objective: To establish the appropriateness of malaria case management at health facility level in four districts in Zambia. Methods: This study was a retrospective evaluation of the quality of malaria case management at health facilities in four districts conveniently sampled to represent both urban and rural settings in different epidemiological zones and health facility coverage. The review period was from January to December 2008. The sample included twelve lower level health facilities from four districts. The Pearson Chi-square test was used to identify characteristics which affected the quality of case management.Results:Out of 4891 suspected malaria cases recorded at the 12 health facilities, more than 80% of the patients had a temperature taken to establish their fever status. About 67% (CI95 66.1-68.7) were tested for parasitemia by either rapid diagnostic test or microscopy, whereas the remaining 22.5% (CI95 21.3.1-23.7) were not subjected to any malaria test. Of the 2247 malaria cases reported (complicated and uncomplicated), 71% were parasitologically confirmed while 29% were clinically diagnosed (unconfirmed). About 56% (CI95 53.9-58.1) of the malaria cases reported were treated with artemether-lumefantrine (AL), 35% (CI95 33.1-37.0) with sulphadoxine-pyrimethamine, 8% (CI95 6.9-9.2) with quinine and 1% did not receive any anti-malarial. Approximately 30% of patients WHO were found negative for malaria parasites were still prescribed an anti-malarial, contrary to the guidelines. There were marked inter-district variations in the proportion of patients in WHOm a diagnostic tool was used, and in the choice of anti-malarials for the treatment of malaria confirmed cases. Association between health worker characteristics and quality of case malaria management showed that nurses performed better than environmental health technicians and clinical officers on the decision whether to use the rapid diagnostic test or not. Gender, in service training on malaria

  9. First experiences in the implementation of biometric technology to link data from Health and Demographic Surveillance Systems with health facility data

    Directory of Open Access Journals (Sweden)

    Adwoa Serwaa-Bonsu

    2010-02-01

    Full Text Available Background: In developing countries, Health and Demographic Surveillance Systems (HDSSs provide a framework for tracking demographic and health dynamics over time in a defined geographical area. Many HDSSs co-exist with facility-based data sources in the form of Health Management Information Systems (HMIS. Integrating both data sources through reliable record linkage could provide both numerator and denominator populations to estimate disease prevalence and incidence rates in the population and enable determination of accurate health service coverage. Objective: To measure the acceptability and performance of fingerprint biometrics to identify individuals in demographic surveillance populations and those attending health care facilities serving the surveillance populations. Methodology: Two HDSS sites used fingerprint biometrics for patient and/or surveillance population participant identification. The proportion of individuals for whom a fingerprint could be successfully enrolled were characterised in terms of age and sex. Results: Adult (18–65 years fingerprint enrolment rates varied between 94.1% (95% CI 93.6–94.5 for facility-based fingerprint data collection at the Africa Centre site to 96.7% (95% CI 95.9–97.6 for population-based fingerprint data collection at the Agincourt site. Fingerprint enrolment rates in children under 1 year old (Africa Centre site were only 55.1% (95% CI 52.7–57.4. By age 5, child fingerprint enrolment rates were comparable to those of adults. Conclusion: This work demonstrates the feasibility of fingerprint-based individual identification for population-based research in developing countries. Record linkage between demographic surveillance population databases and health care facility data based on biometric identification systems would allow for a more comprehensive evaluation of population health, including the ability to study health service utilisation from a population perspective, rather than the

  10. Safety evaluation report related to the renewal of the facility license for the research reactor at the Dow Chemical Company

    Energy Technology Data Exchange (ETDEWEB)

    1989-04-01

    This safety evaluation report for the application filed by the Dow Chemical Company for renewal of facility Operating License R-108 to continue to operate its research reactor at an increased operating power level has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is located on the grounds of the Michigan Division of the Dow Chemical Company in Midland, Michigan. The staff concludes that the Dow Chemical Company can continue to operate its reactor without endangering the health and safety of the public.

  11. Ways to optimize understanding health related information: the patients' perspective.

    Science.gov (United States)

    Heinrich, Carol; Karner, Karen

    2011-01-01

    Self-management of chronic illness is a high priority health care need of community dwelling elderly. Effective patient provider health communication related to health promotion, disease prevention, and disease management is a key intervention necessary to achieve optimal health outcomes. Little is known about the methods elderly patients actually use to help understand health related teaching by their health care providers. Focus groups were held to describe these ways from a patient's perspective. Facilitators of understanding were identified as persevere in getting questions answered, come prepared to office visit, and work to develop a good relationship with health care providers. Barriers were identified as not having questions answered lack of time with provider, hearing difficulty, and fragmented care. Copyright © 2011 Mosby, Inc. All rights reserved.

  12. The assumed relation between occupation and inequality in health

    DEFF Research Database (Denmark)

    Madsen, Jacob; Kanstrup, Anne Marie; Josephsson, Staffan

    2016-01-01

    Background: Occupational science and therapy scholars have argued that research on inequality in health is needed. Simultaneously, a knowledge gap between how to understand and take action on health inequalities exists in occupational science and therapy. Objective: To identify how inequality...... in health, high-risk areas of health, and engagement in health for low-income adult citizens have been described and conceptualized in contemporary occupational science and therapy literature. Material and methods: A structured literature review of 37 publications in occupational science and therapy...... on assumptions regarding the relation between occupation and inequality in health, and statements on the need to explore this relation. Conclusion: Basic theory and reasoning, as well as empirical studies, on inequality in health are missing in occupational science and therapy. Based on the findings...

  13. The assumed relation between occupation and inequality in health

    DEFF Research Database (Denmark)

    Madsen, Jacob Østergaard; Kanstrup, Anne Marie; Josephsson, Staffan

    2015-01-01

    Background: Occupational science and therapy scholars have argued that research on inequality in health is needed. Simultaneously, a knowledge gap between how to understand and take action on health inequalities exists in occupational science and therapy. Objective: To identify how inequality...... in health, high-risk areas of health, and engagement in health for low-income adult citizens have been described and conceptualized in contemporary occupational science and therapy literature. Material and methods: A structured literature review of 37 publications in occupational science and therapy...... on assumptions regarding the relation between occupation and inequality in health, and statements on the need to explore this relation. Conclusion: Basic theory and reasoning, as well as empirical studies, on inequality in health are missing in occupational science and therapy. Based on the findings...

  14. Is the political system really related to health?

    Science.gov (United States)

    Klomp, Jeroen; de Haan, Jakob

    2009-07-01

    We analyze whether the political system and its stability are related to cross-country differences in health. We apply factor analysis on various national health indicators for a large sample of countries over the period 2000-2005 and use the outcomes of the factor analysis to construct two new health measures, i.e., the health of individuals and the quality of the health care sector. Using a cross-country structural equation model with various economic and demographic control variables, we examine the relationship between the type of regime and political stability on the one hand and health on the other. The political variables and the control variables are measured as averages over the period 1980-1999. Our results suggest that democracy has a positive relationship with the health of individuals, while regime instability has a negative relationship with the health of individuals. Government instability is negatively related to individual health via its link with the quality of the health care sector, while democracy is positively related with individual health through its link with income. Our main findings are confirmed by the results of a panel model and various sensitivity tests.

  15. A Toolbox for Health Risk Related Decisions

    Science.gov (United States)

    1996-05-01

    context of this paradiagm in order to estimate "toxic equivalency factors" for the class of materials known as dioxins . The many dioxin congeners are...the toxic equivalent factor (our relative potency) concept as promulgated by the EPA for congeners of PCBs, dioxins and furans represents a...these ideas. In the conceptual approach, the biomarkers in the table are used to "translate" the data fiom higher dose animal and human data to the

  16. [Position of health at international relations. Part II. Organizational dimensions of health].

    Science.gov (United States)

    Cianciara, Dorota; Wysocki, Mirosław J

    2011-01-01

    The aim of this article was: (1) the analysis of some concepts and definitions related with "set up of health", used in UN international arrangements; (2) an attempt to explain the evolution of organizational dimensions of health at worldwide agenda. The following organizational dimensions of health were discussed: (a) health for all, (b) health promotion, intersectoral and multisectoral actions, health in all policies, (c) health development, health as an element of human development, (d) investment for health, (e) health diplomacy and (f) mainstreaming of health. The analysis was based on World Health Assembly and UN General Assembly resolutions as well as supranational reports and statements available through conventional channels, not grey literature. It is apparent that some of notions are not in common use in Poland, some seems to be unknown. It was argued that some general and discreet thoughts and statements concerning organizational aspects of health were expressed in the preamble of WHO Constitution. Nevertheless they are not comparable with later propositions and proceedings. The first modern concepts and notions related as process were developed at late seventies. They originated from efforts to realize a vision of health for all and formulate national policies, strategies and plans of action for attaining this goal. The turning point was in 1981, when WHA adopted Global Strategy for Heath for All by the Year 2000. Since then one can observe considerable progress and new concepts came into existence, more and more precise and better reflecting the sense of health actions. The evolution of organizational dimensions of health was described in the context of brand positioning. It was assumed that first step of positioning was concentrated on structural dimensions of health. That served to awareness raise, attitudes change and motivation to action. That made a foundation to the next step--positioning based on process approach to health. Among others the

  17. Health related quality of life of Canary Island citizens

    Directory of Open Access Journals (Sweden)

    Lopez-Bastida Julio

    2010-11-01

    Full Text Available Abstract Background The aim of the study was to describe the health-related quality of life of Canarian population using information from the Canary Island Health Survey and three observational studies developed in the Canary Islands. Methods A descriptive analysis was carried out on a sample of 5.549 Canarian citizens using information from 2004 Canary Island Health Survey and three observational studies on Alzheimer's disease, Stroke and HIV. EQ-5 D was the generic tool used for revealing quality of life of people surveyed. Besides the rate of people reporting moderate or severe decrease in quality of life, TTO-index scores and visual analogue scale were used for assessing health related quality of life of people that suffer a specific diseases and general population. Results Self-perceived health status of citizens that suffer chronic diseases of high prevalence, identifies by the Canary Island Health Survey and other diseases such Alzheimer's disease, Stroke and HIV, independently examined in observational studies, are worse than self-perceived health of general population. Depression/anxiety and pain/discomfort were identified as the dimensions of the EQ-5 D with highest prevalence of problems. Alzheimer's disease and stroke were the illnesses with greater loss of quality of life. Conclusions Health related quality of life should be integrated into a set of information along with expectancy of life, incidence and prevalence of chronic diseases for developing health policy and planning health care activities The combination of information on health related quality of life from population health surveys with data from observational studies enlarges the sources of relevant information for setting health priorities and assessing the impact of health policies.

  18. A hospital-based estimate of major causes of death among under-five children from a health facility in Lagos, Southwest Nigeria: possible indicators of health inequality

    Directory of Open Access Journals (Sweden)

    Afolabi Bamgboye M

    2012-08-01

    Full Text Available Abstract Introduction Current evidence on the root-causes of deaths among children younger than 5years is critical to direct international efforts to improve child survival, focus on health promotion and achieve Millennium Development Goal 4. We report a hospital-based estimate for 2005-2007 of the major causes of death in children in this age-group in south-west Nigeria. Methods We used retrospective data from the intensive care unit of a second-tier health facility to extract the presenting complaints, clinical diagnosis, treatment courses, prognosis and outcome among children aged 6—59months. SPSS-19 was used for data analysis. Results Of the 301 children (58% males, 42% females admitted into the ICU within the period of study, 173 (26% presented with complaints related to the gastrointestinal system, 138 (21% with respiratory symptoms and 196 (29% with complaints of fever. Overall, 708 investigations were requested for among which were full blood count (215, 30% and blood slides for malaria parasite (166, 23%. Infection ranked highest (181, 31% in clinicians’ diagnosis, followed by haematological health problems (109, 19% and respiratory illnesses (101, 17%. There were negative correlations between outcome of the illness and patient’s weight (r=-0.195, p=0.001 and a strong positive correlation between prognosis and outcome of admission (r=0.196, p=0.001. Of the 59 (20% children that died, presentation of respiratory tract illnesses were significantly higher in females (75% than in males (39% (χ²=7.06; p=0.008 and diagnoses related to gastrointestinal pathology were significantly higher in males (18% than in females (0% (χ²=4.07; p=0.05. Majority of the deaths (21% occurred among children aged 1.0 to 1.9years old and among weight group of 5.1-15.0kg. Conclusion The major causes of deaths among under-five years old originate from respiratory, gastrointestinal and infectious diseases – diseases that were recognized as major causes

  19. Perceived reciprocal value of health professionals participation in global child health-related work

    National Research Council Canada - National Science Library

    Sarah Carbone; Jannah Wigle; Nadia Akseer; Raluca Barac; Melanie Barwick; Stanley Zlotkin

    2017-01-01

    ...’ participation in global child health-related work. Benefits were measured in the form of skills, knowledge and attitude strengthening as estimated by an adapted Global Health Competency Model...

  20. The Availability and Properness of The Health Care Facilities for Waste Handling Based on Indonesian Topography and Geo

    Directory of Open Access Journals (Sweden)

    Suci Wulansari

    2016-06-01

    Full Text Available Background: medical facilities research (Rifakes 2011 was performed to know a comprehensive image about thegovernment health care facilities as a plan in medical service development that fi ts with the society needs. Although healthcenter was already available, but the availability and the properness of the health care facilities were not spread evenly,such as waste handling facilities. The aim of this research is analyzing the availability and the properness of waste handlingin health center based on demography and geography in Indonesia. Methods: This research is a secondary data analysisof Rifakes 2011 about the availability and the properness of waste handling in health center. The data analysis was donein univariat and bivariat. The correlation between the properness of waste handling and the isolation of an area was testedwith spearmann correlation. The correlation between the properness of waste handling of health care in archipelago and ofthat in frontier area was tested with mann whitney test. Results: More than a half ( 66,8% of the waste handling of healthcenter is already available, yet with improper category ( 72,7% . There is a signifi cant correlation between the propernessof waste handling with a location topography ( isolation area, archipelago, and frontier area . The improper waste handlingis especially in rural area with 80, 6%, whereas in city with 5,7%. Conclusion: There is a signifi cant correlation between theproperness of waste handling in health center with topographical and geographical condition. Recommendation: Wastemanagement in health centers should be more serious attention and handling, availability WWTP, feasibility of handlingthe waste, and if possible waste minimalisali clinic.

  1. [The Computer Competency of Nurses in Long-Term Care Facilities and Related Factors].

    Science.gov (United States)

    Chang, Ya-Ping; Kuo, Huai-Ting; Li, I-Chuan

    2016-12-01

    It is important for nurses who work in long-term care facilities (LTCFs) to have an adequate level of computer competency due to the multidisciplinary and comprehensive nature of long-term care services. Thus, it is important to understand the current computer competency of nursing staff in LTCFs and the factors that relate to this competency. To explore the computer competency of LTCF nurses and to identify the demographic and computer-usage characteristics that relate significantly to computer competency in the LTCF environment. A cross-sectional research design and a self-report questionnaire were used to collect data from 185 nurses working at LTCFs in Taipei. The results found that the variables of the frequency of computer use (β = .33), age (β = -.30), type(s) of the software used at work (β = .28), hours of on-the-job training (β = -.14), prior work experience at other LTCFs (β = -.14), and Internet use at home (β = .12) explain 58.0% of the variance in the computer competency of participants. The results of the present study suggest that the following measures may help increase the computer competency of LTCF nurses. (1) Nurses should be encouraged to use electronic nursing records rather than handwritten records. (2) On-the-job training programs should emphasize participant competency in the Excel software package in order to maintain efficient and good-quality of LTC services after implementing of the LTC insurance policy.

  2. Building an Interoperable Relational Database for the National Deep Submergence Facility (NDSF)

    Science.gov (United States)

    Ferrini, V.; McCue, S.; Arko, R.

    2008-12-01

    The National Deep Submergence Facility (NDSF) operates the Human Occupied Vehicle (HOV) Alvin, the Remote Operated Vehicle (ROV) Jason 2, and the Autonomous Underwater Vehicle (AUV) Sentry. Data acquired with these platforms is provided both to the science party on each expedition, and to the Woods Hole Oceanographic Institution (WHOI) Data Library. Although several data sets are inventoried online, and some data are accessible, there has not yet been a coordinated effort to construct an interoperable NDSF database that can serve data to other data systems. We present on progress made with the creation of an NDSF relational database maintained at WHOI and developed through collaborative efforts with the Marine Geoscience Data System (MGDS). While our initial efforts focus on standardizing vehicle metadata and developing techniques for digitally acquiring metadata at sea, the creation of a relational database backend provides opportunities for improved data access and interoperability. Constructing the database using PostgresSQL, coupled with spatial database extensions (PostGIS), and an online GIS backend (MapServer), enables a searchable database and Open Geospatial Consortium (OGC) compliant map based web services (Web Map Service and Web Feature Service) that can be used to provide data access pathways through several programmatic interfaces.

  3. Disability and health-related rehabilitation in international disaster relief

    Directory of Open Access Journals (Sweden)

    On behalf of the International Society of Physical and Rehabilitation Medicine's Sub-Committee on Rehabilitation Disaster Relief

    2011-08-01

    Full Text Available Natural disasters result in significant numbers of disabling impairments. Paradoxically, however, the traditional health system response to natural disasters largely neglects health-related rehabilitation as a strategic intervention.To examine the role of health-related rehabilitation in natural disaster relief along three lines of inquiry: (1 epidemiology of injury and disability, (2 impact on health and rehabilitation systems, and (3 the assessment and measurement of disability.Qualitative literature review and secondary data analysis.Absolute numbers of injuries as well as injury to death ratios in natural disasters have increased significantly over the last 40 years. Major impairments requiring health-related rehabilitation include amputations, traumatic brain injuries, spinal cord injuries (SCI, and long bone fractures. Studies show that persons with pre-existing disabilities are more likely to die in a natural disaster. Lack of health-related rehabilitation in natural disaster relief may result in additional burdening of the health system capacity, exacerbating baseline weak rehabilitation and health system infrastructure. Little scientific evidence on the effectiveness of health-related rehabilitation interventions following natural disaster exists, however. Although systematic assessment and measurement of disability after a natural disaster is currently lacking, new approaches have been suggested.Health-related rehabilitation potentially results in decreased morbidity due to disabling injuries sustained during a natural disaster and is, therefore, an essential component of the medical response by the host and international communities. Significant systematic challenges to effective delivery of rehabilitation interventions during disaster include a lack of trained responders as well as a lack of medical recordkeeping, data collection, and established outcome measures. Additional development of health-related rehabilitation following

  4. [Valuation of health-related quality of life and utilities in health economics].

    Science.gov (United States)

    Greiner, Wolfgang; Klose, Kristina

    2014-01-01

    Measuring health-related quality of life is an important aspect in economic evaluation of health programmes. The development of utility-based (preference-based) measures is advanced by the discipline of health economics. Different preference measures are applied for valuing health states to produce a weighted health state index. Those preference weights should be derived from a general population sample in case of resource allocation on a collective level (as in current valuation studies of the EuroQol group).

  5. Monitoring System for Storm Readiness and Recovery of Test Facilities: Integrated System Health Management (ISHM) Approach

    Science.gov (United States)

    Figueroa, Fernando; Morris, Jon; Turowski, Mark; Franzl, Richard; Walker, Mark; Kapadia, Ravi; Venkatesh, Meera; Schmalzel, John

    2010-01-01

    Severe weather events are likely occurrences on the Mississippi Gulf Coast. It is important to rapidly diagnose and mitigate the effects of storms on Stennis Space Center's rocket engine test complex to avoid delays to critical test article programs, reduce costs, and maintain safety. An Integrated Systems Health Management (ISHM) approach and technologies are employed to integrate environmental (weather) monitoring, structural modeling, and the suite of available facility instrumentation to provide information for readiness before storms, rapid initial damage assessment to guide mitigation planning, and then support on-going assurance as repairs are effected and finally support recertification. The system is denominated Katrina Storm Monitoring System (KStorMS). Integrated Systems Health Management (ISHM) describes a comprehensive set of capabilities that provide insight into the behavior the health of a system. Knowing the status of a system allows decision makers to effectively plan and execute their mission. For example, early insight into component degradation and impending failures provides more time to develop work around strategies and more effectively plan for maintenance. Failures of system elements generally occur over time. Information extracted from sensor data, combined with system-wide knowledge bases and methods for information extraction and fusion, inference, and decision making, can be used to detect incipient failures. If failures do occur, it is critical to detect and isolate them, and suggest an appropriate course of action. ISHM enables determining the condition (health) of every element in a complex system-of-systems or SoS (detect anomalies, diagnose causes, predict future anomalies), and provide data, information, and knowledge (DIaK) to control systems for safe and effective operation. ISHM capability is achieved by using a wide range of technologies that enable anomaly detection, diagnostics, prognostics, and advise for control: (1

  6. The Tanzania Connect Project: a cluster-randomized trial of the child survival impact of adding paid community health workers to an existing facility-focused health system

    OpenAIRE

    Ramsey, Kate; Hingora,Ahmed; Kante, Malick; Jackson, Elizabeth; Exavery, Amon; Pemba, Senga; Manzi, Fatuma; Baynes, Colin; Helleringer, Stephane; Phillips, James F.

    2013-01-01

    Background Tanzania has been a pioneer in establishing community-level services, yet challenges remain in sustaining these systems and ensuring adequate human resource strategies. In particular, the added value of a cadre of professional community health workers is under debate. While Tanzania has the highest density of primary health care facilities in Africa, equitable access and quality of care remain a challenge. Utilization for many services proven to reduce child and maternal mortality ...

  7. Treatment of malaria from monotherapy to artemisinin-based combination therapy by health professionals in urban health facilities in Yaoundé, central province, Cameroon

    OpenAIRE

    Bley Daniel; Malvy Denis; Vernazza-Licht Nicole; Gausseres Mathieu; Sayang Collins; Millet Pascal

    2009-01-01

    Abstract Background After adoption of artesunate-amodiaquine (AS/AQ) as first-line therapy for the treatment of uncomplicated malaria by the malaria control programme, this study was designed to assess the availability of anti-malarial drugs, treatment practices and acceptability of the new protocol by health professionals, in the urban health facilities and drugstores of Yaoundé city, Cameroon. Methods Between April and August 2005, retrospective and current information was collected by cons...

  8. Assessing the Impact of Community Engagement Interventions on Health Worker Motivation and Experiences with Clients in Primary Health Facilities in Ghana: A Randomized Cluster Trial.

    Directory of Open Access Journals (Sweden)

    Robert Kaba Alhassan

    Full Text Available Health worker density per 1000 population in Ghana is one of the lowest in the world estimated to be 2.3, below the global average of 9.3. Low health worker motivation induced by poor working conditions partly explain this challenge. Albeit the wage bill for public sector health workers is about 90% of domestic government expenditure on health in countries such as Ghana, staff motivation and performance output remain a challenge, suggesting the need to complement financial incentives with non-financial incentives through a community-based approach. In this study, a systematic community engagement (SCE intervention was implemented to engage community groups in healthcare quality assessment to promote mutual collaboration between clients and healthcare providers, and enhance health worker motivation levels. SCE involves structured use of existing community groups and associations to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements made and rewards given to best performing facilities for closing quality care gaps.To evaluate the effect of SCE interventions on health worker motivation and experiences with clients.The study is a cluster randomized trial involving health workers in private (n = 38 and public (n = 26 primary healthcare facilities in two administrative regions in Ghana. Out of 324 clinical and non-clinical staff randomly interviewed at baseline, 234 (72% were successfully followed at end-line and interviewed on workplace motivation factors and personal experiences with clients. Propensity score matching and difference-in-difference estimations were used to estimate treatment effect of the interventions on staff motivation.Intrinsic (non-financial work incentives including cordiality with clients and perceived career prospects appeared to be prime sources of motivation for health staff interviewed in intervention health facilities while financial incentives were

  9. Assessing the Impact of Community Engagement Interventions on Health Worker Motivation and Experiences with Clients in Primary Health Facilities in Ghana: A Randomized Cluster Trial.

    Science.gov (United States)

    Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Spieker, Nicole; Arhinful, Daniel Kojo; Rinke de Wit, Tobias F

    2016-01-01

    Health worker density per 1000 population in Ghana is one of the lowest in the world estimated to be 2.3, below the global average of 9.3. Low health worker motivation induced by poor working conditions partly explain this challenge. Albeit the wage bill for public sector health workers is about 90% of domestic government expenditure on health in countries such as Ghana, staff motivation and performance output remain a challenge, suggesting the need to complement financial incentives with non-financial incentives through a community-based approach. In this study, a systematic community engagement (SCE) intervention was implemented to engage community groups in healthcare quality assessment to promote mutual collaboration between clients and healthcare providers, and enhance health worker motivation levels. SCE involves structured use of existing community groups and associations to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements made and rewards given to best performing facilities for closing quality care gaps. To evaluate the effect of SCE interventions on health worker motivation and experiences with clients. The study is a cluster randomized trial involving health workers in private (n = 38) and public (n = 26) primary healthcare facilities in two administrative regions in Ghana. Out of 324 clinical and non-clinical staff randomly interviewed at baseline, 234 (72%) were successfully followed at end-line and interviewed on workplace motivation factors and personal experiences with clients. Propensity score matching and difference-in-difference estimations were used to estimate treatment effect of the interventions on staff motivation. Intrinsic (non-financial) work incentives including cordiality with clients and perceived career prospects appeared to be prime sources of motivation for health staff interviewed in intervention health facilities while financial incentives were ranked

  10. Malaria prevalence and morbidity among children reporting at health facilities in Nouakchott, Mauritania.

    Science.gov (United States)

    Lekweiry, Khadijetou Mint; Basco, Leonardo K; Salem, Mohamed Salem O Ahmedou; Hafid, Jamal Eddine; Marin-Jauffre, Adeline; Weddih, Abdallahi O; Briolant, Sébastien; Bogreau, Hervé; Pradines, Bruno; Rogier, Christophe; Trape, Jean-François; Boukhary, Ali O Mohamed Salem O

    2011-12-01

    Although malaria has become a serious public health problem in Mauritania since the late 1990s, few documented data on its epidemiology exist. The objective of this study was to assess the morbidity of clinical malaria among children in Nouakchott. Three hundred and one febrile children, consulting at three health facilities of Nouakchott, were screened for malaria in 2009 (n=216) and 2010 (n=85). Plasmodium species identification and parasite density were determined by microscopic examination of Giemsa-stained thin and thick films and confirmed by rapid diagnostic test and nested PCR. Of 301 febrile children, 105 (34.9%) were malaria-positive by nested PCR and 87 (28.9%) by microscopy. Plasmodium vivax represented 97.1% (102/105) and P. falciparum accounted for 2.9% (3/105) of positive cases. All positive children under five years old were infected with P. vivax. The highest numbers of malaria positives were found during or shortly after the rainy season and the lowest during the dry season. Fifty-four of 105 (51.4%) malaria cases, all with P. vivax, had never travelled outside Nouakchott. Individuals belonging to the Moors ethnic group represented 97.0% of P. vivax cases. Results of the present study indicate that malaria is endemic in Nouakchott and that P. vivax is the principal causative agent. Regular surveillance is required to monitor malaria prevalence and incidence, and further measures are needed to counter the possible spread of malaria in the country. Copyright © 2011 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

  11. How best practices are copied, transferred, or translated between health care facilities: A conceptual framework.

    Science.gov (United States)

    Guzman, Gustavo; Fitzgerald, Janna Anneke; Fulop, Liz; Hayes, Kathryn; Poropat, Arthur; Avery, Mark; Campbell, Steve; Fisher, Ron; Gapp, Rod; Herington, Carmel; McPhail, Ruth; Vecchio, Nerina

    2015-01-01

    In spite of significant investment in quality programs and activities, there is a persistent struggle to achieve quality outcomes and performance improvements within the constraints and support of sociopolitical parsimonies. Equally, such constraints have intensified the need to better understand the best practice methods for achieving quality improvements in health care organizations over time.This study proposes a conceptual framework to assist with strategies for the copying, transferring, and/or translation of best practice between different health care facilities. Applying a deductive logic, the conceptual framework was developed by blending selected theoretical lenses drawn from the knowledge management and organizational learning literatures. The proposed framework highlighted that (a) major constraints need to be addressed to turn best practices into everyday practices and (b) double-loop learning is an adequate learning mode to copy and to transfer best practices and deuteron learning mode is a more suitable learning mode for translating best practice. We also found that, in complex organizations, copying, transferring, and translating new knowledge is more difficult than in smaller, less complex organizations. We also posit that knowledge translation cannot happen without transfer and copy, and transfer cannot happen without copy of best practices. Hence, an integration of all three learning processes is required for knowledge translation (copy best practice-transfer knowledge about best practice-translation of best practice into new context). In addition, the higher the level of complexity of the organization, the more best practice is tacit oriented and, in this case, the higher the level of K&L capabilities are required to successfully copy, transfer, and/or translate best practices between organizations. The approach provides a framework for assessing organizational context and capabilities to guide copy/transfer/translation of best practices. A

  12. Global Health Cooperation: International Relations' New Frontier.

    Science.gov (United States)

    2015-07-01

    This issue of MEDICC Review appears in the wake of a media splash on the reopening of the Cuban and US embassies in Washington and Havana, signaling the renewal of full diplomatic relations between the two governments. Although the US embargo is still law and one of the thorniest bilateral issues remaining, the Obama administration's bold opening towards Cuba is being echoed in the chambers of Senate committees, calling for an end to the policy in place since 1962. Meanwhile, people from the United States have begun to travel to Cuba in droves, and for the first time in many years, we perceive real hope that cooperation may replace hostility-at least in the sectors that most matter to ordinary people in both nations.

  13. Seroprevalence of yellow fever virus in selected health facilities in Western Kenya from 2010 to 2012.

    Science.gov (United States)

    Kwallah, Allan ole; Inoue, Shingo; Thairu-Muigai, Anne Wangari; Kuttoh, Nancy; Morita, Kouichi; Mwau, Matilu

    2015-01-01

    Yellow fever (YF), which is caused by a mosquito-borne virus, is an important viral hemorrhagic fever endemic in equatorial Africa and South America. Yellow fever virus (YFV) is the prototype of the family Flaviviridae and genus Flavivirus. The aim of this study was to determine the seroprevalence of YFV in selected health facilities in Western Kenya during the period 2010-2012. A total of 469 serum samples from febrile patients were tested for YFV antibodies using in-house IgM-capture ELISA, in-house indirect IgG ELISA, and 50% focus reduction neutralization test (FRNT50). The present study did not identify any IgM ELISA-positive cases, indicating absence of recent YFV infection in the area. Twenty-eight samples (6%) tested positive for YFV IgG, because of either YFV vaccination or past exposure to various flaviviruses including YFV. Five cases were confirmed by FRNT50; of these, 4 were either vaccination or natural infection during the YF outbreak in 1992-1993 or another period and 1 case was confirmed as a West Nile virus infection. Domestication and routine performance of arboviral differential diagnosis will help to address the phenomenon of pyrexia of unknown origin, contribute to arboviral research in developing countries, and enhance regular surveillance.

  14. Study of Cyclospora cayetanensis in health care facilities, sewage water and green leafy vegetables in Nepal.

    Science.gov (United States)

    Sherchand, J B; Cross, J H; Jimba, M; Sherchand, S; Shrestha, M P

    1999-03-01

    Cyclospora cayetanensis, a newly emerging parasite, is endemic in Nepal. A total of 2,123 stool specimens were collected from 3 health care facilities based on clinical symptoms during the period between 1995 to October, 1998. Out of these specimens, cayetanensis oocysts were found in 632 (29.8%). To identify possible sources for Cyclospora infection, drinking water, sewage water, green-leafy vegetables including fecal samples of various animals were collected and examined. The vegetable leaves were washed in distilled water then the washings, sewage water and drinking water were centrifuged and the sediment were examined microscopically. As a result, oocyst of Cyclospora were identified in sewage water and vegetable washings on four different occasions in June, August, October and November. The positive results were also confirmed as C. cayetanensis by development of 2 sporocysts after 2 week incubation period in potassium dichromate. A survey of 196 domestic animals from the same areas demonstrated that two chickens were positive for Cyclospora-like organism and others were negative. Although further studies are needed to clarify the direct link between Cyclospora infection and these sources, the results suggest that sewage water, green leafy vegetables are possible sources of infection and chickens could be possible reservoir host of Cyclospora in Nepal.

  15. Pregnancy outcomes associated with Cesarean deliveries in Peruvian public health facilities

    Science.gov (United States)

    Gonzales, Gustavo F; Tapia, Vilma L; Fort, Alfredo L; Betran, Ana Pilar

    2013-01-01

    A continuous rise in the rate of cesarean deliveries has been reported in many countries over recent decades. This trend has prompted the emergence of a debate on the risks and benefits associated with cesarean section. The present study was designed to estimate cesarean section rates over time during the period between 2000 and 2010 in Peru and to present outcomes for each mode of delivery. This is a secondary analysis of a large database obtained from the Perinatal Information System, which includes 570,997 pregnant women and their babies from 43 Peruvian public health facilities in three geographical regions: coast, highlands, and jungle. Over 10 years, 558,901 women delivered 563,668 infants weighing at least 500 g. The cesarean section rate increased from 25.5% in 2000 to 29.9% in 2010 (26.9% average; P cesarean than vaginal deliveries (P cesarean section (P cesarean section group than in the vaginal delivery group. Data suggest that cesarean sections are associated with adverse pregnancy outcomes. PMID:24124393

  16. Integration of Chiropractic Services in Military and Veteran Health Care Facilities: A Systematic Review of the Literature.

    Science.gov (United States)

    Green, Bart N; Johnson, Claire D; Daniels, Clinton J; Napuli, Jason G; Gliedt, Jordan A; Paris, David J

    2016-04-01

    This literature review examined studies that described practice, utilization, and policy of chiropractic services within military and veteran health care environments. A systematic search of Medline, CINAHL, and Index to Chiropractic Literature was performed from inception through April 2015. Thirty articles met inclusion criteria. Studies reporting utilization and policy show that chiropractic services are successfully implemented in various military and veteran health care settings and that integration varies by facility. Doctors of chiropractic that are integrated within military and veteran health care facilities manage common neurological, musculoskeletal, and other conditions; severe injuries obtained in combat; complex cases; and cases that include psychosocial factors. Chiropractors collaboratively manage patients with other providers and focus on reducing morbidity for veterans and rehabilitating military service members to full duty status. Patient satisfaction with chiropractic services is high. Preliminary findings show that chiropractic management of common conditions shows significant improvement.

  17. Brucellosis is not a major cause of febrile illness in patients at public health care facilities in Binh Thuan Province, Vietnam

    NARCIS (Netherlands)

    T.T.T. Nga; P.J. de Vries; T.H. Abdoel; H.L. Smits

    2006-01-01

    Objective: To determine the presence of brucellosis among patients with acute febrile illness at health care facilities in Binh Thuan province, Vietnam. Method: A retrospective seroepidemiological study on serum samples collected at 13 not adjacent health care facilities using the Rose Bengal test a

  18. The gap in human resources to deliver the guaranteed package of prevention and health promotion services at urban and rural primary care facilities in Mexico.

    Science.gov (United States)

    Alcalde-Rabanal, Jacqueline Elizabeth; Nigenda, Gustavo; Bärnighausen, Till; Velasco-Mondragón, Héctor Eduardo; Darney, Blair Grant

    2017-08-03

    The purpose of this study was to estimate the gap between the available and the ideal supply of human resources (physicians, nurses, and health promoters) to deliver the guaranteed package of prevention and health promotion services at urban and rural primary care facilities in Mexico. We conducted a cross-sectional observational study using a convenience sample. We selected 20 primary health facilities in urban and rural areas in 10 states of Mexico. We calculated the available and the ideal supply of human resources in these facilities using estimates of time available, used, and required to deliver health prevention and promotion services. We performed descriptive statistics and bivariate hypothesis testing using Wilcoxon and Friedman tests. Finally, we conducted a sensitivity analysis to test whether the non-normal distribution of our time variables biased estimation of available and ideal supply of human resources. The comparison between available and ideal supply for urban and rural primary health care facilities reveals a low supply of physicians. On average, primary health care facilities are lacking five physicians when they were estimated with time used and nine if they were estimated with time required (P facilities. There is a shortage of health promoters in urban primary health facilities (P facilities.

  19. Health service interventions targeting relatives of heart patients

    DEFF Research Database (Denmark)

    Nissen, Nina Konstantin; Madsen, Mette; Olsen Zwisler, Ann-Dorthe

    2008-01-01

    AIMS: Relatives of heart patients experience anxiety, uncertainty, and low quality of life, and the hospitalization of a heart patient is associated with increased risk of death for the partner. Relatives' physical and mental problems may be rectified by activities established by the health...... systematically reviewed to clarify what the health services do for relatives of heart patients and to assess the effects of interventions. We searched Medline, EMBASE, PsycINFO, CINAHL database, CSA and the Cochrane Library from January 2000 to March 2006. RESULTS: Only six scientific articles reported...... on interventions testing health service activities for relatives of heart patients, and one literature review scrutinized earlier studies within the field. All the interventions indicate positive effects on patients' and/or relatives' health and well-being, in accordance with nurses' assessments. Nevertheless...

  20. Client views, perception and satisfaction with immunisation services at Primary Health Care Facilities in Calabar, South-South Nigeria

    Institute of Scientific and Technical Information of China (English)

    Udonwa NE; Gyuse AN; Etokidem AJ; Ogaji DST

    2010-01-01

    Objective:To determine the degree of client satisfaction with immunisation services at Primary Health facilities in Calabar, Cross River State, Nigeria.Method: A semi-structured questionnaire was administered on 402 caregivers who were selected using systematic random sampling from four primary health centres. The four centres were randomly selected from the 19 health centres using the table of random numbers. Data obtained were analysed using Epi-Info software version 2002.Results: The majority of clients were dissatisfied with most aspects of care given at the Health Care Centres including long waiting time, accessibility of immunisation services, poor respect for clients' rights, especially to their dignity, health information and counseling on their medical needs.Conclusions:The study concludes that client satisfaction with immunization service in Calabar was low due to poor attitude of health care providers, long waiting time and lack of respect for clients' rights.

  1. Using silver yoga exercises to promote physical and mental health of elders with dementia in long-term care facilities.

    Science.gov (United States)

    Fan, Jue-Ting; Chen, Kuei-Min

    2011-10-01

    This study aimed to test the effects of yoga exercises on the physical and mental health of elderly people with dementia living in long-term care facilities. A quasi-experimental, pretest-post-test design was used. A convenience sample of 68 residents in long-term care facilities in southern Taiwan, aged 60 years and above with mild to moderate dementia, was selected. An experimental group of 33 elders participated in a 12-week yoga training program of three 55-minute sessions a week; a control group of 35 elders maintained their usual daily activities. Data were collected before and after completing the 12-week study. Measurements included body composition, cardiopulmonary functions, body flexibility, muscle strength and endurance, balance, joints motion, depression, and problem behaviors. The yoga-trained participants had better physical and mental health than those who did not participate, including lowered blood pressure, reduced respiration rate, strengthened cardiopulmonary fitness, enhanced body flexibility, improved muscle strength and endurance, improved balance, and increased joints motion (all p values Yoga exercise has positive benefits for both the physical and mental health of elders with dementia living in long-term care facilities. It is recommended that yoga be included as one of the routine activities in these long-term care facilities.

  2. Enriching the trustworthiness of health-related web pages.

    Science.gov (United States)

    Gaudinat, Arnaud; Cruchet, Sarah; Boyer, Celia; Chrawdhry, Pravir

    2011-06-01

    We present an experimental mechanism for enriching web content with quality metadata. This mechanism is based on a simple and well-known initiative in the field of the health-related web, the HONcode. The Resource Description Framework (RDF) format and the Dublin Core Metadata Element Set were used to formalize these metadata. The model of trust proposed is based on a quality model for health-related web pages that has been tested in practice over a period of thirteen years. Our model has been explored in the context of a project to develop a research tool that automatically detects the occurrence of quality criteria in health-related web pages.

  3. Aging Men’s Health-Related Behaviors

    Directory of Open Access Journals (Sweden)

    Terry Peak

    2014-11-01

    Full Text Available This conceptual review summarizes the current research on older men and their health-related behaviors with special attention given to the influence of the hegemonic masculinity framework over the life span. The authors consider whether masculinity precepts can be modified to enable men to alter their gendered morbidity/mortality factors and achieve healthier and longer lives. Also included is an overview of the gender-based research and health education efforts to persuade men to adopt more effective health-related behaviors or health practices earlier in the life span. Given the current attention being paid to men’s health, for example, their higher risk of morbidity and mortality both generally and at younger ages, and the associated health care costs tied to those risks, the ethical and economic implications of this review may prove useful.

  4. The Relational-Behavior Survey as a Predictor of HIV-Related Parental Miscommunication: Implications for HIV, Prevention and Education at Primary Healthcare Service Facilities

    Science.gov (United States)

    Chandler, Michele Denise; Chandler, Donald S.; Chandler, Donald S., Jr.; Race, James

    2012-01-01

    The study examined the relational-behavior survey (RBS) as a predictor of HIV-related parental miscommunication (HPM) among a voluntary sample 75 African American parents at a private healthcare facility located in the southwest region of the United States. A multiple regression analysis indicated that there was significant marginal prediction of…

  5. Mammography Facilities

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Mammography Facility Database is updated periodically based on information received from the four FDA-approved accreditation bodies: the American College of...

  6. Impact of free delivery care on health facility delivery and insurance coverage in Ghana's Brong Ahafo Region.

    Directory of Open Access Journals (Sweden)

    Susie Dzakpasu

    Full Text Available BACKGROUND: Many sub-Saharan countries, including Ghana, have introduced policies to provide free medical care to pregnant women. The impact of these policies, particularly on access to health services among the poor, has not been evaluated using rigorous methods, and so the empirical basis for defending these policies is weak. In Ghana, a recent report also cast doubt on the current mechanism of delivering free care--the National Health Insurance Scheme. Longitudinal surveillance data from two randomized controlled trials conducted in the Brong Ahafo Region provided a unique opportunity to assess the impact of Ghana's policies. METHODS: We used time-series methods to assess the impact of Ghana's 2005 policy on free delivery care and its 2008 policy on free national health insurance for pregnant women. We estimated their impacts on facility delivery and insurance coverage, and on socioeconomic differentials in these outcomes after controlling for temporal trends and seasonality. RESULTS: Facility delivery has been increasing significantly over time. The 2005 and 2008 policies were associated with significant jumps in coverage of 2.3% (p = 0.015 and 7.5% (p<0.001, respectively after the policies were introduced. Health insurance coverage also jumped significantly (17.5%, p<0.001 after the 2008 policy. The increases in facility delivery and insurance were greatest among the poorest, leading to a decline in socioeconomic inequality in both outcomes. CONCLUSION: Providing free care, particularly through free health insurance, has been effective in increasing facility delivery overall in the Brong Ahafo Region, and especially among the poor. This finding should be considered when evaluating the impact of the National Health Insurance Scheme and in supporting the continuation and expansion of free delivery care.

  7. ‘Feedback: Where data finally get thrilling’ – tools for facility managers to use data for improved health outcomes in the prevention of mother-to-child transmission of HIV and antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    J Murphy

    2013-09-01

    Full Text Available Data use and data quality continue to be a challenge for government sector health facilities and districts across South Africa. Led by the National Department of Health, key stakeholders, such as the Anova Health Institute and district health management teams, are aligning efforts to address these gaps. Coverage and correct implementation of existing tools – including TIER.net, routine data collection forms and the South African District Health Information System – must be ensured. This conference report provides an overview of such tools and summarises suggestions for quality improvement, data use and systematic evaluation of data-related interventions.

  8. Environmental and nursing-staff factors contributing to aggressive and violent behaviour of patients in mental health facilities

    Directory of Open Access Journals (Sweden)

    Evalina van Wijk

    2014-02-01

    Full Text Available Background: Aggressive and violent behaviour of inpatients in mental health facilities disrupts the therapeutic alliance and hampers treatment.Objectives: The aim of the study was to describe patients’ perceptions of the possible environmental and staff factors that might contribute to their aggressive and violent behaviour after admission to a mental health facility; and to propose strategies to prevent and manage such behaviour.Research design: A qualitative, phenomenological study was utilised, in which purposefully sampled inpatients were interviewed over a six-month period. Inpatients were invited to participate if they had been admitted for at least seven days and were in touch with reality.Method: Forty inpatients in two mental health facilities in Cape Town participated in face-to-face, semi-structured interviews over a period of six months. Tesch’s descriptive method of open coding formed the framework for the data analysis and presentation of the results. Trustworthiness was ensured in accordance with the principles of credibility, confirmability, transferability and dependability.Results: Analysis of the data indicates two central categories in the factors contributing to patients’ aggressive and violent behaviour, namely, environmental factors and the attitude and behaviour of staff. Conclusion: From the perspective of the inpatients included in this study, aggressive and violent episodes are common and require intervention. Specific strategies for preventing such behaviour are proposed and it is recommended that these strategies be incorporated into the in-service training programmes of the staff of mental health facilities. These strategies could prevent, or reduce, aggressive and violent behaviour in in-patient facilities.

  9. Peer relations, adolescent behavior, and public health research and practice.

    Science.gov (United States)

    Crosnoe, Robert; McNeely, Clea

    2008-01-01

    Peer relations are central to adolescent life and, therefore, are crucial to understanding adolescents' engagement in various behaviors. In recent years, public health research has increasingly devoted attention to the implications of peer relations for the kinds of adolescent behaviors that have a direct impact on health. This article advocates for a continuation of this trend. With this aim, we highlight key themes in the rich literature on the general developmental significance of adolescent-peer relations, provide an overview of how these themes have been incorporated into public health research and practice, and suggest future avenues for peer-focused public health research that can inform adolescent health promotion in the United States.

  10. Novel Visualization of Large Health Related Data Sets

    Science.gov (United States)

    2014-03-01

    locations (e.g. areas with high pollen that increases the need for more intensive health care for people with asthma ) and save millions of dollars...be used as a means to explore novel visualizations of large health data sets. We expect this approach to digitized healthcare data will lead to...AD_________ Award Number: W81XWH-13-1-0061 TITLE: Novel Visualization of Large Health Related Data Sets PRINCIPAL INVESTIGATOR: William Ed

  11. Novel Visualization of Large Health Related Data Sets - NPHRD

    Science.gov (United States)

    2015-11-01

    data visualization in health care, most focusing on the technical aspects of visualization, medical imaging , and genomics. A number of prototypes have...been also been reported. LifeLines, first described in 1996 by Plaisant and colleagues, 7,8 was used to visualize health data across a personal ...Award Number: W81XWH-13-1-0061 TITLE: Novel Visualization of Large Health Related Data Sets - NPHRD PRINCIPAL INVESTIGATOR: William Ed Hammond

  12. The Importance of Team Health Climate for Health-Related Outcomes of White-Collar Workers

    Science.gov (United States)

    Schulz, Heiko; Zacher, Hannes; Lippke, Sonia

    2017-01-01

    Occupational health researchers and practitioners have mainly focused on the individual and organizational levels, whereas the team level has been largely neglected. In this study, we define team health climate as employees’ shared perceptions of the extent to which their team is concerned, cares, and communicates about health issues. Based on climate, signaling, and social exchange theories, we examined a multilevel model of team health climate and its relationships with five well-established health-related outcomes (i.e., subjective general health, psychosomatic complaints, mental health, work ability, and presenteeism). Results of multilevel analyses of data provided by 6,449 employees in 621 teams of a large organization showed that team health climate is positively related to subjective general health, mental health, and work ability, and negatively related to presenteeism, above and beyond the effects of team size, age, job tenure, job demands, job control, and employees’ individual perceptions of health climate. Moreover, additional analyses showed that a positive team health climate buffered the negative relationship between employee age and work ability. Implications for future research on team health climate and suggestions for occupational health interventions in teams are discussed. PMID:28194126

  13. The Importance of Team Health Climate for Health-Related Outcomes of White-Collar Workers.

    Science.gov (United States)

    Schulz, Heiko; Zacher, Hannes; Lippke, Sonia

    2017-01-01

    Occupational health researchers and practitioners have mainly focused on the individual and organizational levels, whereas the team level has been largely neglected. In this study, we define team health climate as employees' shared perceptions of the extent to which their team is concerned, cares, and communicates about health issues. Based on climate, signaling, and social exchange theories, we examined a multilevel model of team health climate and its relationships with five well-established health-related outcomes (i.e., subjective general health, psychosomatic complaints, mental health, work ability, and presenteeism). Results of multilevel analyses of data provided by 6,449 employees in 621 teams of a large organization showed that team health climate is positively related to subjective general health, mental health, and work ability, and negatively related to presenteeism, above and beyond the effects of team size, age, job tenure, job demands, job control, and employees' individual perceptions of health climate. Moreover, additional analyses showed that a positive team health climate buffered the negative relationship between employee age and work ability. Implications for future research on team health climate and suggestions for occupational health interventions in teams are discussed.

  14. Rotordynamic Analysis and Feasibility Study of a Disk Spin Test Facility for Rotor Health Monitoring

    Science.gov (United States)

    Sawicki, Jerzy T.

    2005-01-01

    Recently, National Aeronautics and Space Administration (NASA) initiated a program to achieve the significant improvement in aviation safety. One of the technical challenges is the design and development of accelerated experiments that mimic critical damage cases encountered in engine components. The Nondestructive Evaluation (NDE) Group at the NASA Glenn Research Center (GRC) is currently addressing the goal concerning propulsion health management and the development of propulsion system specific technologies intended to detect potential failures prior to catastrophe. For this goal the unique disk spin simulation system was assembled at NASA GRC, which allows testing of rotors with the spinning speeds up to 10K RPM, and at the elevated temperature environment reaching 540 C (1000 F). It is anticipated that the facility can be employed for detection of Low Cycle Fatigue disk cracking and further High Cycle Fatigue blade vibration. The controlled crack growth studies at room and elevated temperatures can be conducted on the turbine wheels, and various NDE techniques can be integrated and assessed as in-situ damage monitoring tools. Critical rotating parts in advanced gas turbine engines such as turbine disks frequently operate at high temperature and stress for long periods of time. The integrity of these parts must be proven by non-destructive evaluation (NDE) during various machining steps ranging from forging blank to finished shape, and also during the systematic overhaul inspections. Conventional NDE methods, however, have unacceptable limits. Some of these techniques are time-consuming and inconvenient for service aircraft testing. Almost all of these techniques require that the vicinity of the damage is known in advance. These experimental techniques can provide only local information and no indication of the structural strength at a component and/or system level. The shortcomings of currently available NDE methods lead to the requirement of new damage

  15. Prescribing behavior of diabetes treating physicians in selected health care facilities of the Diabetic Association of Bangladesh

    Directory of Open Access Journals (Sweden)

    Bilkis Banu

    2014-01-01

    Full Text Available Background: Practicing behavior of the physicians varies from population to population due to diverse socioeconomic, cultural, and professional factors. Evidence on these issues is almost nonexistent in the developing countries. Objective: The prescribing behavior of diabetes treating physicians working in selected hospitals of the Diabetic Association of Bangladesh was studied along with the factors affecting those behaviors. Materials and Methods: This was an observational study on 818 prescriptions given by 49 physicians working in 16 health care facilities, which were photocopied by a portable photocopier. The various components of the prescription were scrutinized for presence and absence, and evaluated independently by two expert Diabetologists for their qualitative aspects. Results: The mean ± standard deviation of the total prescribing score (expressed as percentage was 60 ± 11. Physicians scoring around or below 60% belonged more to lower age (<40 years, less experienced (<7 years and mid-position (Senior Medical Officers groups. Most of them also had public medical college background. Physicians with Certificate Course on Diabetology (CCD had significantly higher score compared with the Non-CCD group (P < 0.001. Direction and duration of drug use were absent in majority of prescriptions (72.0% and 61.6%, respectively. Symptoms were not written in 78.0% and the family histories were not recorded in 98.5% prescriptions. Diet (49.4% and exercise (51.0% related advices were not mentioned in a large number of prescriptions. Appropriate change of drug (78.2% and proper use of drug (99.1% and brand (93.8% were found rational, but still, 22.4% of the prescriptions found illegible. Conclusion: A large proportion of prescriptions in Bangladesh related to diabetes care still lack standardization and acceptable quality. Nondrug related issues (such as history, symptoms, and dietary/exercise-related advices are the most neglected ones in a

  16. Is the political system really related to health?

    NARCIS (Netherlands)

    Klomp, J.G.; de Haan, J.

    2009-01-01

    We analyze whether the political system and its stability are related to cross-country differences in health. We apply factor analysis on various national health indicators for a large sample of countries over the period 2000-2005 and use the outcomes of the factor analysis to construct two new heal

  17. Disaster-related posttraumatic stress disorder and physical health

    NARCIS (Netherlands)

    Dirkzwager, J.E.; van der Velden, P.G.; Grievink, Linda; Yzermans, C.J.

    2007-01-01

    Objective: To examine the relationship between posttraumatic stress disorder (PTSD) and self-reported as well as physicianrecorded physical health in a sample of survivors (n 896) of a man-made disaster, using a longitudinal design that included predisaster health data. Most studies on the relations

  18. The Health-Related Quality of Life of Custodial Grandparents

    Science.gov (United States)

    Neely-Barnes, Susan L.; Graff, J. Carolyn; Washington, Gregory

    2010-01-01

    Health-related quality of life (HRQOL) was explored in a sample of 119 custodial grandparents. A latent profile analysis identified three groups of grandparents along a continuum of good to poor HRQOL, with most custodial grandparents reporting Short Form-12 Health Survey (version 2) scores significantly below U.S. population means. Grandparent…

  19. Relative Deprivation and Health: Which Reference Groups Matter?

    Science.gov (United States)

    Mangyo, Eiji; Park, Albert

    2011-01-01

    We examine the extent to which self-reported health and psychosocial health are affected by relative economic status in China, for the first time examining the importance of reference groups not defined by geographic location or demographic characteristics. We propose a methodology to address potential bias from subjective reporting biases and…

  20. Health-Related Effects of Creative and Expressive Writing

    Science.gov (United States)

    Lowe, Geoff

    2006-01-01

    Purpose: The purpose of this paper is to provide an overview of some health-related effects of creative and expressive writing. Design/methodology/approach: Reviews some of