WorldWideScience

Sample records for health system influences

  1. Managed care: employers' influence on the health care system.

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    Corder, K T; Phoon, J; Barter, M

    1996-01-01

    Health care reform is a complex issue involving many key sectors including providers, consumers, insurers, employers, and the government. System changes must involve all sectors for reform to be effective. Each sector has a responsibility to understand not only its own role in the health care system, but the roles of others as well. The role of business employers is often not apparent to health care providers, especially nurses. Understanding the influence employers have on the health care system is vital if providers want to be proactive change agents ensuring quality care.

  2. Influence of environmental health in the cow-calf dyad system

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    Thayná Barcelos Fernandes

    2012-12-01

    Full Text Available Health factors influence the cow-calf dyad system in the postpartum period until the first suckling. The use of maternity paddock is a recommended management to facilitate the monitoring of parturient cows and calves. However, side effects occur due to environmental health conditions of maternity paddock that can affect the behaviour of the cow and result in the separation of calf from the mother, undermining sucking and the formation of the cow-calf dyad. To improve the understanding of this complex and dynamic system we built a conceptual model using the technique of causal loop diagram, Figure 1. By hypothesis, the environmental variables that act in maternity paddock influence the variable "Sources of pathogens in maternity". Those sources present a positive effect (in the same direction in the infection process of the calf and cow. Thus, a recommended practice is exposing the parturient cow to pathogens in maternity for sufficient period to stimulate their immune system and build disease resistance. That process contributes to improve the quality of colostrum that will be consumed by the calf during the first hours postpartum which has the function of increasing calf immunity, minimizing the occurrence of infections. In the model, sanitary environmental factors work in two Balance feedback loops (B1 and B2. The B1 cycle refers to the production of a healthy cow with a low level of infection by means of the variables: “Vaccine”, "Stimulation of cow immune system" and "Health resistance" with delay. The variable "Cow infection" has a negative influence (in the opposite direction in the "Maternal behaviour", thus the more infected the cow, the less investment will occur in maternal behaviour. The B2 cycle refers to the calf’s health condition, which is positively influenced by “Calf infection” which, in turn, has positive influence, contributing to the increase of "Calf diseases". The increase in “Calf diseases” generates an

  3. Performance of the local health system and contingent influences in Northeast-Brazil: breaking vicious and virtuous circles

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    Regianne Leila Rolim Medeiros

    2013-11-01

    Full Text Available Organizational theory has long emphasized the importance of contingent, environmental influences on organizational performance. Similarly, research has demonstrated the importance of local political culture and informal management on the performance of the local health system, establishing vicious and virtuous circles of influence that contribute to increasing inequalities in performance among decentralized local health systems. A longitudinal ethnography studied the relationship between these elements in the same rural municipality in Northeast Brazil after a four-year interval. The second study found the local health system performance much improved. Two main factors appear to have interacted to bring this about: leadership vision and power to implement of one individual; professionalization of the local health system by hiring a significant number of senior health staff. The origins of these influences combine initiatives at local, state and federal levels.

  4. Factors influencing resource allocation decisions and equity in the health system of Ghana.

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    Asante, A D; Zwi, A B

    2009-05-01

    Allocation of financial resources in the health sector is often seen as a formula-driven activity. However, the decision to allocate a certain amount of resources to a particular health jurisdiction or facility may be based on a broader range of factors, sometimes not reflected in the existing resource allocation formula. This study explores the 'other' factors that influence the equity of resource allocation in the health system of Ghana. The extent to which these factors are, or can be, accounted for in the resource allocation process is analysed. An exploratory design focusing on different levels of the health system and diverse stakeholders. Data were gathered through semi-structured qualitative interviews with health authorities at national, regional and district levels, and with donor representatives and local government officials in 2003 and 2004. The availability of human resources for health, local capacity to utilize funds, donor involvement in the health sector, and commitment to promote equity have considerable influence on resource allocation decisions and affect the equity of funding allocations. However, these factors are not accounted for adequately in the resource allocation process. This study highlights the need for a more transparent resource allocation system in Ghana based on needs, and takes into account key issues such as capacity constraints, the inequitable human resource distribution and donor-earmarked funding.

  5. Exploring the influence of the Global Fund and the GAVI Alliance on health systems in conflict-affected countries.

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    Patel, Preeti; Cummings, Rachael; Roberts, Bayard

    2015-01-01

    Global Health Initiatives (GHIs) respond to high-impact communicable diseases in resource-poor countries, including health systems support, and are major actors in global health. GHIs could play an important role in countries affected by armed conflict given these countries commonly have weak health systems and a high burden of communicable disease. The aim of this study is to explore the influence of two leading GHIs, the Global Fund and the GAVI Alliance, on the health systems of conflict-affected countries. This study used an analytical review approach to identify evidence on the role of the Global Fund and the GAVI Alliance with regards to health systems support to 19 conflict-affected countries. Primary and secondary published and grey literature were used, including country evaluations from the Global Fund and the GAVI Alliance. The WHO heath systems building blocks framework was used for the analysis. There is a limited evidence-base on the influence of GHIs on health systems of conflict-affected countries. The findings suggest that GHIs are increasingly investing in conflict-affected countries which has helped to rapidly scale up health services, strengthen human resources, improve procurement, and develop guidelines and protocols. Negative influences include distorting priorities within the health system, inequitable financing of disease-specific services over other health services, diverting staff away from more essential health care services, inadequate attention to capacity building, burdensome reporting requirements, and limited flexibility and responsiveness to the contextual challenges of conflict-affected countries. There is some evidence of increasing engagement of the Global Fund and the GAVI Alliance with health systems in conflict-affected countries, but this engagement should be supported by more context-specific policies and approaches.

  6. Assessing the influence of knowledge translation platforms on health system policy processes to achieve the health millennium development goals in Cameroon and Uganda: a comparative case study.

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    Ongolo-Zogo, Pierre; Lavis, John N; Tomson, Goran; Sewankambo, Nelson K

    2018-05-01

    There is a scarcity of empirical data on the influence of initiatives supporting evidence-informed health system policy-making (EIHSP), such as the knowledge translation platforms (KTPs) operating in Africa. To assess whether and how two KTPs housed in government-affiliated institutions in Cameroon and Uganda have influenced: (1) health system policy-making processes and decisions aiming at supporting achievement of the health millennium development goals (MDGs); and (2) the general climate for EIHSP. We conducted an embedded comparative case study of four policy processes in which Evidence Informed Policy Network (EVIPNet) Cameroon and Regional East African Community Health Policy Initiative (REACH-PI) Uganda were involved between 2009 and 2011. We combined a documentary review and semi structured interviews of 54 stakeholders. A framework-guided thematic analysis, inspired by scholarship in health policy analysis and knowledge utilization was used. EVIPNet Cameroon and REACH-PI Uganda have had direct influence on health system policy decisions. The coproduction of evidence briefs combined with tacit knowledge gathered during inclusive evidence-informed stakeholder dialogues helped to reframe health system problems, unveil sources of conflicts, open grounds for consensus and align viable and affordable options for achieving the health MDGs thus leading to decisions. New policy issue networks have emerged. The KTPs indirectly influenced health policy processes by changing how interests interact with one another and by introducing safe-harbour deliberations and intersected with contextual ideational factors by improving access to policy-relevant evidence. KTPs were perceived as change agents with positive impact on the understanding, acceptance and adoption of EIHSP because of their complementary work in relation to capacity building, rapid evidence syntheses and clearinghouse of policy-relevant evidence. This embedded case study illustrates how two KTPs influenced

  7. The influence of system quality characteristics on health care providers' performance: Empirical evidence from Malaysia.

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    Mohd Salleh, Mohd Idzwan; Zakaria, Nasriah; Abdullah, Rosni

    The Ministry of Health Malaysia initiated the total hospital information system (THIS) as the first national electronic health record system for use in selected public hospitals across the country. Since its implementation 15 years ago, there has been the critical requirement for a systematic evaluation to assess its effectiveness in coping with the current system, task complexity, and rapid technological changes. The study aims to assess system quality factors to predict the performance of electronic health in a single public hospital in Malaysia. Non-probability sampling was employed for data collection among selected providers in a single hospital for two months. Data cleaning and bias checking were performed before final analysis in partial least squares-structural equation modeling. Convergent and discriminant validity assessments were satisfied the required criterions in the reflective measurement model. The structural model output revealed that the proposed adequate infrastructure, system interoperability, security control, and system compatibility were the significant predictors, where system compatibility became the most critical characteristic to influence an individual health care provider's performance. The previous DeLone and McLean information system success models should be extended to incorporate these technological factors in the medical system research domain to examine the effectiveness of modern electronic health record systems. In this study, care providers' performance was expected when the system usage fits with patients' needs that eventually increased their productivity. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  8. The influence of system quality characteristics on health care providers’ performance: Empirical evidence from Malaysia

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    Mohd Idzwan Mohd Salleh

    2016-11-01

    Full Text Available Summary: Background: The Ministry of Health Malaysia initiated the total hospital information system (THIS as the first national electronic health record system for use in selected public hospitals across the country. Since its implementation 15 years ago, there has been the critical requirement for a systematic evaluation to assess its effectiveness in coping with the current system, task complexity, and rapid technological changes. The study aims to assess system quality factors to predict the performance of electronic health in a single public hospital in Malaysia. Methods: Non-probability sampling was employed for data collection among selected providers in a single hospital for two months. Data cleaning and bias checking were performed before final analysis in partial least squares-structural equation modeling. Results and conclusions: Convergent and discriminant validity assessments were satisfied the required criterions in the reflective measurement model. The structural model output revealed that the proposed adequate infrastructure, system interoperability, security control, and system compatibility were the significant predictors, where system compatibility became the most critical characteristic to influence an individual health care provider’s performance. The previous DeLone and McLean information system success models should be extended to incorporate these technological factors in the medical system research domain to examine the effectiveness of modern electronic health record systems. In this study, care providers’ performance was expected when the system usage fits with patients’ needs that eventually increased their productivity. Keywords: Electronic health records system, System quality characteristics, Care providers’ performance, Evaluation, Partial least squares-structural equation modeling

  9. Exploring health systems research and its influence on policy processes in low income countries

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    Syed Shamsuzzoha B

    2007-10-01

    Full Text Available Abstract Background The interface between research and policymaking in low-income countries is highly complex. The ability of health systems research to influence policy processes in such settings face numerous challenges. Successful analysis of the research-policy interface in these settings requires understanding of contextual factors as well as key influences on the interface. Future Health Systems (FHS: Innovations for Equity is a consortium conducting research in six countries in Asia and Africa. One of the three cross-country research themes of the consortium is analysis of the relationship between research (evidence and policy making, especially their impact on the poor; insights gained in the initial conceptual phase of FHS activities can inform the global knowledge pool on this subject. Discussion This paper provides a review of the research-policy interface in low-income countries and proposes a conceptual framework, followed by directions for empirical approaches. First, four developmental perspectives are considered: social institutional factors; virtual versus grassroots realities; science-society relationships; and construction of social arrangements. Building on these developmental perspectives three research-policy interface entry points are identified: 1. Recognizing policy as complex processes; 2. Engaging key stakeholders: decision-makers, providers, scientists, and communities; and 3. Enhancing accountability. A conceptual framework with three entry points to the research-policy interface – policy processes; stakeholder interests, values, and power; and accountability – within a context provided by four developmental perspectives is proposed. Potential empirical approaches to the research-policy interface are then reviewed. Finally, the value of such innovative empirical analysis is considered. Conclusion The purpose of this paper is to provide the background, conceptual framework, and key research directions for

  10. Key influences in the design and implementation of mental health information systems in Ghana and South Africa.

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    Ahuja, S; Mirzoev, T; Lund, C; Ofori-Atta, A; Skeen, S; Kufuor, A

    2016-01-01

    Strengthening of mental health information systems (MHIS) is essential to monitor and evaluate mental health services in low and middle-income countries. While research exists assessing wider health management information systems, there is limited published evidence exploring the design and implementation of MHIS in these settings. This paper aims to identify and assess the key factors affecting the design and implementation of MHIS, as perceived by the key stakeholders in Ghana and South Africa. We report findings from the Mental Health and Poverty Project, a 5-year research programme implemented within four African countries. The MHIS strengthening in South Africa and Ghana included two related components: intervention and research. The intervention component aimed to strengthen MHIS in the two countries, and the research component aimed to document interventions in each country, including the key influences. Data were collected using semi structured interviews with key stakeholders and reviews of key documents and secondary data from the improved MHIS. We analyzed the qualitative data using a framework approach. Key components of the MHIS intervention involved the introduction of a redesigned patient registration form, entry into computers for analysis every 2 months by clinical managerial staff, and utilization of data in hospital management meetings in three psychiatric hospitals in Ghana; and the introduction of a new set of mental health indicators and related forms and tally sheets at primary care clinics and district hospitals in five districts in the KwaZulu-Natal and Northern Cape provinces in South Africa. Overall, the key stakeholders perceived the MHIS strengthening as an effective intervention in both countries with an enhanced set of indicators in South Africa and introduction of a computerized system in Ghana. Influences on the design and implementation of MHIS interventions in Ghana and South Africa relate to resources, working approaches

  11. The influence of health care policies and health care system distrust on willingness to undergo genetic testing.

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    Armstrong, Katrina; Putt, Mary; Halbert, Chanita Hughes; Grande, David; Schwartz, Jerome Sanford; Liao, Kaijun; Marcus, Noora; Demeter, Mirar Bristol; Shea, Judy

    2012-05-01

    As the potential role of genetic testing in disease prevention and management grows, so does concern about differences in uptake of genetic testing across social and racial groups. Characteristics of how genetic tests are delivered may influence willingness to undergo testing and, if they affect population subgroups differently, alter disparities in testing. Conjoint analysis study of the effect of 3 characteristics of genetic test delivery (ie, attributes) on willingness to undergo genetic testing for cancer risk. Data were collected using a random digit dialing survey of 128 African American and 209 white individuals living in the United States. Measures included conjoint scenarios, the Revised Health Care System Distrust Scale (including the values and competence subscales), health insurance coverage, and sociodemographic characteristics. The 3 attributes studied were disclosure of test results to the health insurer, provision of the test by a specialist or primary care doctor, and race-specific or race-neutral marketing. In adjusted analyses, disclosure of test results to insurers, having to get the test from a specialist, and race-specific marketing were all inversely associated with willingness to undergo the genetic test, with the greatest effect for the disclosure attribute. Racial differences in willingness to undergo testing were not statistically significant (P=0.07) and the effect of the attributes on willingness to undergo testing did not vary by patient race. However, the decrease in willingness to undergo testing with insurance disclosure was greater among individuals with high values distrust (P=0.03), and the decrease in willingness to undergo testing from specialist access was smaller among individuals with high competence distrust (P=0.03). Several potentially modifiable characteristics of how genetic tests are delivered are associated with willingness to undergo testing. The effect of 2 of these characteristics vary according to the level of

  12. Anchoring contextual analysis in health policy and systems research: A narrative review of contextual factors influencing health committees in low and middle income countries.

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    George, Asha; Scott, Kerry; Garimella, Surekha; Mondal, Shinjini; Ved, Rajani; Sheikh, Kabir

    2015-05-01

    Health committees, councils or boards (HCs) mediate between communities and health services in many health systems. Despite their widespread prevalence, HC functions vary due to their diversity and complexity, not least because of their context specific nature. We undertook a narrative review to better understand the contextual features relevant to HCs, drawing from Scopus and the internet. We found 390 English language articles from journals and grey literature since 1996 on health committees, councils and boards. After screening with inclusion and exclusion criteria, we focused on 44 articles. Through an iterative process of exploring previous attempts at understanding context in health policy and systems research (HPSR) and the HC literature, we developed a conceptual framework that delineates these contextual factors into four overlapping spheres (community, health facilities, health administration, society) with cross-cutting issues (awareness, trust, benefits, resources, legal mandates, capacity-building, the role of political parties, non-governmental organizations, markets, media, social movements and inequalities). While many attempts at describing context in HPSR result in empty arenas, generic lists or amorphous detail, we suggest anchoring an understanding of context to a conceptual framework specific to the phenomena of interest. By doing so, our review distinguishes between contextual elements that are relatively well understood and those that are not. In addition, our review found that contextual elements are dynamic and porous in nature, influencing HCs but also being influenced by them due to the permeability of HCs. While reforms focus on tangible HC inputs and outputs (training, guidelines, number of meetings held), our review of contextual factors highlights the dynamic relationships and broader structural elements that facilitate and/or hinder the role of health committees in health systems. Such an understanding of context points to its

  13. Performance of community health workers: situating their intermediary position within complex adaptive health systems.

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    Kok, Maryse C; Broerse, Jacqueline E W; Theobald, Sally; Ormel, Hermen; Dieleman, Marjolein; Taegtmeyer, Miriam

    2017-09-02

    Health systems are social institutions, in which health worker performance is shaped by transactional processes between different actors.This analytical assessment unravels the complex web of factors that influence the performance of community health workers (CHWs) in low- and middle-income countries. It examines their unique intermediary position between the communities they serve and actors in the health sector, and the complexity of the health systems in which they operate. The assessment combines evidence from the international literature on CHW programmes with research outcomes from the 5-year REACHOUT consortium, undertaking implementation research to improve CHW performance in six contexts (two in Asia and four in Africa). A conceptual framework on CHW performance, which explicitly conceptualizes the interface role of CHWs, is presented. Various categories of factors influencing CHW performance are distinguished in the framework: the context, the health system and intervention hardware and the health system and intervention software. Hardware elements of CHW interventions comprise the supervision systems, training, accountability and communication structures, incentives, supplies and logistics. Software elements relate to the ideas, interests, relationships, power, values and norms of the health system actors. They influence CHWs' feelings of connectedness, familiarity, self-fulfilment and serving the same goals and CHWs' perceptions of support received, respect, competence, honesty, fairness and recognition.The framework shines a spotlight on the need for programmes to pay more attention to ideas, interests, relationships, power, values and norms of CHWs, communities, health professionals and other actors in the health system, if CHW performance is to improve.

  14. Influence of religious leaders in the health-disease process

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    Elton Lima Macêdo

    2017-02-01

    Full Text Available Introduction: Religion has helped the lower classes to raise the perspective of "divine justice" in the struggle for survival by allowing their believers to seek, in their practices, under the influence of religious leaders, the main guidelines to alleviate the suffering from the health-disease process. Objective: Unveil the limits and potentialities of religious leaders' influence on the health-disease process. Materials and Methods: Exploratory-type research, with a qualitative approach, based methodologically on the Historical Dialectical Materialism. For the data analysis, one used the discourse analysis technique proposed by Fiorin. Results: From the empirical universe, two analytical categories emerged: (1. Limits and possibilities of religious influence in relation to the health-disease process; 2. Vulnerabilities of the Unified Health System and the complementarity of religion: Interfaces of the health-disease process in postmodernity, in which religious practices, institutions and leaders express positively health care in the face of the disease process. However, the religious leader's power relations over the community and religious fanaticism make the search for religion to have a negative influence on people's health-disease process. Conclusion: Religious leaders encourage the complementarity between religion and medicine only at times when their believers need medium and high-complexity assistance, showing little attention to the preventive aspects of self-care, which reinforces the need to invest in new studies in the area.

  15. Physical health of young and middle age women under influence of step-aerobics exercises

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    I.P. Masliak

    2015-10-01

    Full Text Available Purpose: to determine the degree of step-aerobics exercises’ influence on 20-35 years age women’s health. Material: in the research 28 women of 20-35 years old age participated. Anthropometric indicators, heart beats rate in rest and after load (20 squats for 30 sec., blood pressure, vital capacity of lungs, hand dynamometry were registered. Results: level of physical health has been determined; influence of step-aerobics on women’s health has been found; age differences in the tested indicators have been analyzed. It was found out that step-aerobic trainings influence greatly on the following indicators: body mass, circumferential sizes and cardio vascular system; on functioning of respiratory system, strength of hand’s flexors and regulation of 31-35 years age women’s cardio-vascular system. Conclusions: application of step-aerobic exercises positively influenced on health of 20-35 years old women.

  16. Antibiotic use by farmers to control mastitis as influenced by health advice and dairy farming systems.

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    Poizat, A; Bonnet-Beaugrand, F; Rault, A; Fourichon, C; Bareille, N

    2017-10-01

    Mastitis is a bacterial disease common in dairy farms. Although knowledge about mastitis and its optimal technical management and treatment is now available, some dairy farmers still use antibiotics in inappropriate ways. Antibiotic use by farmers can be influenced by personal restraints and motivations, but it can be assumed that external drivers are also influential. The main purpose of this article is thus to analyse the choices of antibiotic and alternative medicine use for mastitis treatment and investigate the possible influence of two unexplored external drivers in dairy farms: (i) the health advice offered to farmers by farm advisors and veterinarians, (ii) the dairy farming system, as defined by combining the market valuation chosen for the milk, the level of intensification, and the perceived pressure related to investments. Research was based on 51 individual semi-structured interviews with farmers and their corresponding veterinarians and farm advisors. Based on verbatim, the use of antibiotics and alternative medicine by farmers for mastitis treatment, the vet-farmers interactions, and the dairy farming systems are described. The advisory relationships between farmers and farm advisors and between farmers and veterinarians influenced the implementation of selective dry cow therapy, but had very little effect on the use of alternative medicines by farmers, who were more willing to experiment alternative medicines than their advisors. The dairy farming system had very little influence on antibiotic use: some misuse of antibiotics was found whatever the farming system. Systematic dry cow therapy was also a widespread habit in all dairy farming systems except organic. The use of alternative medicine was common in all farming systems. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Social influences and reproductive health of adolescents

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    Stanković Biljana

    2007-01-01

    Full Text Available Reproductive health represents a state of complete physical, mental and social prosperity, and not just the absence of illness or weakness, and it refers to reproductive processes, functions and systems. Adolescents, young people from the age of ten to nineteen, are yet to achieve their reproductive function, thus their reproductive health and behavior are very significant both from the individual and social standpoint. Risky behavior, which represents the main cause of diseases that young people contract most often, in the field of sexuality often lead to unplanned pregnancies and abortions, as well as diseases from sexually transmitted infections. The extensiveness can be decreased by prevention. Reproductive health promotion, as well as general health promotion, understands a social surrounding that supports healthy behavior styles. Above all, the family, schoolmates, health and school systems, mass media, without neglecting the importance of economic, social and political security in society, political and legal solutions, as well as activities of nongovernmental, religious and other organizations. Their impact, in complex interaction, directly and indirectly influence youth behavior and determine the decisions they make regarding reproductive health.

  18. Understanding the impact of global trade liberalization on health systems pursuing universal health coverage.

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    Missoni, Eduardo

    2013-01-01

    In the context of reemerging universalistic approaches to health care, the objective of this article was to contribute to the discussion by highlighting the potential influence of global trade liberalization on the balance between health demand and the capacity of health systems pursuing universal health coverage (UHC) to supply adequate health care. Being identified as a defining feature of globalization affecting health, trade liberalization is analyzed as a complex and multidimensional influence on the implementation of UHC. The analysis adopts a systems-thinking approach and refers to the six building blocks of World Health Organization's current "framework for action," emphasizing their interconnectedness. While offering new opportunities to increase access to health information and care, in the absence of global governance mechanisms ensuring adequate health protection and promotion, global trade tends to have negative effects on health systems' capacity to ensure UHC, both by causing higher demand and by interfering with the interconnected functioning of health systems' building blocks. The prevention of such an impact and the effective implementation of UHC would highly benefit from a more consistent commitment and stronger leadership by the World Health Organization in protecting health in global policymaking fora in all sectors. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  19. Advancing the application of systems thinking in health: managing rural China health system development in complex and dynamic contexts.

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    Zhang, Xiulan; Bloom, Gerald; Xu, Xiaoxin; Chen, Lin; Liang, Xiaoyun; Wolcott, Sara J

    2014-08-26

    This paper explores the evolution of schemes for rural finance in China as a case study of the long and complex process of health system development. It argues that the evolution of these schemes has been the outcome of the response of a large number of agents to a rapidly changing context and of efforts by the government to influence this adaptation process and achieve public health goals. The study draws on several sources of data including a review of official policy documents and academic papers and in-depth interviews with key policy actors at national level and at a sample of localities. The study identifies three major transition points associated with changes in broad development strategy and demonstrates how the adaptation of large numbers of actors to these contextual changes had a major impact on the performance of the health system. Further, it documents how the Ministry of Health viewed its role as both an advocate for the interests of health facilities and health workers and as the agency responsible for ensuring that government health system objectives were met. It is argued that a major reason for the resilience of the health system and its ability to adapt to rapid economic and institutional change was the ability of the Ministry to provide overall strategy leadership. Additionally, it postulates that a number of interest groups have emerged, which now also seek to influence the pathway of health system development. This history illustrates the complex and political nature of the management of health system development and reform. The paper concludes that governments will need to increase their capacity to analyze the health sector as a complex system and to manage change processes.

  20. Integrating Social impacts on Health and Health-Care Systems in Systemic Seismic Vulnerability Analysis

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    Kunz-Plapp, T.; Khazai, B.; Daniell, J. E.

    2012-04-01

    This paper presents a new method for modeling health impacts caused by earthquake damage which allows for integrating key social impacts on individual health and health-care systems and for implementing these impacts in quantitative systemic seismic vulnerability analysis. In current earthquake casualty estimation models, demand on health-care systems is estimated by quantifying the number of fatalities and severity of injuries based on empirical data correlating building damage with casualties. The expected number of injured people (sorted by priorities of emergency treatment) is combined together with post-earthquake reduction of functionality of health-care facilities such as hospitals to estimate the impact on healthcare systems. The aim here is to extend these models by developing a combined engineering and social science approach. Although social vulnerability is recognized as a key component for the consequences of disasters, social vulnerability as such, is seldom linked to common formal and quantitative seismic loss estimates of injured people which provide direct impact on emergency health care services. Yet, there is a consensus that factors which affect vulnerability and post-earthquake health of at-risk populations include demographic characteristics such as age, education, occupation and employment and that these factors can aggravate health impacts further. Similarly, there are different social influences on the performance of health care systems after an earthquake both on an individual as well as on an institutional level. To link social impacts of health and health-care services to a systemic seismic vulnerability analysis, a conceptual model of social impacts of earthquakes on health and the health care systems has been developed. We identified and tested appropriate social indicators for individual health impacts and for health care impacts based on literature research, using available European statistical data. The results will be used to

  1. Switzerland: Health System Review.

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    De Pietro, Carlo; Camenzind, Paul; Sturny, Isabelle; Crivelli, Luca; Edwards-Garavoglia, Suzanne; Spranger, Anne; Wittenbecher, Friedrich; Quentin, Wilm

    2015-01-01

    This analysis of the Swiss health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The Swiss health system is highly complex, combining aspects of managed competition and corporatism (the integration of interest groups in the policy process) in a decentralized regulatory framework shaped by the influences of direct democracy. The health system performs very well with regard to a broad range of indicators. Life expectancy in Switzerland (82.8 years) is the highest in Europe after Iceland, and healthy life expectancy is several years above the European Union (EU) average. Coverage is ensured through mandatory health insurance (MHI), with subsidies for people on low incomes. The system offers a high degree of choice and direct access to all levels of care with virtually no waiting times, though managed care type insurance plans that include gatekeeping restrictions are becoming increasingly important. Public satisfaction with the system is high and quality is generally viewed to be good or very good. Reforms since the year 2000 have improved the MHI system, changed the financing of hospitals, strengthened regulations in the area of pharmaceuticals and the control of epidemics, and harmonized regulation of human resources across the country. In addition, there has been a slow (and not always linear) process towards more centralization of national health policy-making. Nevertheless, a number of challenges remain. The costs of the health care system are well above the EU average, in particular in absolute terms but also as a percentage of gross domestic product (GDP) (11.5%). MHI premiums have increased more quickly than incomes since 2003. By European standards, the share of out-of-pocket payments is exceptionally high at 26% of total health expenditure (compared to the EU average of 16%). Low and middle-income households contribute a greater share of their income to

  2. Organizational factors influencing successful primary care and public health collaboration.

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    Valaitis, Ruta; Meagher-Stewart, Donna; Martin-Misener, Ruth; Wong, Sabrina T; MacDonald, Marjorie; O'Mara, Linda

    2018-06-07

    Public health and primary care are distinct sectors within western health care systems. Within each sector, work is carried out in the context of organizations, for example, public health units and primary care clinics. Building on a scoping literature review, our study aimed to identify the influencing factors within these organizations that affect the ability of these health care sectors to collaborate with one another in the Canadian context. Relationships between these factors were also explored. We conducted an interpretive descriptive qualitative study involving in-depth interviews with 74 key informants from three provinces, one each in western, central and eastern Canada, and others representing national organizations, government, or associations. The sample included policy makers, managers, and direct service providers in public health and primary care. Seven major organizational influencing factors on collaboration were identified: 1) Clear Mandates, Vision, and Goals; 2) Strategic Coordination and Communication Mechanisms between Partners; 3) Formal Organizational Leaders as Collaborative Champions; 4) Collaborative Organizational Culture; 5) Optimal Use of Resources; 6) Optimal Use of Human Resources; and 7) Collaborative Approaches to Programs and Services Delivery. While each influencing factor was distinct, the many interactions among these influences are indicative of the complex nature of public health and primary care collaboration. These results can be useful for those working to set up new or maintain existing collaborations with public health and primary care which may or may not include other organizations.

  3. Armenia: Influences and Organization of Mental Health Services

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    McCarthy, John; Harutyunyan, Hasmik; Smbatyan, Meri; Cressley, Heidi

    2013-01-01

    Relatively little has been published on mental health care and counseling as they pertain to Armenia, a country of approximately three million residents that gained independence in 1991 from the former Soviet Union. Various influences, such as its history, economy, religious and family systems, and a major natural disaster in 1988, have affected…

  4. Influence of Health Behaviors and Occupational Stress on Prediabetic State among Male Office Workers.

    Science.gov (United States)

    Ryu, Hosihn; Moon, Jihyeon; Jung, Jiyeon

    2018-06-14

    This study examined the influence of health behaviors and occupational stress on the prediabetic state of male office workers, and identified related risks and influencing factors. The study used a cross-sectional design and performed an integrative analysis on data from regular health checkups, health questionnaires, and a health behavior-related survey of employees of a company, using Spearman’s correlation coefficients and multiple logistic regression analysis. The results showed significant relationships of prediabetic state with health behaviors and occupational stress. Among health behaviors, a diet without vegetables and fruits (Odds Ratio (OR) = 3.74, 95% Confidence Interval (CI) = 1.93⁻7.66) was associated with a high risk of prediabetic state. In the subscales on occupational stress, organizational system in the 4th quartile (OR = 4.83, 95% CI = 2.40⁻9.70) was significantly associated with an increased likelihood of prediabetic state. To identify influencing factors of prediabetic state, the multiple logistic regression was performed using regression models. The results showed that dietary habits (β = 1.20, p = 0.002), total occupational stress score (β = 1.33, p = 0.024), and organizational system (β = 1.13, p = 0.009) were significant influencing factors. The present findings indicate that active interventions are needed at workplace for the systematic and comprehensive management of health behaviors and occupational stress that influence prediabetic state of office workers.

  5. Performance of community health workers:situating their intermediary position within complex adaptive health systems

    OpenAIRE

    Kok, Maryse. C; Broerse, Jacqueline E.W; Theobald, Sally; Ormel, Hermen; Dieleman, Marjolein; Taegtmeyer, Miriam

    2017-01-01

    Health systems are social institutions, in which health worker performance is shaped by transactional processes between different actors. This analytical assessment unravels the complex web of factors that influence the performance of community health workers (CHWs) in low- and middle-income countries. It examines their unique intermediary position between the communities they serve and actors in the health sector, and the complexity of the health systems in which they operate. The assessment...

  6. Factors influencing consumer dietary health preventative behaviours.

    Science.gov (United States)

    Petrovici, Dan A; Ritson, Christopher

    2006-09-01

    The deterioration of the health status of the Romanian population during the economic transition from a centrally planned to a free market economy has been linked to lifestyles factors (e.g. diet) regarded as a main determinants of the disparity in life expectancy between Eastern and Western Europe. Reforms in the health care system in this transition economy aim to focus on preventive action. The purpose of this study was to identify the factors that impact on the individual decision to engage in Dietary Health Preventive Behaviour (DHPB) and investigate their influence in the context of an adapted health cognition model. A population-based study recruited 485 adult respondents using random route sampling and face-to-face administered questionnaires. Respondents' health motivation, beliefs that diet can prevent disease, knowledge about nutrition, level of education attainment and age have a positive influence on DHPB. Perceived barriers to healthy eating have a negative impact on alcohol moderation. The information acquisition behaviour (frequency of reading food labels) is negatively predicted by age and positively predicted by health motivation, education, self-reported knowledge about nutrition and household financial status. A significant segment of respondents believe they are not susceptible to the elicited diseases. Health promotion strategies should aim to change the judgments of health risk. The adaptation of the Health Belief Model and the Theory of Health Preventive Behaviour represents a valid framework of predicting DHPB. The negative sign of perceived threat of disease on DHPB may suggest that, under an income constraint, consumers tend to trade off long-term health benefits for short-term benefits. This cautions against the use of negative messages in public health campaigns. Raising the awareness of diet-disease relationships, knowledge about nutrition (particularly sources and risks associated with dietary fat and cholesterol) may induce people to

  7. Performance of community health workers : situating their intermediary position within complex adaptive health systems

    NARCIS (Netherlands)

    Kok, Maryse C; Broerse, Jacqueline E W; Theobald, Sally; Ormel, Hermen; Dieleman, Marjolein; Taegtmeyer, Miriam

    2017-01-01

    Health systems are social institutions, in which health worker performance is shaped by transactional processes between different actors.This analytical assessment unravels the complex web of factors that influence the performance of community health workers (CHWs) in low- and middle-income

  8. Are there differences in health information exchange by health system type?

    Science.gov (United States)

    Opoku-Agyeman, William; Menachemi, Nir

    2016-01-01

    Despite the potential of health information exchange (HIE) to improve safety and reduce cost, hospitals have been slow to adopt HIE with only 30% of U.S. hospitals doing so in 2012. The aim of this study was to explore the relationship between different health system types and how they engage in HIE. Data on health system types and engagement in HIE activity were combined with secondary hospital characteristics. Ordinal logistic regression analyses were used to examine the relationship between a scale measuring the level of HIE engagement and health system type controlling for hospital and market characteristics. Data from 1552 hospitals were available for analyses. Overall, hospital in a health system of any kind exchanged more patient data elements (e.g., patient demographics, clinical summaries, laboratory results, medication history, and radiology report) compared with stand-alone hospitals (3.82 vs. 1.80, p centralized health systems, 75 (4.8%) were in centralized physician/insurance health system, 284 (18.3%) were in moderately centralized health system, 391 (25.2%) were in decentralized health system, and 91 (5.9%) were in independent health system. In regression analyses, hospitals belonging to a health system were more likely to exchange patient health data with other hospitals in the same system (OR = 3.94, p < .001) but not with hospitals outside their system (OR = 1.89, p = .445). Across health system types, there was no significant difference in the exchange of patient health data. Hospital engagement in HIE is associated with health system membership. These findings will assist hospital leaders and managers to better understand how the structure and nature of their system may influence what their individual hospital can and cannot do in their decision to engage in HIE and other decisions that support the overall system objectives.

  9. Population preferences for health care in liberia: insights for rebuilding a health system.

    Science.gov (United States)

    Kruk, Margaret E; Rockers, Peter C; Tornorlah Varpilah, S; Macauley, Rose

    2011-12-01

    OBJECTIVE. To quantify the influence of health system attributes, particularly quality of care, on preferences for health clinics in Liberia, a country with a high burden of disease that is rebuilding its health system after 14 years of civil war. DATA SOURCES/STUDY SETTING. Informed by focus group discussions, a discrete choice experiment (DCE) was designed to assess preferences for structure and process of care at health clinics. The DCE was fielded in rural, northern Liberia as part of a 2008 population-based survey on health care utilization. DATA COLLECTION. The survey response rate was 98 percent with DCE data available for 1,431 respondents. Mixed logit models were used to estimate the influence of six attributes on choice of hypothetical clinics for a future illness. PRINCIPAL FINDINGS. Participants' choice of clinic was most influenced by provision of a thorough physical exam and consistent availability of medicines. Respectful treatment and government (versus NGO) management marginally increased utility, whereas waiting time was not significant. CONCLUSIONS. Liberians value technical quality of care over convenience, courtesy, and public management in selecting clinics for curative care. This suggests that investments in improved competence of providers and availability of medicines may increase population utilization of essential services as well as promote better clinical outcomes. © Health Research and Educational Trust.

  10. Health financing for universal coverage and health system performance: concepts and implications for policy.

    Science.gov (United States)

    Kutzin, Joseph

    2013-08-01

    Unless the concept is clearly understood, "universal coverage" (or universal health coverage, UHC) can be used to justify practically any health financing reform or scheme. This paper unpacks the definition of health financing for universal coverage as used in the World Health Organization's World health report 2010 to show how UHC embodies specific health system goals and intermediate objectives and, broadly, how health financing reforms can influence these. All countries seek to improve equity in the use of health services, service quality and financial protection for their populations. Hence, the pursuit of UHC is relevant to every country. Health financing policy is an integral part of efforts to move towards UHC, but for health financing policy to be aligned with the pursuit of UHC, health system reforms need to be aimed explicitly at improving coverage and the intermediate objectives linked to it, namely, efficiency, equity in health resource distribution and transparency and accountability. The unit of analysis for goals and objectives must be the population and health system as a whole. What matters is not how a particular financing scheme affects its individual members, but rather, how it influences progress towards UHC at the population level. Concern only with specific schemes is incompatible with a universal coverage approach and may even undermine UHC, particularly in terms of equity. Conversely, if a scheme is fully oriented towards system-level goals and objectives, it can further progress towards UHC. Policy and policy analysis need to shift from the scheme to the system level.

  11. [Influencing factors for reproductive health of female workers in petrochemical industry].

    Science.gov (United States)

    Kou, Z X; Wang, S L; Chen, Z L; He, Y H; Yu, W L; Mei, L Y; Zhang, H D

    2018-02-20

    Objective: To investigate the reproductive health status of female workers in petrochemical industry, and to provide a reference for improving reproductive health status and developing preventive and control measures for female workers in petrochemical industry. Methods: A face-to-face questionnaire survey was performed from January to October, 2016. The Questionnaire on Women's Reproductive Health was used to investigate the reproductive health of female workers in petrochemical industry. The multivariate logistic regression model was used to identify the influencing factors for reproductive health of female workers in petrochemical industry. Results: Among the 7485 female workers, 1 268 (40.9%) had abnormal menstrual period, 1 437 (46.4%) had abnormal menstrual volume, 177 (28.5%) had hyperplasia of mammary glands, and 1 807 (24.6%) had gynecological inflammation. The reproductive system diseases in female workers in petrochemical industry were associated with the factors including age, marital status, education level, unhealthy living habits, abortion, overtime work, work shift, workload, video operation, occupational exposure, positive events, and negative events, and among these factors, negative events (odds ratio[ OR ]= 1.856) , unhealthy living habits ( OR =1.542) , and positive events ( OR =1.516) had greater impact on reproductive system diseases. Conclusion: Many chemical substances in the occupational environment of petrochemical industry can cause damage to the reproductive system, which not only affects the health of the female workers, but also poses potential threats to the health of their offspring. Occupational exposure, unhealthy living habits, overtime work, and work shift have great influence on reproductive system diseases in female workers.

  12. Influencing public health without authority.

    Science.gov (United States)

    Suresh, K

    2012-01-01

    This paper analyzes the present processes, products and needs of post-graduate public health education for the health programming, implementation and oversight responsibilities at field level and suggests some solutions for the institutes to adopt or adapt for improving the quality of their scholars. Large number of institutions has cropped up in India in the recent years to meet the growing demand of public health specialists/practitioners in various national health projects, international development partners, national and international NGOs. Throwing open MPH courses to multi-disciplinary graduate's is a new phenomenon in India and may be a two edged sword. On one hand it is advantageous to produce multi-faceted Public health postgraduates to meet the multi tasking required, on the other hand getting all of them to a common basic understanding, demystifying technical teaching and churning out products that are acceptable to the traditional health system. These Institutions can and must influence public health in the country through producing professionals of MPH/ MD degree with right attitude and skill-mix. Engaging learners in experimentation, experience sharing projects, stepping into health professionals' roles and similar activities lead to development of relatively clear and permanent neural traces in the brain. The MPH institutes may not have all efficient faculties, for which they should try to achieve this by inviting veterans in public health and professionals from corporate health industry for interface with students on a regular basis. The corporate and public health stalwarts have the capacities to transmit the winning skills and knowledge and also inspire them to adopt or adapt in order to achieve the desired goals.

  13. Strengthening primary health care through primary care and public health collaboration: the influence of intrapersonal and interpersonal factors.

    Science.gov (United States)

    Valaitis, Ruta K; O'Mara, Linda; Wong, Sabrina T; MacDonald, Marjorie; Murray, Nancy; Martin-Misener, Ruth; Meagher-Stewart, Donna

    2018-04-12

    AimThe aim of this paper is to examine Canadian key informants' perceptions of intrapersonal (within an individual) and interpersonal (among individuals) factors that influence successful primary care and public health collaboration. Primary health care systems can be strengthened by building stronger collaborations between primary care and public health. Although there is literature that explores interpersonal factors that can influence successful inter-organizational collaborations, a few of them have specifically explored primary care and public health collaboration. Furthermore, no papers were found that considered factors at the intrapersonal level. This paper aims to explore these gaps in a Canadian context. This interpretative descriptive study involved key informants (service providers, managers, directors, and policy makers) who participated in one h telephone interviews to explore their perceptions of influences on successful primary care and public health collaboration. Transcripts were analyzed using NVivo 9.FindingsA total of 74 participants [from the provinces of British Columbia (n=20); Ontario (n=19); Nova Scotia (n=21), and representatives from other provinces or national organizations (n=14)] participated. Five interpersonal factors were found that influenced public health and primary care collaborations including: (1) trusting and inclusive relationships; (2) shared values, beliefs and attitudes; (3) role clarity; (4) effective communication; and (5) decision processes. There were two influencing factors found at the intrapersonal level: (1) personal qualities, skills and knowledge; and (2) personal values, beliefs, and attitudes. A few differences were found across the three core provinces involved. There were several complex interactions identified among all inter and intra personal influencing factors: One key factor - effective communication - interacted with all of them. Results support and extend our understanding of what influences

  14. Exploring how different modes of governance act across health system levels to influence primary healthcare facility managers' use of information in decision-making: experience from Cape Town, South Africa.

    Science.gov (United States)

    Scott, Vera; Gilson, Lucy

    2017-09-15

    Governance, which includes decision-making at all levels of the health system, and information have been identified as key, interacting levers of health system strengthening. However there is an extensive literature detailing the challenges of supporting health managers to use formal information from health information systems (HISs) in their decision-making. While health information needs differ across levels of the health system there has been surprisingly little empirical work considering what information is actually used by primary healthcare facility managers in managing, and making decisions about, service delivery. This paper, therefore, specifically examines experience from Cape Town, South Africa, asking the question: How is primary healthcare facility managers' use of information for decision-making influenced by governance across levels of the health system? The research is novel in that it both explores what information these facility managers actually use in decision-making, and considers how wider governance processes influence this information use. An academic researcher and four facility managers worked as co-researchers in a multi-case study in which three areas of management were served as the cases. There were iterative cycles of data collection and collaborative analysis with individual and peer reflective learning over a period of three years. Central governance shaped what information and knowledge was valued - and, therefore, generated and used at lower system levels. The central level valued formal health information generated in the district-based HIS which therefore attracted management attention across the levels of the health system in terms of design, funding and implementation. This information was useful in the top-down practices of planning and management of the public health system. However, in facilities at the frontline of service delivery, there was a strong requirement for local, disaggregated information and experiential

  15. Population Preferences for Health Care in Liberia: Insights for Rebuilding a Health System

    Science.gov (United States)

    Kruk, Margaret E; Rockers, Peter C; Tornorlah Varpilah, S; Macauley, Rose

    2011-01-01

    Objective To quantify the influence of health system attributes, particularly quality of care, on preferences for health clinics in Liberia, a country with a high burden of disease that is rebuilding its health system after 14 years of civil war. Data Sources/Study Setting Informed by focus group discussions, a discrete choice experiment (DCE) was designed to assess preferences for structure and process of care at health clinics. The DCE was fielded in rural, northern Liberia as part of a 2008 population-based survey on health care utilization. Data Collection The survey response rate was 98 percent with DCE data available for 1,431 respondents. Mixed logit models were used to estimate the influence of six attributes on choice of hypothetical clinics for a future illness. Principal Findings Participants' choice of clinic was most influenced by provision of a thorough physical exam and consistent availability of medicines. Respectful treatment and government (versus NGO) management marginally increased utility, whereas waiting time was not significant. Conclusions Liberians value technical quality of care over convenience, courtesy, and public management in selecting clinics for curative care. This suggests that investments in improved competence of providers and availability of medicines may increase population utilization of essential services as well as promote better clinical outcomes. PMID:21517835

  16. Factors influencing consumer dietary health preventative behaviours

    Directory of Open Access Journals (Sweden)

    Ritson Christopher

    2006-09-01

    Full Text Available Abstract Background The deterioration of the health status of the Romanian population during the economic transition from a centrally planned to a free market economy has been linked to lifestyles factors (e.g. diet regarded as a main determinants of the disparity in life expectancy between Eastern and Western Europe. Reforms in the health care system in this transition economy aim to focus on preventive action. The purpose of this study was to identify the factors that impact on the individual decision to engage in Dietary Health Preventive Behaviour (DHPB and investigate their influence in the context of an adapted health cognition model. Methods A population-based study recruited 485 adult respondents using random route sampling and face-to-face administered questionnaires. Results and discussion Respondents' health motivation, beliefs that diet can prevent disease, knowledge about nutrition, level of education attainment and age have a positive influence on DHPB. Perceived barriers to healthy eating have a negative impact on alcohol moderation. The information acquisition behaviour (frequency of reading food labels is negatively predicted by age and positively predicted by health motivation, education, self-reported knowledge about nutrition and household financial status. A significant segment of respondents believe they are not susceptible to the elicited diseases. Health promotion strategies should aim to change the judgments of health risk. Conclusion The adaptation of the Health Belief Model and the Theory of Health Preventive Behaviour represents a valid framework of predicting DHPB. The negative sign of perceived threat of disease on DHPB may suggest that, under an income constraint, consumers tend to trade off long-term health benefits for short-term benefits. This cautions against the use of negative messages in public health campaigns. Raising the awareness of diet-disease relationships, knowledge about nutrition (particularly

  17. Maturity of hospital information systems: Most important influencing factors.

    Science.gov (United States)

    Vidal Carvalho, João; Rocha, Álvaro; Abreu, António

    2017-07-01

    Maturity models facilitate organizational management, including information systems management, with hospital organizations no exception. This article puts forth a study carried out with a group of experts in the field of hospital information systems management with a view to identifying the main influencing factors to be included in an encompassing maturity model for hospital information systems management. This study is based on the results of a literature review, which identified maturity models in the health field and relevant influencing factors. The development of this model is justified to the extent that the available maturity models for the hospital information systems management field reveal multiple limitations, including lack of detail, absence of tools to determine their maturity and lack of characterization for stages of maturity structured by different influencing factors.

  18. Public health preparedness in Alberta: a systems-level study.

    Science.gov (United States)

    Moore, Douglas; Shiell, Alan; Noseworthy, Tom; Russell, Margaret; Predy, Gerald

    2006-12-28

    Recent international and national events have brought critical attention to the Canadian public health system and how prepared the system is to respond to various types of contemporary public health threats. This article describes the study design and methods being used to conduct a systems-level analysis of public health preparedness in the province of Alberta, Canada. The project is being funded under the Health Research Fund, Alberta Heritage Foundation for Medical Research. We use an embedded, multiple-case study design, integrating qualitative and quantitative methods to measure empirically the degree of inter-organizational coordination existing among public health agencies in Alberta, Canada. We situate our measures of inter-organizational network ties within a systems-level framework to assess the relative influence of inter-organizational ties, individual organizational attributes, and institutional environmental features on public health preparedness. The relative contribution of each component is examined for two potential public health threats: pandemic influenza and West Nile virus. The organizational dimensions of public health preparedness depend on a complex mix of individual organizational characteristics, inter-agency relationships, and institutional environmental factors. Our study is designed to discriminate among these different system components and assess the independent influence of each on the other, as well as the overall level of public health preparedness in Alberta. While all agree that competent organizations and functioning networks are important components of public health preparedness, this study is one of the first to use formal network analysis to study the role of inter-agency networks in the development of prepared public health systems.

  19. Health, Health Care, and Systems Science: Emerging Paradigm.

    Science.gov (United States)

    Janecka, Ivo

    2017-02-15

    Health is a continuum of an optimized state of a biologic system, an outcome of positive relationships with the self and others. A healthy system follows the principles of systems science derived from observations of nature, highlighting the character of relationships as the key determinant. Relationships evolve from our decisions, which are consequential to the function of our own biologic system on all levels, including the genome, where epigenetics impact our morphology. In healthy systems, decisions emanate from the reciprocal collaboration of hippocampal memory and the executive prefrontal cortex. We can decide to change relationships through choices. What is selected, however, only represents the cognitive interpretation of our limited sensory perception; it strongly reflects inherent biases toward either optimizing state, making a biologic system healthy, or not. Health or its absence is then the outcome; there is no inconsequential choice. Public health effort should not focus on punitive steps (e.g. taxation of unhealthy products or behaviors) in order to achieve a higher level of public's health. It should teach people the process of making healthy decisions; otherwise, people will just migrate/shift from one unhealthy product/behavior to another, and well-intended punitive steps will not make much difference. Physical activity, accompanied by nutrition and stress management, have the greatest impact on fashioning health and simultaneously are the most cost-effective measures. Moderate-to-vigorous exercise not only improves aerobic fitness but also positively influences cognition, including memory and senses. Collective, rational societal decisions can then be anticipated. Health care is a business system principally governed by self-maximizing decisions of its components; uneven and contradictory outcomes are the consequences within such a non-optimized system. Health is not health care. We are biologic systems subject to the laws of biology in spite of

  20. Assessing the influence of health systems on Type 2 Diabetes Mellitus awareness, treatment, adherence, and control: A systematic review.

    Science.gov (United States)

    Ong, Suan Ee; Koh, Joel Jun Kai; Toh, Sue-Anne Ee Shiow; Chia, Kee Seng; Balabanova, Dina; McKee, Martin; Perel, Pablo; Legido-Quigley, Helena

    2018-01-01

    Type 2 Diabetes Mellitus (T2DM) is reported to affect one in 11 adults worldwide, with over 80% of T2DM patients residing in low-to-middle-income countries. Health systems play an integral role in responding to this increasing global prevalence, and are key to ensuring effective diabetes management. We conducted a systematic review to examine the health system-level factors influencing T2DM awareness, treatment, adherence, and control. A protocol for this study was published on the PROSPERO international prospective register of systematic reviews (PROSPERO 2016: CRD42016048185). Studies included in this review reported the effects of health systems factors, interventions, policies, or programmes on T2DM control, awareness, treatment, and adherence. The following databases were searched on 22 February 2017: Medline, Embase, Global health, LILACS, Africa-Wide, IMSEAR, IMEMR, and WPRIM. There were no restrictions on date, language, or study designs. Two reviewers independently screened studies for eligibility, extracted the data, and screened for risk of bias. Thereafter, we performed a narrative synthesis. A meta-analysis was not conducted due to methodological heterogeneity across different aspects of included studies. 93 studies were included for qualitative synthesis; 7 were conducted in LMICs. Through this review, we found two key health system barriers to effective T2DM care and management: financial constraints faced by the patient and limited access to health services and medication. We also found three health system factors that facilitate effective T2DM care and management: the use of innovative care models, increased pharmacist involvement in care delivery, and education programmes led by healthcare professionals. This review points to the importance of reducing, or possibly eliminating, out-of-pocket costs for diabetes medication and self-monitoring supplies. It also points to the potential of adopting more innovative and integrated models of care, and the

  1. How does context influence performance of community health workers in low- and middle-income countries? Evidence from the literature.

    Science.gov (United States)

    Kok, Maryse C; Kane, Sumit S; Tulloch, Olivia; Ormel, Hermen; Theobald, Sally; Dieleman, Marjolein; Taegtmeyer, Miriam; Broerse, Jacqueline E W; de Koning, Korrie A M

    2015-03-07

    Community health workers (CHWs) are increasingly recognized as an integral component of the health workforce needed to achieve public health goals in low- and middle-income countries (LMICs). Many factors intersect to influence CHW performance. A systematic review with a narrative analysis was conducted to identify contextual factors influencing performance of CHWs. We searched six databases for quantitative, qualitative, and mixed-methods studies that included CHWs working in promotional, preventive or curative primary health care services in LMICs. We differentiated CHW performance outcome measures at two levels: CHW level and end-user level. Ninety-four studies met the inclusion criteria and were double read to extract data relevant to the context of CHW programmes. Thematic coding was conducted and evidence on five main categories of contextual factors influencing CHW performance was synthesized. Few studies had the influence of contextual factors on CHW performance as their primary research focus. Contextual factors related to community (most prominently), economy, environment, and health system policy and practice were found to influence CHW performance. Socio-cultural factors (including gender norms and values and disease related stigma), safety and security and education and knowledge level of the target group were community factors that influenced CHW performance. Existence of a CHW policy, human resource policy legislation related to CHWs and political commitment were found to be influencing factors within the health system policy context. Health system practice factors included health service functionality, human resources provisions, level of decision-making, costs of health services, and the governance and coordination structure. All contextual factors can interact to shape CHW performance and affect the performance of CHW interventions or programmes. Research on CHW programmes often does not capture or explicitly discuss the context in which CHW

  2. Metabolomic applications to decipher gut microbial metabolic influence in health and disease

    Directory of Open Access Journals (Sweden)

    Francois-Pierre eMartin

    2012-04-01

    Full Text Available Dietary preferences and nutrients composition have been shown to influence human and gut microbial metabolism, which ultimately has specific effects on health and diseases’ risk. Increasingly, results from molecular biology and microbiology demonstrate the key role of the gut microbiota metabolic interface to the overall mammalian host’s health status. There is therefore raising interest in nutrition research to characterize the molecular foundations of the gut microbial mammalian cross-talk at both physiological and biochemical pathway levels. Tackling these challenges can be achieved through systems biology approaches, such as metabolomics, to underpin the highly complex metabolic exchanges between diverse biological compartments, including organs, systemic biofluids and microbial symbionts. By the development of specific biomarkers for prediction of health and disease, metabolomics is increasingly used in clinical applications as regard to disease aetiology, diagnostic stratification and potentially mechanism of action of therapeutical and nutraceutical solutions. Surprisingly, an increasing number of metabolomics investigations in pre-clinical and clinical studies based on proton nuclear magnetic resonance (1H NMR spectroscopy and mass spectrometry (MS provided compelling evidence that system wide and organ-specific biochemical processes are under the influence of gut microbial metabolism. This review aims at describing recent applications of metabolomics in clinical fields where main objective is to discern the biochemical mechanisms under the influence of the gut microbiota, with insight into gastrointestinal health and diseases diagnostics and improvement of homeostasis metabolic regulation.

  3. Public health preparedness in Alberta: a systems-level study

    Directory of Open Access Journals (Sweden)

    Noseworthy Tom

    2006-12-01

    Full Text Available Abstract Background Recent international and national events have brought critical attention to the Canadian public health system and how prepared the system is to respond to various types of contemporary public health threats. This article describes the study design and methods being used to conduct a systems-level analysis of public health preparedness in the province of Alberta, Canada. The project is being funded under the Health Research Fund, Alberta Heritage Foundation for Medical Research. Methods/Design We use an embedded, multiple-case study design, integrating qualitative and quantitative methods to measure empirically the degree of inter-organizational coordination existing among public health agencies in Alberta, Canada. We situate our measures of inter-organizational network ties within a systems-level framework to assess the relative influence of inter-organizational ties, individual organizational attributes, and institutional environmental features on public health preparedness. The relative contribution of each component is examined for two potential public health threats: pandemic influenza and West Nile virus. Discussion The organizational dimensions of public health preparedness depend on a complex mix of individual organizational characteristics, inter-agency relationships, and institutional environmental factors. Our study is designed to discriminate among these different system components and assess the independent influence of each on the other, as well as the overall level of public health preparedness in Alberta. While all agree that competent organizations and functioning networks are important components of public health preparedness, this study is one of the first to use formal network analysis to study the role of inter-agency networks in the development of prepared public health systems.

  4. How decentralisation influences the retention of primary health care workers in rural Nigeria.

    Science.gov (United States)

    Abimbola, Seye; Olanipekun, Titilope; Igbokwe, Uchenna; Negin, Joel; Jan, Stephen; Martiniuk, Alexandra; Ihebuzor, Nnenna; Aina, Muyi

    2015-01-01

    In Nigeria, the shortage of health workers is worst at the primary health care (PHC) level, especially in rural communities. And the responsibility for PHC - usually the only form of formal health service available in rural communities - is shared among the three tiers of government (federal, state, and local governments). In addition, the responsibility for community engagement in PHC is delegated to community health committees. This study examines how the decentralisation of health system governance influences retention of health workers in rural communities in Nigeria from the perspective of health managers, health workers, and people living in rural communities. The study adopted a qualitative approach, and data were collected using semi-structured in-depth interviews and focus group discussions. The multi-stakeholder data were analysed for themes related to health system decentralisation. The results showed that decentralisation influences the retention of rural health workers in two ways: 1) The salary of PHC workers is often delayed and irregular as a result of delays in transfer of funds from the national to sub-national governments and because one tier of government can blame failure on another tier of government. Further, the primary responsibility for PHC is often left to the weakest tier of government (local governments). And the result is that rural PHC workers are attracted to working at levels of care where salaries are higher and more regular - in secondary care (run by state governments) and tertiary care (run by the federal government), which are also usually in urban areas. 2) Through community health committees, rural communities influence the retention of health workers by working to increase the uptake of PHC services. Community efforts to retain health workers also include providing social, financial, and accommodation support to health workers. To encourage health workers to stay, communities also take the initiative to co-finance and co

  5. Value as the key concept in the health care system: how it has influenced medical practice and clinical decision-making processes.

    Science.gov (United States)

    Marzorati, Chiara; Pravettoni, Gabriella

    2017-01-01

    In the last 10 years, value has played a key role in the health care system. In this concept, innovations in medical practice and the increasing importance of patient centeredness have contributed to draw the attention of the medical community. Nonetheless, a large consensus on the meaning of "value" is still lacking: patients, physicians, policy makers, and other health care professionals have different ideas on which component of value may play a prominent role. Yet, shared clinical decision-making and patient empowerment have been recognized as fundamental features of the concept of value. Different paradigms of health care system embrace different meanings of value, and the absence of common and widely accepted definition does not help to identify a unique model of care in health care system. Our aim is to provide an overview of those paradigms that have considered value as a key theoretical concept and to investigate how the presence of value can influence the medical practice. This article may contribute to draw attention toward patients and propose a possible link between health care system based on "value" and new paradigms such as patient-centered system (PCS), patient empowerment, and P5 medicine, in order to create a predictive, personalized, preventive, participatory, and psycho-cognitive model to treat patients. Indeed, patient empowerment, value-based system, and P5 medicine seem to shed light on different aspects of a PCS, and this allows a better understanding of people under care.

  6. Influencing organizations to promote health: applying stakeholder theory.

    Science.gov (United States)

    Kok, Gerjo; Gurabardhi, Zamira; Gottlieb, Nell H; Zijlstra, Fred R H

    2015-04-01

    Stakeholder theory may help health promoters to make changes at the organizational and policy level to promote health. A stakeholder is any individual, group, or organization that can influence an organization. The organization that is the focus for influence attempts is called the focal organization. The more salient a stakeholder is and the more central in the network, the stronger the influence. As stakeholders, health promoters may use communicative, compromise, deinstitutionalization, or coercive methods through an ally or a coalition. A hypothetical case study, involving adolescent use of harmful legal products, illustrates the process of applying stakeholder theory to strategic decision making. © 2015 Society for Public Health Education.

  7. Health system vision of iran in 2025.

    Science.gov (United States)

    Rostamigooran, N; Esmailzadeh, H; Rajabi, F; Majdzadeh, R; Larijani, B; Dastgerdi, M Vahid

    2013-01-01

    Vast changes in disease features and risk factors and influence of demographic, economical, and social trends on health system, makes formulating a long term evolutionary plan, unavoidable. In this regard, to determine health system vision in a long term horizon is a primary stage. After narrative and purposeful review of documentaries, major themes of vision statement were determined and its context was organized in a work group consist of selected managers and experts of health system. Final content of the statement was prepared after several sessions of group discussions and receiving ideas of policy makers and experts of health system. Vision statement in evolutionary plan of health system is considered to be :"a progressive community in the course of human prosperity which has attained to a developed level of health standards in the light of the most efficient and equitable health system in visionary region(1) and with the regarding to health in all policies, accountability and innovation". An explanatory context was compiled either to create a complete image of the vision. Social values and leaders' strategic goals, and also main orientations are generally mentioned in vision statement. In this statement prosperity and justice are considered as major values and ideals in society of Iran; development and excellence in the region as leaders' strategic goals; and also considering efficiency and equality, health in all policies, and accountability and innovation as main orientations of health system.

  8. Embedding research in health systems: lessons from complexity theory.

    Science.gov (United States)

    Caffrey, Louise; Wolfe, Charles; McKevitt, Christopher

    2016-07-22

    Internationally, there has been increasing focus on creating health research systems. This article aims to investigate the challenges of implementing apparently simple strategies to support the development of a health research system. We focus on a case study of an English National Health Service Hospital Trust that sought to implement the national recommendation that health organisations should introduce a statement about research on all patient admission letters. We apply core concepts from complexity theory to the case study and undertake a documentary analysis of the email dialogue between staff involved in implementing this initiative. The process of implementing a research statement in patient admission letters in one clinical service took 1 year and 21 days. The length of time needed was influenced firstly by adaptive self-organisation, underpinned by competing interests. Secondly, it was influenced by the relationship between systems, rather than simply being a product of issues within those systems. The relationship between the health system and the research system was weaker than might have been expected. Responsibilities were unclear, leading to confusion and delayed action. Conventional ways of thinking about organisations suggest that change happens when leaders and managers change the strategic vision, structure or procedures in an organisation and then persuade others to rationally implement the strategy. However, health research systems are complex adaptive systems characterised by high levels of unpredictability due to self-organisation and systemic interactions, which give rise to 'emergent' properties. We argue for the need to study how micro-processes of organisational dynamics may give rise to macro patterns of behaviour and strategic organisational direction and for the use of systems approaches to investigate the emergent properties of health research systems.

  9. Social Factors Influencing Child Health in Ghana.

    Directory of Open Access Journals (Sweden)

    Emmanuel Quansah

    Full Text Available Social factors have profound effects on health. Children are especially vulnerable to social influences, particularly in their early years. Adverse social exposures in childhood can lead to chronic disorders later in life. Here, we sought to identify and evaluate the impact of social factors on child health in Ghana. As Ghana is unlikely to achieve the Millennium Development Goals' target of reducing child mortality by two-thirds between 1990 and 2015, we deemed it necessary to identify social determinants that might have contributed to the non-realisation of this goal.ScienceDirect, PubMed, MEDLINE via EBSCO and Google Scholar were searched for published articles reporting on the influence of social factors on child health in Ghana. After screening the 98 articles identified, 34 of them that met our inclusion criteria were selected for qualitative review.Major social factors influencing child health in the country include maternal education, rural-urban disparities (place of residence, family income (wealth/poverty and high dependency (multiparousity. These factors are associated with child mortality, nutritional status of children, completion of immunisation programmes, health-seeking behaviour and hygiene practices.Several social factors influence child health outcomes in Ghana. Developing more effective responses to these social determinants would require sustainable efforts from all stakeholders including the Government, healthcare providers and families. We recommend the development of interventions that would support families through direct social support initiatives aimed at alleviating poverty and inequality, and indirect approaches targeted at eliminating the dependence of poor health outcomes on social factors. Importantly, the expansion of quality free education interventions to improve would-be-mother's health knowledge is emphasised.

  10. Information system success model for customer relationship management system in health promotion centers.

    Science.gov (United States)

    Choi, Wona; Rho, Mi Jung; Park, Jiyun; Kim, Kwang-Jum; Kwon, Young Dae; Choi, In Young

    2013-06-01

    Intensified competitiveness in the healthcare industry has increased the number of healthcare centers and propelled the introduction of customer relationship management (CRM) systems to meet diverse customer demands. This study aimed to develop the information system success model of the CRM system by investigating previously proposed indicators within the model. THE EVALUATION AREAS OF THE CRM SYSTEM INCLUDES THREE AREAS: the system characteristics area (system quality, information quality, and service quality), the user area (perceived usefulness and user satisfaction), and the performance area (personal performance and organizational performance). Detailed evaluation criteria of the three areas were developed, and its validity was verified by a survey administered to CRM system users in 13 nationwide health promotion centers. The survey data were analyzed by the structural equation modeling method, and the results confirmed that the model is feasible. Information quality and service quality showed a statistically significant relationship with perceived usefulness and user satisfaction. Consequently, the perceived usefulness and user satisfaction had significant influence on individual performance as well as an indirect influence on organizational performance. This study extends the research area on information success from general information systems to CRM systems in health promotion centers applying a previous information success model. This lays a foundation for evaluating health promotion center systems and provides a useful guide for successful implementation of hospital CRM systems.

  11. Information System Success Model for Customer Relationship Management System in Health Promotion Centers

    Science.gov (United States)

    Choi, Wona; Rho, Mi Jung; Park, Jiyun; Kim, Kwang-Jum; Kwon, Young Dae

    2013-01-01

    Objectives Intensified competitiveness in the healthcare industry has increased the number of healthcare centers and propelled the introduction of customer relationship management (CRM) systems to meet diverse customer demands. This study aimed to develop the information system success model of the CRM system by investigating previously proposed indicators within the model. Methods The evaluation areas of the CRM system includes three areas: the system characteristics area (system quality, information quality, and service quality), the user area (perceived usefulness and user satisfaction), and the performance area (personal performance and organizational performance). Detailed evaluation criteria of the three areas were developed, and its validity was verified by a survey administered to CRM system users in 13 nationwide health promotion centers. The survey data were analyzed by the structural equation modeling method, and the results confirmed that the model is feasible. Results Information quality and service quality showed a statistically significant relationship with perceived usefulness and user satisfaction. Consequently, the perceived usefulness and user satisfaction had significant influence on individual performance as well as an indirect influence on organizational performance. Conclusions This study extends the research area on information success from general information systems to CRM systems in health promotion centers applying a previous information success model. This lays a foundation for evaluating health promotion center systems and provides a useful guide for successful implementation of hospital CRM systems. PMID:23882416

  12. Technical aspects of portal technology application for e-health systems.

    Science.gov (United States)

    Kosińska, Joanna; Słowikowski, Paweł

    2004-01-01

    E-health is an emerging field on the intersection of medical information technologies, public health and business, referring to health services and information delivered or enhanced through the Internet and related technologies. Portal technology, allowing services to be accessible over the Internet is a perfect tool for providing e-health services. The use of portal technologies has had deep influence on the architecture of the whole e-health system, both regarding new subsystems and older ones which we want to integrate with the portal. Portals provide new possibilities for creating novel types of e-health applications as well. In this paper we provide a brief overview of e-health systems and portal technologies, and present many technical aspects of portal technology application for e-health systems such as the architecture of portal-based e-health systems, graphical user interfaces, access to various e-health systems' resources, personalization, security and privacy.

  13. National healthcare systems and the need for health information governance.

    Science.gov (United States)

    Hovenga, Evelyn J S

    2013-01-01

    This chapter gives an overview of health data, information and knowledge governance needs and associated generic principles so that information systems are able to automate such data collections from point-of-care operational systems. Also covered are health information systems' dimensions and known barriers to the delivery of quality health services, including environmental, technology and governance influences of any population's health status within the context of national health systems. This is where health information managers and health informaticians need to resolve the many challenges associated with eHealth implementations where data are assets, efficient information flow is essential, the ability to acquire new knowledge desirable, and where the use of data and information needs to be viewed from a governance perspective to ensure reliable and quality information is obtained to enhance decision making.

  14. Factors Influencing Teamwork in Health Care

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    Mijal Michał

    2017-06-01

    Full Text Available The purpose of this paper is to analyse different views on interpersonal relations and team composition among managers and medical professionals with respect to the transition of professional roles in healthcare in Poland. To achieve that goal, a description based on a quantitative and qualitative questionnaire was conducted. Since the questionnaire covered various areas of health care, only its small fraction was used for the analysis. The main result is that most of the medical professionals and medical managers consider technology to be the single most important external factor influencing the team work efficiency and team composition in health care, and the managers consider skillset as the crucial factor determining whether a person would be a good team member. Based on the literature on professional roles in health care and their evolution in recent years, one can assume that constant development and lifelong learning would play a significant role in the healthcare systems reform. The findings are an important contribution to the discussion of the healthcare reform and its possible directions in future years as well a reference point for policy makers.

  15. The Health System Dynamics Framework: The introduction of an analytical model for health system analysis and its application to two case-studies

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    J van Olmen

    2012-03-01

    Full Text Available Frameworks can clarify concepts and improve understanding of underlying mechanisms in the domain of health systems research and strengthening. Many existing frameworks have a limited capacity to analyze interactions and equilibriums within a health system overlooking values as an underlying steering mechanism. This paper introduces the health system dynamics framework and demonstrates its application as a tool for analysis and modelling. The added value of this framework is: 1 consideration of different levels of a health system and tracing how interventions or events at one level influence other elements and other levels; 2 emphasizes the importance of values; 3 a central axis linking governance, human resources, service delivery and population, and 4 taking into account the key elements of complexity in analysis and strategy development. We urge  the analysis of individual health systems and meta-analysis, for a better understanding of their functioning and strengthening. 

  16. Influencers of career choice among allied health students.

    Science.gov (United States)

    Brown-West, A P

    1991-01-01

    This study focused on the factors that influence students' choice of an allied health profession. A survey of 153 students in three allied health programs at the University of Connecticut revealed that "the need to help others," "prestige," "professional autonomy," "opportunities for advancement," "income potential," and "the effect of the specialty on family and personal life," were the major influencers of career choice among allied health students. Only a few students regarded malpractice suits and AIDS as negative influencers. While medical laboratory science majors regarded these as important factors, dietetics and physical therapy majors did not. The article suggests further use of these findings by program directors and career counselors.

  17. WHAT CAN TANZANIA'S HEALTH CARE SYSTEM LEARN FROM OECD COUNTRIES?

    OpenAIRE

    Kajuna, Dezidery Theobard

    2014-01-01

    Abstract Healthcare systems around the world have different shapes that are largely affected by socio-economic and political situations of a particular country. It is essential for the population to have better health services which requires the country to have better health policies, enough funding for health care sector, and a well structured delivery system. Tanzania like any other developing countries continue to face different challenges in healthcare sector greatly influenced by poor ec...

  18. Influencing Organizations to Promote Health: Applying Stakeholder Theory

    Science.gov (United States)

    Kok, Gerjo; Gurabardhi, Zamira; Gottlieb, Nell H.; Zijlstra, Fred R. H.

    2015-01-01

    Stakeholder theory may help health promoters to make changes at the organizational and policy level to promote health. A stakeholder is any individual, group, or organization that can influence an organization. The organization that is the focus for influence attempts is called the focal organization. The more salient a stakeholder is and the more…

  19. Practicing governance towards equity in health systems: LMIC perspectives and experience.

    Science.gov (United States)

    Gilson, Lucy; Lehmann, Uta; Schneider, Helen

    2017-09-15

    The unifying theme of the papers in this series is a concern for understanding the everyday practice of governance in low- and middle-income country (LMIC) health systems. Rather than seeing governance as a normative health system goal addressed through the architecture and design of accountability and regulatory frameworks, these papers provide insights into the real-world decision-making of health policy and system actors. Their multiple, routine decisions translate policy intentions into practice - and are filtered through relationships, underpinned by values and norms, influenced by organizational structures and resources, and embedded in historical and socio-political contexts. These decisions are also political acts - in that they influence who accesses benefits and whose voices are heard in decision-making, reinforcing or challenging existing institutional exclusion and power inequalities. In other words, the everyday practice of governance has direct impacts on health system equity.The papers in the series address governance through diverse health policy and system issues, consider actors located at multiple levels of the system and draw on multi-disciplinary perspectives. They present detailed examination of experiences in a range of African and Indian settings, led by authors who live and work in these settings. The overall purpose of the papers in this series is thus to provide an empirical and embedded research perspective on governance and equity in health systems.

  20. Value as the key concept in the health care system: how it has influenced medical practice and clinical decision-making processes

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    Marzorati C

    2017-03-01

    Full Text Available Chiara Marzorati,1,2 Gabriella Pravettoni2,3 1Foundations of the Life Sciences, Bioethics and Cognitive Science, European School of Molecular Medicine (SEMM, 2Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, 3Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy Abstract: In the last 10 years, value has played a key role in the health care system. In this concept, innovations in medical practice and the increasing importance of patient centeredness have contributed to draw the attention of the medical community. Nonetheless, a large consensus on the meaning of “value” is still lacking: patients, physicians, policy makers, and other health care professionals have different ideas on which component of value may play a prominent role. Yet, shared clinical decision-making and patient empowerment have been recognized as fundamental features of the concept of value. Different paradigms of health care system embrace different meanings of value, and the absence of common and widely accepted definition does not help to identify a unique model of care in health care system. Our aim is to provide an overview of those paradigms that have considered value as a key theoretical concept and to investigate how the presence of value can influence the medical practice. This article may contribute to draw attention toward patients and propose a possible link between health care system based on “value” and new paradigms such as patient-centered system (PCS, patient empowerment, and P5 medicine, in order to create a predictive, personalized, preventive, participatory, and psycho-cognitive model to treat patients. Indeed, patient empowerment, value-based system, and P5 medicine seem to shed light on different aspects of a PCS, and this allows a better understanding of people under care. Keywords: health care system, value, value-based medicine, patient empowerment, clinical decision

  1. Does decentralization influence efficiency of health units? A study of opinion and perception of health workers in Odisha

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    Bhuputra Panda

    2016-10-01

    Full Text Available Abstract Background Health systems in low and middle income countries are struggling to improve efficiency in the functioning of health units of which workforce is one of the most critical building blocks. In India, Rogi Kalyan Samiti (RKS was established at every health unit as institutions of local decision making in order to improve productive efficiency and quality. Measuring efficiency of health units is a complex task. This study aimed at assessing the perception (opinion and satisfaction of health workers about influence of RKS on improving efficiency of peripheral decision making health units (DMHU; examining differences between priority and non-priority set-ups; identifying predictors of satisfaction at work; and discussing suggestions to improve performance. Methods Following a cross-sectional, comparative study design, 130 health workers from 30 institutions were selected through a multi-stage stratified random sampling. A semi-structured questionnaire was administered to assess perception and opinion of health workers about influence of RKS on efficiency of decision making at local level, motivation and performance of staff, and availability of funds; improvement of quality of services, and coordination among co-workers; and participation of community in local decision making. Three districts with highest infant mortality rate (IMR, one each, from 3 zones of Odisha and 3 with lowest IMR were selected on the basis of IMR estimates of 2011. The former constituted priority districts (PD and the latter, non-priority districts (NPD. Composite scores were developed and compared between PD and NPD. Adjusted linear regression was conducted to identify predictors of satisfaction at work. Results A majority of respondents felt that RKS was efficient in decision making that resulted in improvement of all critical parameters of health service delivery, including quality; this was significantly higher in PD. Further, higher proportion of

  2. Influence of organisational culture on the implementation of health sector reforms in low- and middle-income countries: a qualitative interpretive review.

    Science.gov (United States)

    Mbau, Rahab; Gilson, Lucy

    2018-01-01

    Health systems, particularly in low- and middle-income countries, are commonly plagued by poor access, poor performance, inefficient use and inequitable distribution of resources. To improve health system efficiency, equity and effectiveness, the World Development Report of 1993 proposed a first wave of health sector reforms, which has been followed by further waves. Various authors, however, suggest that the early reforms did not lead to the anticipated improvements. They offer, as one plausible explanation for this gap, the limited consideration given to the influence over implementation of the software aspects of the health system, such as organisational culture - which has not previously been fully investigated. To identify, interpret and synthesise existing literature for evidence on organisational culture and how it influences implementation of health sector reforms in low- and middle-income countries. We conducted a systematic search of eight databases: PubMed; Africa-Wide Information, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Econlit, PsycINFO, SocINDEX with full text, Emerald and Scopus. Eight papers were identified. We analysed and synthesised these papers using thematic synthesis. This review indicates the potential influence of dimensions of organisational culture such as power distance, uncertainty avoidance, and in-group and institutional collectivism over the implementation of health sector reforms. This influence is mediated through organisational practices such as communication and feedback, management styles, commitment and participation in decision-making. This interpretive review highlights the dearth of empirical literature around organisational culture and therefore its findings can only be tentative. There is a need for health policymakers and health system researchers to conduct further analysis of organisational culture and change within the health system.

  3. Interpersonal influence among public health leaders in the United States department of health and human services.

    Science.gov (United States)

    Harris, Jenine K; Carothers, Bobbi J; Wald, Lana M; Shelton, Sarah C; Leischow, Scott J

    2012-02-17

    In public health, interpersonal influence has been identified as an important factor in the spread of health information, and in understanding and changing health behaviors. However, little is known about influence in public health leadership. Influence is important in leadership settings, where public health professionals contribute to national policy and practice agendas. Drawing on social theory and recent advances in statistical network modeling, we examined influence in a network of tobacco control leaders at the United States Department of Health and Human Services (DHHS). Fifty-four tobacco control leaders across all 11 agencies in the DHHS were identified; 49 (91%) responded to a web-based survey. Participants were asked about communication with other tobacco control leaders, who influenced their work, and general job characteristics. Exponential random graph modeling was used to develop a network model of influence accounting for characteristics of individuals, their relationships, and global network structures. Higher job ranks, more experience in tobacco control, and more time devoted to tobacco control each week increased the likelihood of influence nomination, as did more frequent communication between network members. Being in the same agency and working the same number of hours per week were positively associated with mutual influence nominations. Controlling for these characteristics, the network also exhibited patterns associated with influential clusters of network members. Findings from this unique study provide a perspective on influence within a government agency that both helps to understand decision-making and also can serve to inform organizational efforts that allow for more effective structuring of leadership.

  4. Interpersonal influence among public health leaders in the United States Department of Health and Human Services

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    Jenine K. Harris

    2012-02-01

    Full Text Available Background. In public health, interpersonal influence has been identified as an important factor in the spread of health information, and in understanding and changing health behaviors. However, little is known about influence in public health leadership. Influence is important in leadership settings, where public health professionals contribute to national policy and practice agendas. Drawing on social theory and recent advances in statistical network modeling, we examined influence in a network of tobacco control leaders at the United States Department of Health and Human Services (DHHS. Design and Methods. Fifty-four tobacco control leaders across all 11 agencies in the DHHS were identified; 49 (91% responded to a web-based survey. Participants were asked about communication with other tobacco control leaders, who influenced their work, and general job characteristics. Exponential random graph modeling was used to develop a network model of influence accounting for characteristics of individuals, their relationships, and global network structures. Results. Higher job ranks, more experience in tobacco control, and more time devoted to tobacco control each week increased the likelihood of influence nomination, as did more frequent communication between network members. Being in the same agency and working the same number of hours per week were positively associated with mutual influence nominations. Controlling for these characteristics, the network also exhibited patterns associated with influential clusters of network members. Conclusions. Findings from this unique study provide a perspective on influence within a government agency that both helps to understand decision-making and also can serve to inform organizational efforts that allow for more effective structuring of leadership.

  5. Health care practices influencing health promotion in urban black women in Tshwane

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    SCD Wright

    2008-09-01

    Full Text Available Health promotion is a multifaceted activity. Women and children are particularly vulnerable regarding access to quality health care, with young African women reportedly the poorest and most economically marginalised and least educated sector in South Africa. Understanding the context within which a person lives is an essential component in the health educator’s teaching strategy. Understanding urban black women’s health care practices will enable health promoters to develop interventions that are successful. The problem investigated was to gain an understanding of the health care practices of urban black women that could influence health promotion activities. The design was qualitative exploratory. The respondents were women living in an urban township in Tshwane, South Africa. The sampling method was convenient and purposive and the sample size was determined by saturation of the data. Data was gathered through semi-structured interviews using six specific themes and the analysed using open coding. The results indicated that the social environment created by the registered nurses in the primary health influenced the health care practices of the women negatively. Practices regarding the seriousness of a health problem suggest a possible reason for late admission of a person with a serious health problem.

  6. Health policy and systems research agendas in developing countries

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    Gonzalez-Block Miguel A

    2004-08-01

    Full Text Available Abstract Background Health policy and systems research (HPSR is an international public good with potential to orient investments and performance at national level. Identifying research trends and priorities at international level is therefore important. This paper offers a conceptual framework and defines the HPSR portfolio as a set of research projects under implementation. The research portfolio is influenced by factors external to the research system as well as internal to it. These last include the capacity of research institutions, the momentum of research programs, funding opportunities and the influence of stakeholder priorities and public opinion. These dimensions can vary in their degree of coordination, leading to a complementary or a fragmented research portfolio. Objective The main objective is to identify the themes currently being pursued in the research portfolio and agendas within developing countries and to quantify their frequency in an effort to identify current research topics and their underlying influences. Methods HPSR topics being pursued by developing country producer institutions and their perceived priorities were identified through a survey between 2000 and 2002. The response to a call for letters of intent issued by the Alliance in 2000 for a broad range of topics was also analyzed. The institutions that were the universe of this study consisted of the 176 institutional partners of the Alliance for Health Policy and Systems Research producing research in low and middle income countries outside Europe. HPSR topics as well as the beneficiaries or issues and the health problems addressed were content analyzed. Topics were classified into 19 categories and their frequency analyzed across groups of countries with similar per capita income. Agendas were identified by analyzing the source of funding and of project initiation for projects under implementation. Results The highest ranking topic at the aggregate level is

  7. Systems of career influences: a conceptual model for evaluating the professional development of women in academic medicine.

    Science.gov (United States)

    Magrane, Diane; Helitzer, Deborah; Morahan, Page; Chang, Shine; Gleason, Katharine; Cardinali, Gina; Wu, Chih-Chieh

    2012-12-01

    Surprisingly little research is available to explain the well-documented organizational and societal influences on persistent inequities in advancement of women faculty. The Systems of Career Influences Model is a framework for exploring factors influencing women's progression to advanced academic rank, executive positions, and informal leadership roles in academic medicine. The model situates faculty as agents within a complex adaptive system consisting of a trajectory of career advancement with opportunities for formal professional development programming; a dynamic system of influences of organizational policies, practices, and culture; and a dynamic system of individual choices and decisions. These systems of influence may promote or inhibit career advancement. Within this system, women weigh competing influences to make career advancement decisions, and leaders of academic health centers prioritize limited resources to support the school's mission. The Systems of Career Influences Model proved useful to identify key research questions. We used the model to probe how research in academic career development might be applied to content and methods of formal professional development programs. We generated a series of questions and hypotheses about how professional development programs might influence professional development of health science faculty members. Using the model as a guide, we developed a study using a quantitative and qualitative design. These analyses should provide insight into what works in recruiting and supporting productive men and women faculty in academic medical centers.

  8. INFLUENCE OF SOCIOECONOMIC AND DEMOGRAPHIC ENVIRONMENT ON PRIVATE HEALTH CARE PROVIDERS

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    Lana Kordić

    2013-02-01

    Full Text Available Health care systems face pressure to increase the quality of health care at the same time with pressure to reduce public spending. The attempt to overcome the gap between needs and opportunities can be resolved through the introduction of public-private partnerships. Goals of this study are to investigate variation of the number, form and efficiency of private providers of general/family medicine services in primary health care and the contribution of socioeconomic and demographic environment on those variations, among counties. Socioeconomic and demographic factors are identified as independent variables that influence the health care need and utilization and consequently the decision of private entities to engage in the provision of health care services. This study extended previous studies because it has introduced socioeconomic and demographic variables. This may shed same new lights on the relationship between private providers of health service and efficiency of providing health service in primary health care.

  9. Managing the pharmaceutical industry-health system interface.

    Science.gov (United States)

    Zarowitz, B J; Muma, B; Coggan, P; Davis, G; Barkley, G L

    2001-12-01

    Direct-to-consumer advertising, media, and Internet marketing to physicians and patients, as well as enticing marketing strategies, are used by the pharmaceutical industry to ensure market share growth of new drugs. Our health system adopted a strict vendor policy governing detailing and sampling activities of pharmaceutical representatives, but realized that further analysis of vendor influence in our system was needed. An assessment of tangible benefits, ethical concerns, and financial liabilities and gains was conducted to reassess the need for further vendor restriction. Based on our findings, several recommendations have been made. Medical practices and health systems are encouraged to establish and enforce explicit vendor policies, measure their effectiveness, partner proactively with representatives to deliver a drug-detailing message consistent with system initiatives, monitor and regulate continuing medical education funding, and implement strategies to ensure appropriate drug use.

  10. Influence of health systems in malaria case management as part of malaria control in Tanzania

    OpenAIRE

    Masanja, Irene M.

    2013-01-01

    The World Health Organization report in 2007, declared that, it will not be possible to achieve national and international health goals without greater investments in health systems. It is a known fact that today, the advancement in science has led to a better understanding of aetiologies and risk factors of most diseases burden in the world. However, the capacity to deliver these innovations to the population that needs them the most is severely handicapped by fragile and poor health systems...

  11. Integration of community health workers into health systems in developing countries: Opportunities and challenges

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    Collins Otieno Asweto

    2016-02-01

    Full Text Available Background: Developing countries have the potential to reach vulnerable and underserved populations marginalized by the country’s health care systems by way of community health workers (CHWs. It is imperative that health care systems focus on improving access to quality continuous primary care through the use of CHWs while paying attention to the factors that impact on CHWs and their effectiveness. Objective: To explore the possible opportunities and challenges of integrating CHWs into the health care systems of developing countries. Methods: Six databases were examined for quantitative, qualitative, and mixed-methods studies that included the integration of CHWs, their motivation and supervision, and CHW policy making and implementation in developing countries. Thirty-three studies met the inclusion criteria and were double read to extract data relevant to the context of CHW programs. Thematic coding was conducted and evidence on the main categories of contextual factors influencing integration of CHWs into the health system was synthesized. Results: CHWs are an effective and appropriate element of a health care team and can assist in addressing health disparities and social determinants of health. Important facilitators of integration of CHWs into health care teams are support from other health workers and inclusion of CHWs in case management meetings. Sustainable integration of CHWs into the health care system requires the formulation and implementation of polices that support their work, as well as financial and nonfinancial incentives, motivation, collaborative and supportive supervision, and a manageable workload. Conclusions: For sustainable integration of CHWs into health care systems, high-performing health systems with sound governance, adequate financing, well-organized service delivery, and adequate supplies and equipment are essential. Similarly, competent communities could contribute to better CHW performance through sound

  12. Nursing shaping and influencing health and social care policy.

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    Fyffe, Theresa

    2009-09-01

    This paper seeks to consider how nursing as a profession in the United Kingdom is developing its role in shaping and influencing policy using lessons learnt from a policy study tour undertaken in the United States of America and extensive experience as a senior nurse within the government, the health service and more recently within a Professional Organization. The nursing profession faces major changes in health and health care and nurses need to be visible in the public debate about future models of health and health care. This paper critically reviews recent UK and USA literature and policy with relevance to nursing. Strategies that support nurses and nursing to influence policy are in place but more needs to be done to address all levels of nursing in order to find creative solutions that promote and increase the participation of nurses in the political process and health policy. There are lessons to be learnt in the UK from the US nursing experience. These need to be considered in the context of the UK and devolution. Although much has been achieved in positioning nurses and nursing as an influencer in the arena of policy and political decision-making, there is a need for greater co-ordination of action to ensure that nursing is actively supported in influencing and shaping health and health care policy. All leaders and other stakeholders require to play their part in considering how the actions set out in this article can be taken forward and how gaps such as education, fellowship experience and media engagement can be addressed in the future.

  13. Identifying Factors Influencing the Establishment of a Health System Reform Plan in Iran's Public Hospitals

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    Rasul Fani khiavi

    2016-09-01

    Full Text Available In today's world, health views have found a wider perspective in which non-medical expectations are particularly catered to. The health system reform plan seeks to improve society's health, decrease treatment costs, and increase patient satisfaction. This study investigated factors affecting the successful establishment of a health system reform plan. A mixed qualitative – quantitative approach was applied to conduct to explore influential factors associated with the establishment of a health system reform plan in Iran's public hospitals. The health systems and approaches to improving them in other countries have been studied. A Likert-based five-point questionnaire was the measurement instrument, and its content validity based on content validity ratio (CVR was 0.87. The construct validity, calculated using the factorial analysis and Kaiser Mayer Olkin (KMO techniques, was 0.964, which is a high level and suggests a correlation between the scale items. To complete the questionnaire, 185 experts, specialists, and executives of Iran’s health reform plan were selected using the Purposive Stratified Non Random Sampling and snowball methods. The data was then analyzed using exploratory factorial analysis and SPSS and LISREL software applications. The results of this research imply the existence of a pattern with a significant and direct relationship between the identified independent variables and the dependent variable of the establishment of a health system reform plan. The most important indices of establishing a health system reform plan, in the order of priority, were political support; suitable proportion and coverage of services presented in the society; management of resources; existence of necessary infrastructures; commitment of senior managers; constant planning, monitoring, and evaluation; and presentation of feedback to the plan's executives, intrasector/extrasector cooperation, and the plan’s guiding committee. Considering the

  14. Programming of respiratory health in childhood: influence of outdoor air pollution.

    Science.gov (United States)

    Wright, Rosalind J; Brunst, Kelly J

    2013-04-01

    This overview highlights recent experimental and epidemiological evidence for the programming effects of outdoor air pollution exposures during early development on lung function and chronic respiratory disorders, such as asthma and related allergic disorders. Air pollutants may impact anatomy and/or physiological functioning of the lung and interrelated systems. Programming effects may result from pollutant-induced shifts in a number of molecular, cellular, and physiological states and their interacting systems. Specific key regulatory systems susceptible to programming may influence lung development and vulnerability to respiratory diseases, including both central and peripheral components of neuroendocrine pathways and autonomic nervous system (ANS) functioning which, in turn, influence the immune system. Starting in utero, environmental factors, including air pollutants, may permanently organize these systems toward trajectories of enhanced pediatric (e.g., asthma, allergy) as well as adult disease risk (e.g., chronic obstructive pulmonary disease). Evidence supports a central role of oxidative stress in the toxic effects of air pollution. Additional research suggests xenobiotic metabolism and subcellular components, such as mitochondria are targets of ambient air pollution and play a role in asthma and allergy programming. Mechanisms operating at the level of the placenta are being elucidated. Epigenetic mechanisms may be at the roots of adaptive developmental programming. Optimal coordinated functioning of many complex processes and their networks of interaction are necessary for normal lung development and the maintenance of respiratory health. Outdoor air pollution may play an important role in early programming of respiratory health and is potentially amenable to intervention.

  15. Between reason and coercion: ethically permissible influence in health care and health policy contexts.

    Science.gov (United States)

    Blumenthal-Barby, J S

    2012-12-01

    In bioethics, the predominant categorization of various types of influence has been a tripartite classification of rational persuasion (meaning influence by reason and argument), coercion (meaning influence by irresistible threats-or on a few accounts, offers), and manipulation (meaning everything in between). The standard ethical analysis in bioethics has been that rational persuasion is always permissible, and coercion is almost always impermissible save a few cases such as imminent threat to self or others. However, many forms of influence fall into the broad middle terrain-and this terrain is in desperate need of conceptual refining and ethical analysis in light of recent interest in using principles from behavioral science to influence health decisions and behaviors. This paper aims to address the neglected space between rational persuasion and coercion in bioethics. First, I argue for conceptual revisions that include removing the "manipulation" label and relabeling this space "nonargumentative influence," with two subtypes: "reason-bypassing" and "reason-countering." Second, I argue that bioethicists have made the mistake of relying heavily on the conceptual categories themselves for normative work and instead should assess the ethical permissibility of a particular instance of influence by asking several key ethical questions, which I elucidate, that relate to (1) the impact of the form of influence on autonomy and (2) the relationship between the influencer and the influenced. Finally, I apply my analysis to two examples of nonargumentative influence in health care and health policy: (1) governmental agencies such as the Food and Drug Administration (FDA) trying to influence the public to be healthier using nonargumentative measures such as vivid images on cigarette packages to make more salient the negative effects of smoking, and (2) a physician framing a surgery in terms of survival rates instead of mortality rates to influence her patient to consent to

  16. Household portfolio choices, health status and health care systems: A cross-country analysis based on SHARE.

    Science.gov (United States)

    Atella, Vincenzo; Brunetti, Marianna; Maestas, Nicole

    2012-05-01

    Health risk is increasingly viewed as an important form of background risk that affects household portfolio decisions. However, its role might be mediated by the presence of a protective full-coverage national health service that could reduce households' probability of incurring current and future out-of-pocket medical expenditures. We use SHARE data to study the influence of current health status and future health risk on the decision to hold risky assets, across ten European countries with different health systems, each offering a different degree of protection against out-of-pocket medical expenditures. We find robust empirical evidence that perceived health status matters more than objective health status and, consistent with the theory of background risk, health risk affects portfolio choices only in countries with less protective health care systems. Furthermore, portfolio decisions consistent with background risk models are observed only with respect to middle-aged and highly-educated investors.

  17. Systems of Career Influences: A Conceptual Model for Evaluating the Professional Development of Women in Academic Medicine

    Science.gov (United States)

    Helitzer, Deborah; Morahan, Page; Chang, Shine; Gleason, Katharine; Cardinali, Gina; Wu, Chih-Chieh

    2012-01-01

    Abstract Background Surprisingly little research is available to explain the well-documented organizational and societal influences on persistent inequities in advancement of women faculty. Methods The Systems of Career Influences Model is a framework for exploring factors influencing women's progression to advanced academic rank, executive positions, and informal leadership roles in academic medicine. The model situates faculty as agents within a complex adaptive system consisting of a trajectory of career advancement with opportunities for formal professional development programming; a dynamic system of influences of organizational policies, practices, and culture; and a dynamic system of individual choices and decisions. These systems of influence may promote or inhibit career advancement. Within this system, women weigh competing influences to make career advancement decisions, and leaders of academic health centers prioritize limited resources to support the school's mission. Results and Conclusions The Systems of Career Influences Model proved useful to identify key research questions. We used the model to probe how research in academic career development might be applied to content and methods of formal professional development programs. We generated a series of questions and hypotheses about how professional development programs might influence professional development of health science faculty members. Using the model as a guide, we developed a study using a quantitative and qualitative design. These analyses should provide insight into what works in recruiting and supporting productive men and women faculty in academic medical centers. PMID:23101486

  18. The influences of patient's satisfaction with medical service delivery, assessment of medical service, and trust in health delivery system on patient's life satisfaction in China.

    Science.gov (United States)

    Tang, Liyang

    2012-09-14

    Patient's satisfaction with medical service delivery/assessment of medical service/trust in health delivery system may have significant influence on patient's life satisfaction in China's health delivery system/in various kinds of hospitals.The aim of this study was to test whether and to what extent patient's satisfaction with medical service delivery/patient's assessments of various major aspects of medical service/various major aspects of patient's trust in health delivery system influenced patient's life satisfaction in China's health delivery system/in various kinds of hospitals. This study collaborated with National Bureau of Statistics of China to carry out a 2008 national urban resident household survey in 17 provinces, autonomous regions, and municipalities directly under the central government (N = 3,386), and specified ordered probit models were established to analyze dataset from this household survey. The key considerations in generating patient's life satisfaction involved patient's overall satisfaction with medical service delivery, assessment of doctor-patient communication, assessment of medical cost, assessment of medical treatment process, assessment of medical facility and hospital environment, assessment of waiting time for medical service, trust in prescription, trust in doctor, and trust in recommended medical examination. But the major considerations in generating patient's life satisfaction were different among low level public hospital, high level public hospital, and private hospital. The promotion of patient's overall satisfaction with medical service delivery, the improvement of doctor-patient communication, the reduction of medical cost, the improvement of medical treatment process, the promotion of medical facility and hospital environment, the reduction of waiting time for medical service, the promotion of patient's trust in prescription, the promotion of patient's trust in doctor, and the promotion of patient's trust in

  19. Principles for the development of Aboriginal health interventions: culturally appropriate methods through systemic empathy.

    Science.gov (United States)

    Kendall, Elizabeth; Barnett, Leda

    2015-01-01

    To increase Aboriginal participation in mainstream health services, it is necessary to understand the factors that influence health service usage. This knowledge can contribute to the development of culturally appropriate health services that respect Aboriginal ways of being. We used a community-based participatory approach to examine the reasons for underutilization of health services by Aboriginal Australians. Based on three focus groups and 18 interviews with Aboriginal health professionals, leaders, and community members in rural, regional, and urban settings, we identified five factors that influenced usage, including (1) negative historical experiences, (2) cultural incompetence, (3) inappropriate communication, (4) a collective approach to health, and (5) a more holistic approach to health. Given that these factors have shaped negative Aboriginal responses to health interventions, they are likely to be principles by which more appropriate solutions are generated. Although intuitively sensible and well known, these principles remain poorly understood by non-Aboriginal health systems and even less well implemented. We have conceptualized these principles as the foundation of an empathic health system. Without empathy, health systems in Australia, and internationally, will continue to face the challenge of building effective services to improve the state of health for all minority populations.

  20. System impact research - increasing public health and health care system performance.

    Science.gov (United States)

    Malmivaara, Antti

    2016-01-01

    Interventions directed to system features of public health and health care should increase health and welfare of patients and population. To build a new framework for studies aiming to assess the impact of public health or health care system, and to consider the role of Randomized Controlled Trials (RCTs) and of Benchmarking Controlled Trials (BCTs). The new concept is partly based on the author's previous paper on the Benchmarking Controlled Trial. The validity and generalizability considerations were based on previous methodological studies on RCTs and BCTs. The new concept System Impact Research (SIR) covers all the studies which aim to assess the impact of the public health system or of the health care system on patients or on population. There are two kinds of studies in System Impact Research: Benchmarking Controlled Trials (observational) and Randomized Controlled Trials (experimental). The term impact covers in particular accessibility, quality, effectiveness, safety, efficiency, and equality. System Impact Research - creating the scientific basis for policy decision making - should be given a high priority in medical, public health and health economic research, and should also be used for improving performance. Leaders at all levels of health and social care can use the evidence from System Impact Research for the benefit of patients and population. Key messages The new concept of SIR is defined as a research field aiming at assessing the impacts on patients and on populations of features of public health and health and social care systems or of interventions trying to change these features. SIR covers all features of public health and health and social care system, and actions upon these features. The term impact refers to all effects caused by the public health and health and social care system or parts of it, with particular emphasis on accessibility, quality, effectiveness, adverse effects, efficiency, and equality of services. SIR creates the

  1. Analysis of Factors Influencing Inpatient and Outpatient Satisfaction with the Chinese Military Health Service.

    Science.gov (United States)

    Lv, Yipeng; Xue, Chen; Ge, Yang; Ye, Feng; Liu, Xu; Liu, Yuan; Zhang, Lulu

    2016-01-01

    Relatively few articles have focused on exploring factors influencing soldiers' overall satisfaction and differences between inpatients' and outpatients' satisfaction, particularly in the Chinese army. Elucidating factors influencing military inpatient and outpatient care separately and analyzing their differences may provide more information for the health system. The Revised China National Health Service Survey questionnaire was used in the survey. The questionnaire included 5 sections and 32 items concerning demographic, inpatient, and outpatient characteristics and perception variables for both inpatients and outpatients. Bivariate and multivariate techniques were used to reveal relationships between satisfaction and the variables assessed. Outpatients' and inpatients' overall satisfaction rates were 19.0% and 18.5%, respectively. The strongest determinant of outpatients' satisfaction was satisfaction with doctor's communication regarding therapeutic regimen followed by length of military service, level of trust in medical staff, and disease severity. Determinants of inpatients' satisfaction included staff categories, satisfaction with environment, and satisfaction with medical quality. The factors influencing military outpatients' satisfaction differed from those of inpatients. Exploring the causes of satisfaction and dissatisfaction with military health institutions is important in their fulfillment of their responsibility to maintain soldiers' health.

  2. Analysis of Factors Influencing Inpatient and Outpatient Satisfaction with the Chinese Military Health Service.

    Directory of Open Access Journals (Sweden)

    Yipeng Lv

    Full Text Available Relatively few articles have focused on exploring factors influencing soldiers' overall satisfaction and differences between inpatients' and outpatients' satisfaction, particularly in the Chinese army. Elucidating factors influencing military inpatient and outpatient care separately and analyzing their differences may provide more information for the health system.The Revised China National Health Service Survey questionnaire was used in the survey. The questionnaire included 5 sections and 32 items concerning demographic, inpatient, and outpatient characteristics and perception variables for both inpatients and outpatients. Bivariate and multivariate techniques were used to reveal relationships between satisfaction and the variables assessed.Outpatients' and inpatients' overall satisfaction rates were 19.0% and 18.5%, respectively. The strongest determinant of outpatients' satisfaction was satisfaction with doctor's communication regarding therapeutic regimen followed by length of military service, level of trust in medical staff, and disease severity. Determinants of inpatients' satisfaction included staff categories, satisfaction with environment, and satisfaction with medical quality.The factors influencing military outpatients' satisfaction differed from those of inpatients. Exploring the causes of satisfaction and dissatisfaction with military health institutions is important in their fulfillment of their responsibility to maintain soldiers' health.

  3. Consumer-sponsored prepaid group practice: restructuring the health care system.

    Science.gov (United States)

    Warden, G L

    1984-01-01

    The traditional separation of health care delivery and financing systems is breaking down as various new types of health care facilities are established and as payment continues to be a major concern. Group Health Cooperative of Puget Sound (GHC) was organized as a prepaid group practice system responsive to consumers. Costs, methods of payment and delivery of care are interrelated and are all influenced by consumer ownership. GHC has been refining its benefit programs since 1945. Strategies for controlling use and costs focus on improved provider management and on flexibility. This article explains how the structure of GHC benefits the consumer.

  4. Integrating national community-based health worker programmes into health systems: a systematic review identifying lessons learned from low-and middle-income countries.

    Science.gov (United States)

    Zulu, Joseph Mumba; Kinsman, John; Michelo, Charles; Hurtig, Anna-Karin

    2014-09-22

    Despite the development of national community-based health worker (CBHW) programmes in several low- and middle-income countries, their integration into health systems has not been optimal. Studies have been conducted to investigate the factors influencing the integration processes, but systematic reviews to provide a more comprehensive understanding are lacking. We conducted a systematic review of published research to understand factors that may influence the integration of national CBHW programmes into health systems in low- and middle-income countries. To be included in the study, CBHW programmes should have been developed by the government and have standardised training, supervision and incentive structures. A conceptual framework on the integration of health innovations into health systems guided the review. We identified 3410 records, of which 36 were finally selected, and on which an analysis was conducted concerning the themes and pathways associated with different factors that may influence the integration process. Four programmes from Brazil, Ethiopia, India and Pakistan met the inclusion criteria. Different aspects of each of these programmes were integrated in different ways into their respective health systems. Factors that facilitated the integration process included the magnitude of countries' human resources for health problems and the associated discourses about how to address these problems; the perceived relative advantage of national CBHWs with regard to delivering health services over training and retaining highly skilled health workers; and the participation of some politicians and community members in programme processes, with the result that they viewed the programmes as legitimate, credible and relevant. Finally, integration of programmes within the existing health systems enhanced programme compatibility with the health systems' governance, financing and training functions. Factors that inhibited the integration process included a rapid

  5. Curriculum influence on interdisciplinary oral health education and practice.

    Science.gov (United States)

    Clark, Melinda; Quinonez, Rocio; Bowser, Jonathan; Silk, Hugh

    2017-06-01

    Oral diseases are very prevalent across the lifespan and impact overall health, yet are largely preventable. The Smiles for Life (SFL) curriculum was created to educate healthcare providers about oral disease and support integration of oral health and primary care. This study examines SFL's influence on clinical practice and education. Surveys were sent to registered users of SFL. Users who self-identified as direct care providers (DCPs), or educators, were included in the analysis. Survey response rate was 18 percent, with 87 percent identifying as DCPs and 13 percent as educators. Across professions, 85 percent of DCPs reported SFL influencing their practice to some degree, with variance among profession type and experience. DCPs most commonly reported that SFL led them to improve how they conduct oral health activities, with 60 percent performing the activity more skillfully following completion of SFL. Fluoride varnish application was the most common practice behavior initiated, and caries risk assessments was the oral health activity affected to the greatest degree. A majority of educators (94 percent) reported that SFL led them to incorporate or enhance oral health in their teaching. SFL helped educators emphasize the importance of oral health, improved their ability to teach content, raised motivation, and reduced barriers to teaching oral health. Data supports that SFL is positively influencing oral health practice across professions, especially in areas of caries risk assessment and fluoride varnish application. SFL improves the frequency and quality with which DCPs and educators participate in oral health activities, and facilitates oral health inclusion in primary care. © 2017 American Association of Public Health Dentistry.

  6. Alcohol advertising and public health: systems perspectives versus narrow perspectives.

    Science.gov (United States)

    Petticrew, M; Shemilt, I; Lorenc, T; Marteau, T M; Melendez-Torres, G J; O'Mara-Eves, A; Stautz, K; Thomas, J

    2017-03-01

    Alcohol consumption is influenced by a complex causal system of interconnected psychological, behavioural, social, economic, legal and environmental factors. These factors are shaped by governments (eg, licensing laws and taxation), by consumers (eg, patterns of alcohol consumption drive demand) and by alcohol industry practices, such as advertising. The marketing and advertising of alcoholic products contributes to an 'alcogenic environment' and is a modifiable influence on alcohol consumption and harm. The public health perspective is that there is sufficient evidence that alcohol advertising influences consumption. The alcohol industry disputes this, asserting that advertising only aims to help consumers choose between brands. We review the evidence from recent systematic reviews, including their theoretical and methodological assumptions, to help understand what conclusions can be drawn about the relationships between alcohol advertising, advertising restrictions and alcohol consumption. A wide evidence base needs to be drawn on to provide a system-level overview of the relationship between alcohol advertising, advertising restrictions and consumption. Advertising aims to influence not just consumption, but also to influence awareness, attitudes and social norms; this is because advertising is a system-level intervention with multiple objectives. Given this, assessments of the effects of advertising restrictions which focus only on sales or consumption are insufficient and may be misleading. For this reason, previous systematic reviews, such as the 2014 Cochrane review on advertising restrictions (Siegfried et al ) contribute important, but incomplete representations of 'the evidence' needed to inform the public health case for policy decisions on alcohol advertising. We conclude that an unintended consequence of narrow, linear framings of complex system-level issues is that they can produce misleading answers. Systems problems require systems perspectives

  7. Understanding global health governance as a complex adaptive system.

    Science.gov (United States)

    Hill, Peter S

    2011-01-01

    The transition from international to global health reflects the rapid growth in the numbers and nature of stakeholders in health, as well as the constant change embodied in the process of globalisation itself. This paper argues that global health governance shares the characteristics of complex adaptive systems, with its multiple and diverse players, and their polyvalent and constantly evolving relationships, and rich and dynamic interactions. The sheer quantum of initiatives, the multiple networks through which stakeholders (re)configure their influence, the range of contexts in which development for health is played out - all compound the complexity of this system. This paper maps out the characteristics of complex adaptive systems as they apply to global health governance, linking them to developments in the past two decades, and the multiple responses to these changes. Examining global health governance through the frame of complexity theory offers insight into the current dynamics of governance, and while providing a framework for making meaning of the whole, opens up ways of accessing this complexity through local points of engagement.

  8. The influence of social capital and socio-economic conditions on self-rated health among residents of an economically and health-deprived South African township

    Directory of Open Access Journals (Sweden)

    Cramm Jane M

    2011-11-01

    Full Text Available Abstract Background Surprisingly few studies have investigated the interplay of multiple factors affecting self-rated health outcomes and the role of social capital on health in developing countries, a prerequisite to strengthening our understanding of the influence of social and economic conditions on health and the most effective aid. Our study aimed to identify social and economic conditions for health among residents of an economically and health-deprived community. Methods Data were gathered through a survey administered to respondents from 1,020 households in Grahamstown a suburb in the Eastern Cape, South Africa (response rate 97.9%. We investigated the influence of social and economic conditions (education, employment, income, social capital, housing quality and neighborhood quality on self-rated health. We used ordinal logistic regression analyses to identify the relationship of these conditions and self-rated health. Results Our study found that education and social capital positively correlated with health; unemployment, poor educational level and advanced age negatively correlated. We found no significant correlations between self-rated health and housing quality, neighbourhood quality, income, gender, or marital status. Conclusion We highlight the possible impacts of social capital, employment, and education on health, and suggest that health outcomes may be improved through interventions beyond the health system: creating job opportunities, strengthening social capital, bettering educational systems, and promoting educational access. Policymakers should consider the benefits of such programmes when addressing health outcomes in financially distressed districts.

  9. Factors influencing women's utilization of public health care services ...

    African Journals Online (AJOL)

    the determinants influencing women's use of public health facilities at the time they give birth. Results: Of .... due to distance between their places of abode and health care facilities ..... care: what works for safe motherhood: Bull World Health.

  10. Your Health Buddies Matter: Preferential Selection and Social Influence on Weight Management in an Online Health Social Network.

    Science.gov (United States)

    Meng, Jingbo

    2016-12-01

    A growing number of online social networks are designed with the intention to promote health by providing virtual space wherein individuals can seek and share information and support with similar others. Research has shown that real-world social networks have a significant influence on one's health behavior and outcomes. However, there is a dearth of studies on how individuals form social networks in virtual space and whether such online social networks exert any impact on individuals' health outcomes. Built on the Multi-Theoretical Multilevel (MTML) framework and drawing from literature on social influence, this study examined the mechanisms underlying the formation of an online health social network and empirically tested social influence on individual health outcomes through the network. Situated in a weight management social networking site, the study tracked a health buddy network of 709 users and their weight management activities and outcomes for 4 months. Actor-based modeling was used to test the joint dynamics of preferential selection and social influence among health buddies. The results showed that baseline, inbreeding, and health status homophily significantly predicted preferential selection of health buddies in the weight management social networking site, whereas self-interest in seeking experiential health information did not. The study also found peer influence of online health buddy networks on individual weight outcomes, such that an individual's odds of losing weight increased if, on average, the individual's health buddies were losing weight.

  11. A SUSTAINABLE HEALTH CARE SYSTEM REQUIRES MANAGEMENT TRANSFORMATION

    Directory of Open Access Journals (Sweden)

    Kanellopoulos Dimitros

    2011-12-01

    Full Text Available In order to be the health care system sustainable , management transformations must be based on very precise diagnostic analysis that includes complete and current information. It is necessary to implement an information system that collects information in real time, that watches the parameters that significantly influence the sustainability of the system. Such an information system should point out a radiography(a scan of the system at some time under following aspects:: 1. An overview of system; 2 An overview of the economic situation; 3 A technical presentation ;4. A legal overview; 5. A social overview ; 6. A management overview .Based on these Xrays of the health system, it outlines a series of conclusions and recommendations together with a SWOT analysis that highlights the potential internal (strengths and weaknesses and external potential (opportunities and threats. Based on this analysis and recommendations, the management is going to redesign the system in order to be adapted to the changing environmental requirements. Management transformation is recommended to be by following steps. :1. The development of a new management system that would make a positive change in the health care system 2. Implementation of the new management system 3. Assessment of the changes

  12. Influence of functional food components on gut health.

    Science.gov (United States)

    Wan, Murphy L Y; Ling, K H; El-Nezami, Hani; Wang, M F

    2018-01-30

    Intestinal epithelial cells (IECs) lining the gastrointestinal tract establish a barrier between external environments and the internal milieu. An intact intestinal barrier maintains gut health and overall good health of the body by preventing from tissue injury, pathogen infection and disease development. When the intestinal barrier function is compromised, bacterial translocation can occur. Our gut microbiota also plays a fundamentally important role in health, for example, by maintaining intestinal barrier integrity, metabolism and modulating the immune system, etc. Any disruption of gut microbiota composition (also termed dysbiosis) can lead to various pathological conditions. In short, intestinal barrier and gut microbiota are two crucial factors affecting gut health. The gastrointestinal tract is a complex environment exposed to many dietary components and commensal bacteria. Dietary components are increasingly recognized to play various beneficial roles beyond basic nutrition, resulting in the development of the functional food concepts. Various dietary modifiers, including the consumption of live bacteria (probiotics) and ingestible food constituents such as prebiotics, as well as polyphenols or synbiotics (combinations of probiotics and prebiotics) are the most well characterized dietary bioactive compounds and have been demonstrated to beneficially impact the gut health and the overall well-being of the host. In this review we depict the roles of intestinal epithelium and gut microbiota in mucosal defence responses and the influence of certain functional food components on the modulation of gut health, with a particular focus on probiotics, prebiotics and polyphenols.

  13. Influencers of Career Choice among Allied Health Students.

    Science.gov (United States)

    Brown-West, Anne P.

    1991-01-01

    Major influences on career choice among 153 allied health students were need to help others, prestige, autonomy, and advancement and income potential. Risk of malpractice suits and Acquired Immune Deficiency Syndrome were negative influences for medical laboratory majors, but not for dietetics and physical therapy majors. (SK)

  14. Health-seeking behavior and hospital choice in China's New Cooperative Medical System.

    Science.gov (United States)

    Brown, Philip H; Theoharides, Caroline

    2009-07-01

    Since the dissolution of the Rural Cooperative Medical System at the end of the commune period, illness has emerged as a leading cause of poverty in rural China. To address the poor state of health care, the Chinese government unveiled the New Cooperative Medical System in 2002. Because local governments have been given significant control over program design, fundamental characteristics of the program vary from one county to the next. These differences may influence the decision to seek health care as well as the choice of hospital conditional on that initial decision. In this paper, we use a nested logit model to analyze household survey data from 25 counties to analyze the determinants of such health-seeking behavior. We find that age, the share of household expenditures allocated to food consumption (a measure of relative income), and the presence of other sick people in the household negatively affect the decision to seek health care while disability has a positive influence. Further, conditional on seeking treatment, the reimbursement scheme in place in each county and the average daily expenditure associated with hospitalization strongly influence hospital choice.

  15. Climate change and climate systems influence and control the atmospheric dispersion of desert dust: implications for human health

    Science.gov (United States)

    Griffin, Dale W.; Ragaini, Richard C.

    2010-01-01

    The global dispersion of desert dust through Earth’s atmosphere is greatly influenced by temperature. Temporal analyses of ice core data have demonstrated that enhanced dust dispersion occurs during glacial events. This is due to an increase in ice cover, which results in an increase in drier terrestrial cover. A shorter temporal analysis of dust dispersion data over the last 40 years has demonstrated an increase in dust transport. Climate systems or events such as the North Atlantic Oscillation, the Indian Ocean subtropical High, Pacific Decadal Oscillation, and El Nino-Sothern Oscillation are known to influence global short-term dust dispersion occurrence and transport routes. Anthropogenic influences on dust transport include deforestation, harmful use of topsoil for agriculture as observed during the American Dust Bowl period, and the creation of dry seas (Aral Sea) and lakes (Lake Owens in California and Lake Chad in North Africa) through the diversion of source waters (for irrigation and drinking water supplies). Constituents of desert dust both from source regions (pathogenic microorganisms, organic and inorganic toxins) and those scavenged through atmospheric transport (i.e., industrial and agricultural emissions) are known to directly impact human and ecosystem health. This presentation will present a review of global scale dust storms and how these events can be both a detriment and benefit to various organisms in downwind environments.

  16. mHealth Interventions for Health System Strengthening in China: A Systematic Review.

    Science.gov (United States)

    Tian, Maoyi; Zhang, Jing; Luo, Rong; Chen, Shi; Petrovic, Djordje; Redfern, Julie; Xu, Dong Roman; Patel, Anushka

    2017-03-16

    With rapidly expanding infrastructure in China, mobile technology has been deemed to have the potential to revolutionize health care delivery. There is particular promise for mobile health (mHealth) to positively influence health system reform and confront the new challenges of chronic diseases. The aim of this study was to systematically review existing mHealth initiatives in China, characterize them, and examine the extent to which mHealth contributes toward the health system strengthening in China. Furthermore, we also aimed to identify gaps in mHealth development and evaluation. We systematically reviewed the literature from English and Chinese electronic database and trial registries, including PubMed, EMBASE, Cochrane, China National Knowledge of Infrastructure (CNKI), and World Health Organization (WHO) International Clinical Trials Registry Platform. We used the English keywords of mHealth, eHealth, telemedicine, telehealth, mobile phone, cell phone, text messaging, and China, as well as their corresponding Chinese keywords. All articles using mobile technology for health care management were included in the study. A total of 1704 articles were found using the search terms, and eventually 72 were included. Overall, few high quality interventions were identified. Most interventions were found to be insufficient in scope, and their evaluation was of inadequate rigor to generate scalable solutions and provide reliable evidence of effectiveness. Most interventions focused on text messaging for consumer education and behavior change. There were a limited number of interventions that addressed health information management, health workforce issues, use of medicines and technologies, or leadership and governance from a health system perspective. We provide four recommendations for future mHealth interventions in China that include the need for the development, evaluation and trials examining integrated mHealth interventions to guide the development of future mHealth

  17. mHealth Interventions for Health System Strengthening in China: A Systematic Review

    Science.gov (United States)

    Zhang, Jing; Luo, Rong; Chen, Shi; Petrovic, Djordje; Redfern, Julie; Xu, Dong Roman; Patel, Anushka

    2017-01-01

    Background With rapidly expanding infrastructure in China, mobile technology has been deemed to have the potential to revolutionize health care delivery. There is particular promise for mobile health (mHealth) to positively influence health system reform and confront the new challenges of chronic diseases. Objective The aim of this study was to systematically review existing mHealth initiatives in China, characterize them, and examine the extent to which mHealth contributes toward the health system strengthening in China. Furthermore, we also aimed to identify gaps in mHealth development and evaluation. Methods We systematically reviewed the literature from English and Chinese electronic database and trial registries, including PubMed, EMBASE, Cochrane, China National Knowledge of Infrastructure (CNKI), and World Health Organization (WHO) International Clinical Trials Registry Platform. We used the English keywords of mHealth, eHealth, telemedicine, telehealth, mobile phone, cell phone, text messaging, and China, as well as their corresponding Chinese keywords. All articles using mobile technology for health care management were included in the study. Results A total of 1704 articles were found using the search terms, and eventually 72 were included. Overall, few high quality interventions were identified. Most interventions were found to be insufficient in scope, and their evaluation was of inadequate rigor to generate scalable solutions and provide reliable evidence of effectiveness. Most interventions focused on text messaging for consumer education and behavior change. There were a limited number of interventions that addressed health information management, health workforce issues, use of medicines and technologies, or leadership and governance from a health system perspective. Conclusions We provide four recommendations for future mHealth interventions in China that include the need for the development, evaluation and trials examining integrated mHealth

  18. Health Behaviour Change Support Systems: Past Research and Future Challenges

    OpenAIRE

    Mettler, Tobias

    2015-01-01

    The emergence of mobile devices and social technologies has opened up new possibilities for health promotion and disease prevention. By means of emotional stimuli, motivation, and persuasion health behaviour change support systems (HBCSS) aim at influencing users to improve their health and wellbeing. This article presents the results of a bibliometric analysis related to the existing HBCSS body of knowledge. A total of 51 research studies were analysed with a look at their topical and theore...

  19. Comparison of the Determinants of the Health Service System and the Health Status of the People in the Greater Mekong Subregion (GMS).

    Science.gov (United States)

    Phanphairoj, Kanjanee; Loa, Ritzmond

    2017-12-01

    Health is influenced by numerous factors that affect the health service system and health status of the people in every country. This article aims to compare the determinants of the health service system and the health status of the people in Thailand, the Lao PDR, Vietnam, and Cambodia; and to recommend policies that impact the population's health and the country's development. Methods: A comprehensive search of the literature from a variety of online search and academic databases, and synthesis of previous study was used in this paper. Data on country indicators were taken from published online databases of the Ministry of Public Health of Cambodia, Lao PDR, Thailand,and Vietnam; the World Health Organization, and the World Bank. In Thailand, the determinants of the health service system and health status of the people are medical information and technology because of the government initiatives to improve the quality of healthcare services through the use of modern technology. In Vietnam, the society and culture, and the strengths and weaknesses of the hospital significantly affect the health status and health service system there because of the religious beliefs of the people. However, in Cambodia, the strengths and weaknesses of the hospital are the primary determinant of the health service system and health status of the people due to the condition of the hospitals, the availability of new medical devices, and the number of healthcare professionals. In the Lao PDR, trade and investment, and medical information and technology, significantly influence the health service system and health status of the people because of the government efforts to outsource capital expenditures and medical technology. The strengths and weaknesses of the hospital are the key determinants of the health service system and health status of the people in all GMS countries. Understanding the determinants of health is essential in order to develop policies and programs that impact the

  20. Factors that influence Asian communities' access to mental health care.

    Science.gov (United States)

    Wynaden, Dianne; Chapman, Rose; Orb, Angelica; McGowan, Sunita; Zeeman, Zenith; Yeak, SiewHo

    2005-06-01

    This paper presents the findings of a qualitative study to identify factors that influence Asian communities' access to mental health care and how mental health care is delivered to them. Semistructured interviews were completed with Asian community members/leaders and health-care professionals. Content analysis identified major themes. Participants also completed a demographic data sheet. The research aimed to provide health professionals with an increased understanding of the values and beliefs held by people from Asian communities regarding the cause and treatment of mental illness. Data analysis identified six main themes that influenced Asian communities' access to mental health care and how mental health care is delivered to them. They were: shame and stigma; causes of mental illness; family reputation; hiding up; seeking help; and lack of collaboration. The findings highlighted that people from Asian communities are unwilling to access help from mainstream services because of their beliefs, and that stigma and shame are key factors that influence this reluctance. The findings also highlight that the mental health needs of refugee women are significant, and that they comprise a vulnerable group within Australian society.

  1. People-centred science: strengthening the practice of health policy and systems research

    Science.gov (United States)

    2014-01-01

    Health policy and systems research (HPSR) is a transdisciplinary field of global importance, with its own emerging standards for creating, evaluating, and utilizing knowledge, and distinguished by a particular orientation towards influencing policy and wider action to strengthen health systems. In this commentary, we argue that the ability of the HPSR field to influence real world change hinges on its becoming more people-centred. We see people-centredness as recognizing the field of enquiry as one of social construction, requiring those conducting HPSR to locate their own position in the system, and conduct and publish research in a manner that foregrounds human agency attributes and values, and is acutely attentive to policy context. Change occurs at many layers of a health system, shaped by social, political, and economic forces, and brought about by different groups of people who make up the system, including service users and communities. The seeds of transformative practice in HPSR lie in amplifying the breadth and depth of dialogue across health system actors in the conduct of research – recognizing that these actors are all generators, sources, and users of knowledge about the system. While building such a dialogic practice, those conducting HPSR must strive to protect the autonomy and integrity of their ideas and actions, and also clearly explain their own positions and the value-basis of their work. We conclude with a set of questions that health policy and systems researchers may wish to consider in making their practice more people-centred, and hence more oriented toward real-world change. PMID:24739525

  2. Exploring the Influence of Social Determinants, Social Capital, and Health Expertise on Health and the Rural Church.

    Science.gov (United States)

    Plunkett, Robyn; Leipert, Beverly; Olson, Joanne

    2016-09-01

    In rural communities, religious places can significantly shape health for individuals, families, and communities. Rural churches are prominent community centers in rural communities and are deeply woven into rural culture. Thus, health influences arising from the rural church likely have health implications for the greater community. This article explores health influences emerging from rural churches using social determinants of health, social capital, and health expertise. Although nurses are important health resources for all populations, their value in rural areas may be exceedingly significant. The contribution of nurses to church-based health capital in rural communities may be quite significant and underestimated, although it remains poorly understood. © The Author(s) 2015.

  3. Influence of Religious Beliefs on the Health of Cancer Patients.

    Science.gov (United States)

    Tsai, Tai-Jung; Chung, Ue-Lin; Chang, Chee-Jen; Wang, Hsiu-Ho

    2016-01-01

    This study investigated the influence of religious beliefs on the health of cancer patients and identified the factors contributing to the influence. A questionnaire survey was conducted using a convenient sampling method. A structured questionnaire was used to the samplings, and the data of 200 cancer patients were collected. The effects of religion on the health of cancer patients achieved an average score of 3.58. The top five effects are presented as follows: (a) Religion provides me with mental support and strength, (b) religion enables me to gain confidence in health recovery, (c) religion motivates me to cope with disease-related stress positively and optimistically, (d) religion helps me reduce anxiety, and (e) religion gives me courage to face uncertainties regarding disease progression. Moreover, among the demographic variables, gender, type of religion, and experience of religious miracles contributed to the significantly different effects of religion on patients. Specifically, the effect of religion on the health of patients who were female and Christian and had miracle experiences was significantly (< .01) higher than that on other patients. These results are helpful in understanding the influence of religious beliefs on the health of cancer patients and identified the factors contributing to the influence. The result can serve as a reference for nursing education and clinical nursing practice.

  4. Factors Influencing the Health Behaviour of Indigenous Australians: Perspectives from Support People.

    Science.gov (United States)

    Waterworth, Pippa; Pescud, Melanie; Braham, Rebecca; Dimmock, James; Rosenberg, Michael

    2015-01-01

    Disparities between the health of Indigenous and non-Indigenous populations continue to be prevalent within Australia. Research suggests that Indigenous people participate in health risk behaviour more often than their non-Indigenous counterparts, and that such behaviour has a substantial impact on health outcomes. Although this would indicate that reducing health risk behaviour may have positive effects on health outcomes, the factors that influence Indigenous health behaviour are still poorly understood. This study aimed to interview people who support Indigenous groups to gain an understanding of their views on the factors influencing health behaviour within Indigenous groups in Western Australia. Twenty nine people participated in the study. The emergent themes were mapped against the social ecological model. The results indicated that: (1) culture, social networks, history, racism, socioeconomic disadvantage, and the psychological distress associated with some of these factors interact to affect health behaviour in a complex manner; (2) the desire to retain cultural identity and distinctiveness may have both positive and negative influence on health risk behaviour; (3) strong social connections to family and kin that is intensified by cultural obligations, appears to affirm and disrupt positive health behaviour; (4) the separation between Indigenous and non-Indigenous social connection/networks that appeared to be fostered by marginalisation and racism may influence the effect of social networks on health behaviour; and (5) communication between Indigenous and non-Indigenous people may be interrupted by distrust between the groups, which reduces the influence of some non-Indigenous sources on the health behaviour of Indigenous people.

  5. Factors Influencing the Health Behaviour of Indigenous Australians: Perspectives from Support People

    Science.gov (United States)

    Waterworth, Pippa; Pescud, Melanie; Braham, Rebecca; Dimmock, James; Rosenberg, Michael

    2015-01-01

    Disparities between the health of Indigenous and non-Indigenous populations continue to be prevalent within Australia. Research suggests that Indigenous people participate in health risk behaviour more often than their non-Indigenous counterparts, and that such behaviour has a substantial impact on health outcomes. Although this would indicate that reducing health risk behaviour may have positive effects on health outcomes, the factors that influence Indigenous health behaviour are still poorly understood. This study aimed to interview people who support Indigenous groups to gain an understanding of their views on the factors influencing health behaviour within Indigenous groups in Western Australia. Twenty nine people participated in the study. The emergent themes were mapped against the social ecological model. The results indicated that: (1) culture, social networks, history, racism, socioeconomic disadvantage, and the psychological distress associated with some of these factors interact to affect health behaviour in a complex manner; (2) the desire to retain cultural identity and distinctiveness may have both positive and negative influence on health risk behaviour; (3) strong social connections to family and kin that is intensified by cultural obligations, appears to affirm and disrupt positive health behaviour; (4) the separation between Indigenous and non-Indigenous social connection/networks that appeared to be fostered by marginalisation and racism may influence the effect of social networks on health behaviour; and (5) communication between Indigenous and non-Indigenous people may be interrupted by distrust between the groups, which reduces the influence of some non-Indigenous sources on the health behaviour of Indigenous people. PMID:26599437

  6. Psychological traits influence autonomic nervous system recovery following esophageal intubation in health and functional chest pain.

    Science.gov (United States)

    Farmer, A D; Coen, S J; Kano, M; Worthen, S F; Rossiter, H E; Navqi, H; Scott, S M; Furlong, P L; Aziz, Q

    2013-12-01

    Esophageal intubation is a widely utilized technique for a diverse array of physiological studies, activating a complex physiological response mediated, in part, by the autonomic nervous system (ANS). In order to determine the optimal time period after intubation when physiological observations should be recorded, it is important to know the duration of, and factors that influence, this ANS response, in both health and disease. Fifty healthy subjects (27 males, median age 31.9 years, range 20-53 years) and 20 patients with Rome III defined functional chest pain (nine male, median age of 38.7 years, range 28-59 years) had personality traits and anxiety measured. Subjects had heart rate (HR), blood pressure (BP), sympathetic (cardiac sympathetic index, CSI), and parasympathetic nervous system (cardiac vagal tone, CVT) parameters measured at baseline and in response to per nasum intubation with an esophageal catheter. CSI/CVT recovery was measured following esophageal intubation. In all subjects, esophageal intubation caused an elevation in HR, BP, CSI, and skin conductance response (SCR; all p < 0.0001) but concomitant CVT and cardiac sensitivity to the baroreflex (CSB) withdrawal (all p < 0.04). Multiple linear regression analysis demonstrated that longer CVT recovery times were independently associated with higher neuroticism (p < 0.001). Patients had prolonged CSI and CVT recovery times in comparison to healthy subjects (112.5 s vs 46.5 s, p = 0.0001 and 549 s vs 223.5 s, p = 0.0001, respectively). Esophageal intubation activates a flight/flight ANS response. Future studies should allow for at least 10 min of recovery time. Consideration should be given to psychological traits and disease status as these can influence recovery. © 2013 John Wiley & Sons Ltd.

  7. Health systems around the world - a comparison of existing health system rankings.

    Science.gov (United States)

    Schütte, Stefanie; Acevedo, Paula N Marin; Flahault, Antoine

    2018-06-01

    Existing health systems all over the world are different due to the different combinations of components that can be considered for their establishment. The ranking of health systems has been a focal points for many years especially the issue of performance. In 2000 the World Health Organization (WHO) performed a ranking to compare the Performance of the health system of the member countries. Since then other health system rankings have been performed and it became an issue of public discussion. A point of contention regarding these rankings is the methodology employed by each of them, since no gold standard exists. Therefore, this review focuses on evaluating the methodologies of each existing health system performance ranking to assess their reproducibility and transparency. A search was conducted to identify existing health system rankings, and a questionnaire was developed for the comparison of the methodologies based on the following indicators: (1) General information, (2) Statistical methods, (3) Data (4) Indicators. Overall nine rankings were identified whereas six of them focused rather on the measurement of population health without any financial component and were therefore excluded. Finally, three health system rankings were selected for this review: "Health Systems: Improving Performance" by the WHO, "Mirror, Mirror on the wall: How the Performance of the US Health Care System Compares Internationally" by the Commonwealth Fund and "the Most efficient Health Care" by Bloomberg. After the completion of the comparison of the rankings by giving them scores according to the indicators, the ranking performed the WHO was considered the most complete regarding the ability of reproducibility and transparency of the methodology. This review and comparison could help in establishing consensus in the field of health system research. This may also help giving recommendations for future health rankings and evaluating the current gap in the literature.

  8. The influence of source term release parameters on health effects

    International Nuclear Information System (INIS)

    Jeong, Jong Tae; Ha, Jae Joo

    1998-08-01

    In this study, the influence of source term release parameters on the health effects was examined. This is very useful in identifying the relative importance of release parameters and can be an important factor in developing a strategy for reducing offsite risks. The release parameters investigated in this study are release height, heat content, fuel burnup, release time, release duration, and warning time. The health effects affected by the change of release parameters are early fatalities, cancer fatalities, early injuries, cancer injuries, early fatality risk, population weighted early fatality risk, population weighted cancer fatality risk, effective whole body population dose, population exceeding an early acute red bone marrow dose of 1.5 Sv, and distance at which early fatalities are expected to occur. As release height increases, the values of early health effects such as early fatalities and injuries decrease. However, the release height dose not have significant influences on late health effects. The values of both early and late health effects decrease as heat content increases. The increase fuel burnup, i.e., the increase of core inventories increases the late health effects, however, has small influence on the early health effects. But, the number of early injuries increases as the fuel burnup increases. The effects of release time increase shows very similar influence on both the early and late health effects. As the release time increases to 2 hours, the values of health effects increase and then decrease rapidly. As release duration increases, the values of late health effects increase slightly, however, the values of early health effects decrease. As warning time increases to 2 hours, the values of late health effects decrease and then shows no variation. The number of early injuries decreases rapidly as the warning time increases to 2 hours. However, the number of early fatalities and the early fatality risk increase as the warning time increases

  9. Declining amenable mortality: a reflection of health care systems?

    Science.gov (United States)

    Gianino, Maria Michela; Lenzi, Jacopo; Fantini, Maria Pia; Ricciardi, Walter; Damiani, Gianfranco

    2017-11-15

    Some studies have analyzed the association of health care systems variables, such as health service resources or expenditures, with amenable mortality, but the association of types of health care systems with the decline of amenable mortality has yet to be studied. The present study examines whether specific health care system types are associated with different time trend declines in amenable mortality from 2000 to 2014 in 22 European OECD countries. A time trend analysis was performed. Using Nolte and McKee's list, age-standardized amenable mortality rates (SDRs) were calculated as the annual number of deaths over the population aged 0-74 years per 100,000 inhabitants. We classified health care systems according to a deductively generated classification by Böhm. This classification identifies three dimensions that are not entirely independent of each other but follow a clear order: the regulation dimension is first, followed by the financing dimension and finally service provision. We performed a hierarchical semi-log polynomial regression analysis on the annual SDRs to determine whether specific health care systems were associated with different SDR trajectories over time. The results showed a clear decline in SDRs in all 22 health care systems between 2000 and 2014 although at different annual changes (slopes). Regression analysis showed that there was a significant difference among the slopes according to provision dimension. Health care systems with a private provision exhibited a slowdown in the decline of amenable mortality over time. It therefore seems that ownership is the most relevant dimension in determining a different pattern of decline in mortality. All countries experienced decreases in amenable mortality between 2000 and 2014; this decline seems to be partially a reflection of health care systems, especially when affected by the provision dimension. If the private ownership is maintained or promoted by health systems, these findings might be

  10. System impact research – increasing public health and health care system performance

    Science.gov (United States)

    Malmivaara, Antti

    2016-01-01

    Abstract Background Interventions directed to system features of public health and health care should increase health and welfare of patients and population. Aims To build a new framework for studies aiming to assess the impact of public health or health care system, and to consider the role of Randomized Controlled Trials (RCTs) and of Benchmarking Controlled Trials (BCTs). Methods The new concept is partly based on the author's previous paper on the Benchmarking Controlled Trial. The validity and generalizability considerations were based on previous methodological studies on RCTs and BCTs. Results The new concept System Impact Research (SIR) covers all the studies which aim to assess the impact of the public health system or of the health care system on patients or on population. There are two kinds of studies in System Impact Research: Benchmarking Controlled Trials (observational) and Randomized Controlled Trials (experimental). The term impact covers in particular accessibility, quality, effectiveness, safety, efficiency, and equality. Conclusions System Impact Research – creating the scientific basis for policy decision making - should be given a high priority in medical, public health and health economic research, and should also be used for improving performance. Leaders at all levels of health and social care can use the evidence from System Impact Research for the benefit of patients and population.Key messagesThe new concept of SIR is defined as a research field aiming at assessing the impacts on patients and on populations of features of public health and health and social care systems or of interventions trying to change these features.SIR covers all features of public health and health and social care system, and actions upon these features. The term impact refers to all effects caused by the public health and health and social care system or parts of it, with particular emphasis on accessibility, quality, effectiveness, adverse effects, efficiency

  11. Teacher Reports of Student Health and Its Influence on Students' School Performance

    Science.gov (United States)

    Moore, Tara C.; Wehby, Joseph H.; Hollo, Alexandra; Robertson, Rachel E.; Maggin, Daniel M.

    2014-01-01

    Physical health may be an important variable that influences students' behavioral and academic performance in school settings. Poor health status is hypothesized to negatively influence student performance even in the presence of evidence-based practices. In this study, teachers reported their perceptions of students' health status as well as…

  12. The Influence of Black Identity on Wellbeing and Health Behaviors.

    Science.gov (United States)

    Lewis, Fiona B; Boutrin, Marie-Claire; Dalrymple, Lisa; McNeill, Lorna H

    2018-06-01

    The aim of this study was to investigate the influence of Black identity on wellbeing and health behaviors. Data from the third year (wave) of a longitudinal cohort study (N = 1316) from a large, majority Black, Protestant church of 16,000 members located in Houston, Texas, were used to conduct secondary data analyses. Univariate analyses were used to obtain participants' sociodemographic and health characteristics. ANCOVA and linear regression analyses and Bonferroni adjustments were used to examine the influence of the centrality, public and private regard aspects of Black identity as measured by the Multidimensional Inventory of Black Identity subscales on wellbeing (CES-D scores and self-reported general health) and health behaviors (diet and physical activity levels). Associations were noted between fruit consumption and centrality (F (95,1216) = 2.27) p = .046); soda consumption and private regard (F (5,1214) = 3.04; p = .010); public regard (F (2,1186) = 4.70; p = .009) and physical activity levels; self-reported general health status and private (F (4,1219) = 4.78; p = .001) and public regard (F (4,1211) = 8.53; p identity remain an important factor to consider in addressing health disparities. Racial identity influences mental health, general health, diet and the physical activity levels. Utilizing identity congruent health promotion interventions may positively impact mental, exercise levels, self-reported general health and diet.

  13. The use and effectiveness of information system development methodologies in health information systems / Pieter Wynand Conradie.

    OpenAIRE

    Conradie, Pieter Wynand

    2010-01-01

    Abstract The main focus of this study is the identification of factors influencing the use and effectiveness of information system development methodologies (Le., systems development methodologies) in health information systems. In essence, it can be viewed as exploratory research, utilizing a conceptual research model to investigate the relationships among the hypothesised factors. More specifically, classified as behavioural science, it combines two theoretical models, namely...

  14. Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes.

    Science.gov (United States)

    McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla

    2018-01-01

    Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10-20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.

  15. The influence of social hierarchy on primate health.

    Science.gov (United States)

    Sapolsky, Robert M

    2005-04-29

    Dominance hierarchies occur in numerous social species, and rank within them can greatly influence the quality of life of an animal. In this review, I consider how rank can also influence physiology and health. I first consider whether it is high- or low-ranking animals that are most stressed in a dominance hierarchy; this turns out to vary as a function of the social organization in different species and populations. I then review how the stressful characteristics of social rank have adverse adrenocortical, cardiovascular, reproductive, immunological, and neurobiological consequences. Finally, I consider how these findings apply to the human realm of health, disease, and socioeconomic status.

  16. Denmark: Health system review

    DEFF Research Database (Denmark)

    Juul, Annegrete; Krasnik, Allan; Rudkjøbing, Andreas

    The Health Systems in Transition (HiT) series provide detailed descriptions of health systems in the countries of the WHO European Region as well as some additional OECD countries. An individual health system review (HiT) examines the specific approach to the organization, financing and delivery...... of health services in a particular country and the role of the main actors in the health system. It describes the institutional framework, process, content, and implementation of health and health care policies. HiTs also look at reforms in progress or under development and make an assessment of the health...... system based on stated objectives and outcomes with respect to various dimensions (health status, equity, quality, efficiency, accountability)....

  17. The impact of global health initiatives on the health system in Angola.

    Science.gov (United States)

    Craveiro, Isabel; Dussault, Gilles

    2016-01-01

    We assessed the impact of global health initiatives (GHIs) on the health care system of Angola, as a contribution to documenting how GHIs, such as the Global Fund, GAVI and PEPFAR, influence the planning and delivery of health services in low-income countries and how national systems respond. We collected the views of national and sub-national key informants through 42 semi-structured interviews between April 2009 and May 2011 (12 at the national level and 30 at the sub-national level). We used a snowball technique to identify respondents from government, donors and non-governmental organisations. GHIs stimulated the formulation of a health policy and of plans and strategies, but the country has yet to decide on its priorities for health. At the regional level, managers lack knowledge of how GHIs' function, but they assess the effects of external funds as positive as they increased training opportunities, and augment the number of workers engaged in HIV or other specific disease programmes. However, GHIs did not address the challenge of attraction and retention of qualified personnel in provinces. Since Angola is not entirely dependent on external funding, national strategic programmes and the interventions of GHIs co-habit well, in contrast to countries such as Mozambique, which heavily depend on external aid.

  18. Understanding multinational companies in public health systems, using a competitive advantage framework.

    Science.gov (United States)

    Lethbridge, Jane

    2011-07-01

    This paper discusses the findings of a study which developed five case studies of five multinational health care companies involved in public health care systems. Strategies were analysed in terms of attitude to marketing, pricing and regulation. The company strategies have been subjected to an analysis using Porter's Five Forces, a business strategy framework, which is unusual in health policy studies. This paper shows how analysing company strategy using a business tool can contribute to understanding the strategies of global capital in national health systems. It shows how social science methodologies can draw from business methods to explain company strategies. The five companies considered in this paper demonstrate that their strategies have many dimensions, which fit into Porter's Five Forces of comparative advantage. More importantly the Five Forces can be used to identify factors that influence company entry into public health care systems. The process of examining the strategic objectives of five health care companies shows that a business tool can help to explain the actions and motives of health care companies towards public health care systems, and so contribute to a better understanding of the strategies of global capital in national health systems. Health service commissioners need to understand this dynamic process, which will evolve as the nature of public health care systems change.

  19. Understanding the organization of public health delivery systems: an empirical typology.

    Science.gov (United States)

    Mays, Glen P; Scutchfield, F Douglas; Bhandari, Michelyn W; Smith, Sharla A

    2010-03-01

    Policy discussions about improving the U.S. health care system increasingly recognize the need to strengthen its capacities for delivering public health services. A better understanding of how public health delivery systems are organized across the United States is critical to improvement. To facilitate the development of such evidence, this article presents an empirical method of classifying and comparing public health delivery systems based on key elements of their organizational structure. This analysis uses data collected through a national longitudinal survey of local public health agencies serving communities with at least 100,000 residents. The survey measured the availability of twenty core public health activities in local communities and the types of organizations contributing to each activity. Cluster analysis differentiated local delivery systems based on the scope of activities delivered, the range of organizations contributing, and the distribution of effort within the system. Public health delivery systems varied widely in organizational structure, but the observed patterns of variation suggested that systems adhere to one of seven distinct configurations. Systems frequently migrated from one configuration to another over time, with an overall trend toward offering a broader scope of services and engaging a wider range of organizations. Public health delivery systems exhibit important structural differences that may influence their operations and outcomes. The typology developed through this analysis can facilitate comparative studies to identify which delivery system configurations perform best in which contexts.

  20. Political and institutional influences on the use of evidence in public health policy. A systematic review.

    Science.gov (United States)

    Liverani, Marco; Hawkins, Benjamin; Parkhurst, Justin O

    2013-01-01

    There is increasing recognition that the development of evidence-informed health policy is not only a technical problem of knowledge exchange or translation, but also a political challenge. Yet, while political scientists have long considered the nature of political systems, the role of institutional structures, and the political contestation of policy issues as central to understanding policy decisions, these issues remain largely unexplored by scholars of evidence-informed policy making. We conducted a systematic review of empirical studies that examined the influence of key features of political systems and institutional mechanisms on evidence use, and contextual factors that may contribute to the politicisation of health evidence. Eligible studies were identified through searches of seven health and social sciences databases, websites of relevant organisations, the British Library database, and manual searches of academic journals. Relevant findings were extracted using a uniform data extraction tool and synthesised by narrative review. 56 studies were selected for inclusion. Relevant political and institutional aspects affecting the use of health evidence included the level of state centralisation and democratisation, the influence of external donors and organisations, the organisation and function of bureaucracies, and the framing of evidence in relation to social norms and values. However, our understanding of such influences remains piecemeal given the limited number of empirical analyses on this subject, the paucity of comparative works, and the limited consideration of political and institutional theory in these studies. This review highlights the need for a more explicit engagement with the political and institutional factors affecting the use of health evidence in decision-making. A more nuanced understanding of evidence use in health policy making requires both additional empirical studies of evidence use, and an engagement with theories and approaches

  1. Pathways of undue influence in health policy-making: a main actor's perspective.

    Science.gov (United States)

    Hernández-Aguado, Ildefonso; Chilet-Rosell, Elisa

    2018-02-01

    It is crucial to know the extent to which influences lead to policy capture-by which the policy-making process is shifted away from the public interest towards narrow private interests. Using the case study of Spain, our aim was to identify interactions between public administration, civil society and private companies that could influence health policies. 54 semistructured interviews with key actors related to health policy. The interviews were used to gather information on main policy actors as well as on direct and subtle influences that could modify health policies. The analysis identified and described, from the interviewed persons' experiences, both the inappropriate influences exerted on the actors and those that they exerted. Inappropriate influences were identified at all levels of administration and policy. They included actions for personal benefits, pressure for blocking health policies and pressure from high levels of government in favour of private corporations. The private sector played a significant role in these strategies through bribery, personal gifts, revolving doors, negative campaigns and by blocking unfavourable political positions or determining the knowledge agenda. The interviewees reported subtle forms of influence (social events, offers of technical support, invitations, etc) that contributed to the intellectual and cultural capture of health officials. The health policy decision-making processes in Spain are subject to influences by stakeholders that determine a degree of policy capture, which is avoidable. The private sector uses different strategies, from subtle influences to outright corruption, taking advantage in many cases of flexible legislation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Individual and institutional influences on faith-based health and wellness programming.

    Science.gov (United States)

    Bopp, Melissa; Fallon, Elizabeth A

    2011-12-01

    The majority of the US population is affiliated with faith-based organizations (FBO). Health and wellness activities (HWAs) within FBOs have great potential for reach, though the factors influencing faith-based HWA are not well understood. The purpose of this study was to examine individual faith leader and institutional influences on HWAs offered within FBOs. A national convenience sample of faith leaders (N = 844) completed an online survey assessing individual (demographics, health, health behaviors and attitudes) and institutional influences (size, location and external support) on health and HWA within FBO. Respondents were primarily White (93%), male (72%), middle-aged and affiliated with Methodist (42.5%) or Lutheran (20.2%) religions. Respondents reported 4.8 ± 3.2 HWA within their FBO per year. Faith leader education, length of service to the FBO, physical activity and fruit/vegetable intake were positively related to HWA and body mass index was negatively related. Denomination, congregation diversity, location and size were also related to HWA. Results show a strong relationship between faith leaders' health and HWA, indicating the influence of the social environment on health promotion in FBOs. Institutional variables, though not modifiable, were significant predictors of HWA and should be considered when delivering interventions to achieve a significant impact.

  3. Slovenia: Health System Review.

    Science.gov (United States)

    Albreht, Tit; Pribakovic Brinovec, Radivoje; Josar, Dusan; Poldrugovac, Mircha; Kostnapfel, Tatja; Zaletel, Metka; Panteli, Dimitra; Maresso, Anna

    2016-06-01

    This analysis of the Slovene health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The health of the population has improved over the last few decades. While life expectancy for both men and women is similar to EU averages, morbidity and mortality data show persistent disparities between regions, and mortality from external causes is particularly high. Satisfaction with health care delivery is high, but recently waiting times for some outpatient specialist services have increased. Greater focus on preventive measures is also needed as well as better care coordination, particularly for those with chronic conditions. Despite having relatively high levels of co-payments for many services covered by the universal compulsory health insurance system, these expenses are counterbalanced by voluntary health insurance, which covers 95% of the population liable for co-payments. However, Slovenia is somewhat unique among social health insurance countries in that it relies almost exclusively on payroll contributions to fund its compulsory health insurance system. This makes health sector revenues very susceptible to economic and labour market fluctuations. A future challenge will be to diversify the resource base for health system funding and thus bolster sustainability in the longer term, while preserving service delivery and quality of care. Given changing demographics and morbidity patterns, further challenges include restructuring the funding and provision of long-term care and enhancing health system efficiency through reform of purchasing and provider-payment systems. World Health Organization 2016 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  4. Factors influencing perceived sustainability of Dutch community health programs

    NARCIS (Netherlands)

    Vermeer, A. J. M.; van Assema, P.; Hesdahl, B.; Harting, J.; de Vries, N. K.

    2015-01-01

    We assessed the perceived sustainability of community health programs organized by local intersectoral coalitions, as well as the factors that collaborating partners think might influence sustainability. Semi-structured interviews were conducted among 31 collaborating partners of 5 community health

  5. On the influence of the alternation of two different cooling systems on dairy cow daily activities

    Directory of Open Access Journals (Sweden)

    Simona M.C. Porto

    2017-02-01

    Full Text Available Among the causes that influence cow welfare, heat stress induced by microclimatic conditions is one of the most relevant and many studies have investigated the efficacy of different cooling systems on animal health status. Nevertheless, the direct influence of the cooling systems on possible modifications of dairy cow behaviour has been addressed in a few studies and the related results were affected by the presence of a paddock, which gave a refuge from hot temperature. Since an alteration of the daily time budget spent by dairy cows in their usual activities can be associated with changes in their health status, this study investigated the effects of the alternation of two different cooling systems on lying, standing, and feeding behaviour of a group of dairy cows bred in a free-stall dairy house where animals had no access to a paddock. The barn was equipped with a fogging system associated with forced ventilation installed in the resting area and a sprinkler system associated with forced ventilation installed in the feeding area. The two systems were activated alternately. The results demonstrated that the management of the two cooling systems affected the analysed behaviours. Though the activation of the cooling system installed in the resting area encouraged the decubitus of animals in the stalls, the activation of that one of the feeding alley could not be able to influence the standing behaviour and had only a moderate positive influence on the feeding activity.

  6. Primary health care and public health: foundations of universal health systems.

    Science.gov (United States)

    White, Franklin

    2015-01-01

    The aim of this review is to advocate for more integrated and universally accessible health systems, built on a foundation of primary health care and public health. The perspective outlined identified health systems as the frame of reference, clarified terminology and examined complementary perspectives on health. It explored the prospects for universal and integrated health systems from a global perspective, the role of healthy public policy in achieving population health and the value of the social-ecological model in guiding how best to align the components of an integrated health service. The importance of an ethical private sector in partnership with the public sector is recognized. Most health systems around the world, still heavily focused on illness, are doing relatively little to optimize health and minimize illness burdens, especially for vulnerable groups. This failure to improve the underlying conditions for health is compounded by insufficient allocation of resources to address priority needs with equity (universality, accessibility and affordability). Finally, public health and primary health care are the cornerstones of sustainable health systems, and this should be reflected in the health policies and professional education systems of all nations wishing to achieve a health system that is effective, equitable, efficient and affordable. © 2015 S. Karger AG, Basel.

  7. Using a plant health system framework to assess plant clinic performance in Uganda

    DEFF Research Database (Denmark)

    Danielsen, Solveig; Matsiko, Frank B.

    2016-01-01

    and expand, new analytical frameworks and tools are needed to identify factors influencing performance of services and systems in specific contexts, and to guide interventions. In this paper we apply a plant health system framework to assess plant clinic performance, using Uganda as a case study...... factors, influenced by basic operational and financial concerns, inter-institutional relations and public sector policies. Overall, there was a fairly close match between the plant health system attributes and plant clinic performance, suggesting that the framework can help explain system functioning....... A comparative study of plant clinics was carried out between July 2010 and September 2011 in the 12 districts where plant clinics were operating at that time. The framework enabled us to organise multiple issues and identify key features that affected the plant clinics. Clinic performance was, among other...

  8. Pharmaceutical industry gifts to physicians: patient beliefs and trust in physicians and the health care system.

    Science.gov (United States)

    Grande, David; Shea, Judy A; Armstrong, Katrina

    2012-03-01

    Pharmaceutical industry gifts to physicians are common and influence physician behavior. Little is known about patient beliefs about the prevalence of these gifts and how these beliefs may influence trust in physicians and the health care system. To measure patient perceptions about the prevalence of industry gifts and their relationship to trust in doctors and the health care system. Cross sectional random digit dial telephone survey. African-American and White adults in 40 large metropolitan areas. Respondents' beliefs about whether their physician and physicians in general receive industry gifts, physician trust, and health care system distrust. Overall, 55% of respondents believe their physician receives gifts, and 34% believe almost all doctors receive gifts. Respondents of higher socioeconomic status (income, education) and younger age were more likely to believe their physician receives gifts. In multivariate analyses, those that believe their personal physician receives gifts were more likely to report low physician trust (OR 2.26, 95% CI 1.56-3.30) and high health care system distrust (OR 2.03, 95% CI 1.49-2.77). Similarly, those that believe almost all doctors accept gifts were more likely to report low physician trust (OR 1.69, 95% CI 1.25-2.29) and high health care system distrust (OR 2.57, 95% CI 1.82-3.62). Patients perceive physician-industry gift relationships as common. Patients that believe gift relationships exist report lower levels of physician trust and higher rates of health care system distrust. Greater efforts to limit industry-physician gifts could have positive effects beyond reducing influences on physician behavior.

  9. INFLUENCE OF HEALTH TECHNOLOGY ASSESSMENT AND ITS MEASUREMENT.

    Science.gov (United States)

    Hailey, David; Werkö, Sophie; Rosén, Måns; Macpherson, Karen; Myles, Susan; Gallegos Rivero, Verónica; Hipólito-Olivares, Cecilia; Sihvo, Sinikka; Pwu, Jasmine; Yang, Wen-Wen; Chen, Yong-Chen; Perez Galán, Ana; Aleman, Alicia; Villamil, Elena

    2016-01-01

    The aim of this study was to obtain information on methods used to measure health technology assessment (HTA) influence, decisions that were influenced, and outcomes linked to HTA. Electronic databases were used to locate studies in which HTA influence had been demonstrated. Inclusion criteria were studies that reliably reported consideration by decision makers of HTA findings; comparative studies of technology use before and after HTA; and details of changes in policy, health outcomes, or research that could be credibly linked to an HTA. Fifty-one studies were selected for review. Settings were national (24), regional (12), both national and regional (3) hospitals (9), and multinational (3). The most common approach to appraisal of influence was review of policy or administrative decisions following HTA recommendations (51 percent). Eighteen studies (35 percent) reported interview or survey findings, thirteen (26 percent) reviewed administrative data, and six considered the influence of primary studies. Of 142 decisions informed by HTA, the most common types were on routine clinical practice (67 percent of studies), coverage (63 percent), and program operation (37 percent). The most frequent indications of HTA influence were on decisions related to resource allocation (59 percent), change in practice pattern (31 percent), and incorporation of HTA details in reference material (18 percent). Few publications assessed the contribution of HTA to changing patient outcomes. The literature on HTA influence remains limited, with little on longer term effects on practice and outcomes. The reviewed publications indicated how HTA is being used in different settings and approaches to measuring its influence that might be more widely applied, such as surveys and monitoring administrative data.

  10. Predicting homeless people's perceived health after entering the social relief system in The Netherlands.

    Science.gov (United States)

    van der Laan, Jorien; van Straaten, Barbara; Boersma, Sandra N; Rodenburg, Gerda; van de Mheen, Dike; Wolf, Judith R L M

    2018-03-01

    We explored whether changes in the perceived health of homeless people after entering the social relief system (SRS) in The Netherlands were predicted by housing, income, hours of work, social support, unmet care needs, arrests, physical and mental health, substance use, and experiences of autonomy, competence and relatedness, in addition to perceived health at baseline, demographics, suspected intellectual disability, the duration of homelessness and the company of children in the shelter facility. A hierarchical regression analysis was used to explore the significant predictors of the perceived health of 344 homeless persons 18 months after entering the social relief system. A decrease in psychological distress and an increase in hours of (paid/voluntary) work as well as competence predicted a better perceived health. Perceived health is not only influenced by objective circumstances related to work and mental health, but also self-determination, as shown by the influence of competence. Services should aim to reduce psychological distress of homeless people, support them in increasing their working hours and focus on strengthening their competence.

  11. Belgium: Health system review.

    Science.gov (United States)

    Gerkens, Sophie; Merkur, Sherry

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The Belgian population continues to enjoy good health and long life expectancy. This is partly due to good access to health services of high quality. Financing is based mostly on proportional social security contributions and progressive direct taxation. The compulsory health insurance is combined with a mostly private system of health care delivery, based on independent medical practice, free choice of physician and predominantly fee-for-service payment. This Belgian HiT profile (2010) presents the evolution of the health system since 2007, including detailed information on new policies. While no drastic reforms were undertaken during this period, policy-makers have pursued the goals of improving access to good quality of care while making the system sustainable. Reforms to increase the accessibility of the health system include measures to reduce the out-of-pocket payments of more vulnerable populations (low-income families and individuals as well as the chronically ill). Quality of care related reforms have included incentives to better integrate different levels of care and the establishment of information systems, among others. Additionally, several measures on pharmaceutical products have aimed to reduce costs for both the National Institute for Health and Disability Insurance (NIHDI) and patients, while maintaining the quality of care. World Health Organization 2010, on behalf of the European Observatory on health systems and Policies.

  12. Patient complaints in healthcare services in Vietnam’s health system

    Directory of Open Access Journals (Sweden)

    Bui Thi Thu Ha

    2015-10-01

    Full Text Available Background: There is growing recognition of patient rights in health sectors around the world. Patients’ right to complain in hospitals, often visible in legislative and regulatory protocols, can be an important information source for service quality improvement and achievement of better health outcomes. However, empirical evidence on complaint processes is scarce, particularly in the developing countries. To contribute in addressing this gap, we investigated patients’ complaint handling processes and the main influences on their implementation in public hospitals in Vietnam. Methods: The study was conducted in two provinces of Vietnam. We focused specifically on the implementation of the Law on Complaints and Denunciations and the Ministry of Health regulation on resolving complaints in the health sector. The data were collected using document review and in-depth interviews with key respondents. Framework approach was used for data analysis, guided by a conceptual framework and aided by qualitative data analysis software. Results: Five steps of complaint handling were implemented, which varied in practice between the provinces. Four groups of factors influenced the procedures: (1 insufficient investment in complaint handling procedures; (2 limited monitoring of complaint processes; (3 patients’ low awareness of, and perceived lack of power to change, complaint procedures and (4 autonomization pressures on local health facilities. While the existence of complaint handling processes is evident in the health system in Vietnam, their utilization was often limited. Different factors which constrained the implementation and use of complaint regulations included health system–related issues as well as social and cultural influences. Conclusion: The study aimed to contribute to improved understanding of complaint handling processes and the key factors influencing these processes in public hospitals in Vietnam. Specific policy implications for

  13. Examining fiscal federalism, regionalization and community-based initiatives in Canada's health care delivery system.

    Science.gov (United States)

    Forest, Pierre-Gerlier; Palley, Howard A

    2008-01-01

    This study focuses on the ability of Canadian provinces to shape in different ways the development of various provincial health delivery systems within the constraints of the mandates of the federal Canada Health Act of 1984 and the fiscal revenues that the provinces receive if they comply with these mandates. In so doing, it will examine the operation of Canadian federalism with respect to various provincial health systems. This study applies a comparative analysis framework developed by Heisler and Peters to facilitate an understanding of the dimensionality of provincial health delivery systems as applied to the case of provincial regionalization and community-based initiatives. The three sets of relationships touched upon are: first, the levels of government and the nature of their involvement in public policy concerning the provincial health care delivery systems; and secondly, understanding of the factors influencing provincial governments' political dispositions to act in various directions. A third dimension that is taken are the factors influencing the "timing" of particular decisions. A fourth area noted by Heisler and Peters and other comparative analysts is the nature and characteristics of public and private sector activities in health care and other social policy areas. While the evolving nature of public and private sector health care delivery activities within Canada's provincial and territorial systems is a significant policy matter in the Canadian context, due to the space limitations of this article, they are not discussed herein.

  14. Conservation of resources theory and research use in health systems.

    Science.gov (United States)

    Alvaro, Celeste; Lyons, Renée F; Warner, Grace; Hobfoll, Stevan E; Martens, Patricia J; Labonté, Ronald; Brown, Richard E

    2010-10-20

    Health systems face challenges in using research evidence to improve policy and practice. These challenges are particularly evident in small and poorly resourced health systems, which are often in locations (in Canada and globally) with poorer health status. Although organizational resources have been acknowledged as important in understanding research use resource theories have not been a focus of knowledge translation (KT) research. What resources, broadly defined, are required for KT and how does their presence or absence influence research use?In this paper, we consider conservation of resources (COR) theory as a theoretical basis for understanding the capacity to use research evidence in health systems. Three components of COR theory are examined in the context of KT. First, resources are required for research uptake. Second, threat of resource loss fosters resistance to research use. Third, resources can be optimized, even in resource-challenged environments, to build capacity for KT. A scan of the KT literature examined organizational resources needed for research use. A multiple case study approach examined the three components of COR theory outlined above. The multiple case study consisted of a document review and key informant interviews with research team members, including government decision-makers and health practitioners through a retrospective analysis of four previously conducted applied health research studies in a resource-challenged region. The literature scan identified organizational resources that influence research use. The multiple case study supported these findings, contributed to the development of a taxonomy of organizational resources, and revealed how fears concerning resource loss can affect research use. Some resources were found to compensate for other resource deficits. Resource needs differed at various stages in the research use process. COR theory contributes to understanding the role of resources in research use, resistance to

  15. Towards mHealth Systems for Support of Psychotherapeutic Practice: A Qualitative Study of Researcher-Clinician Collaboration in System Design and Evaluation

    Directory of Open Access Journals (Sweden)

    Karin Halje

    2016-01-01

    Full Text Available We examined clinicians’ and researchers’ experiences from participation in collaborative research on the introduction of Internet and mobile information systems (mHealth systems in psychotherapeutic routines. The study used grounded theory methodology and was set in a collaboration that aimed to develop and evaluate mHealth support of psychotherapy provided to young people. Soundness of the central objects developed in the design phase (the collaboration contract, the trial protocol, and the system technology was a necessary foundation for successful collaborative mHealth research; neglect of unanticipated organizational influences during the trial phase was a factor in collaboration failure. The experiences gained in this study can be used in settings where collaborative research on mHealth systems in mental health is planned.

  16. The Mass Media Influence on the Impact of Health Policy

    Directory of Open Access Journals (Sweden)

    Cătălin BABA

    2007-02-01

    Full Text Available The theme of this study is a distinct examination of the issues regarding health policy, social representations and mass media. The analysis of the mass media influence on the impact of health policy leads to a portrayal of the related programs and the way they are received by citizens through mass media. Owing to the mass media quality to be an indicator of democracy it is very important to study its role in setting people daily agenda considering how it is able to maintain and create trends merely through recurrent messages. The issues frequently conveyed by media industry influences citizens’ interest with regard to community, producing effects on public policy. We must bear in mind that the more persistent in media they are, the more relevant for community this issues will be. The authors of the study put forward a method through which diverse programmes can be analysed. A comparative analysis of mass media and citizens’ social representations and its findings provide information about the influence between them. According to agenda setting theory and many international studies on health policy the authors conclude that mass media institution highly influence the impact of the health policy in health. Moreover, it is important to mention that the impact refers to all the stages of a policy-making: beginning with the problem identification and ending with the evaluation of the implementation process.

  17. Examining the use of health systems and policy research in the health policymaking process in Israel: views of researchers.

    Science.gov (United States)

    Ellen, Moriah E; Lavis, John N; Shemer, Joshua

    2016-09-01

    All too often, health policy and management decisions are made without making use of or consulting with the best available research evidence, which can lead to ineffective and inefficient health systems. One of the main actors that can ensure the use of evidence to inform policymaking is researchers. The objective of this study is to explore Israeli health systems and policy researchers' views and perceptions regarding the role of health systems and policy research (HSPR) in health policymaking and the barriers and facilitators to the use of evidence in the policymaking process. A survey of researchers who have conducted HSPR in Israel was developed. The survey consisted of a demographics section and closed questions, which focused on support both within the researchers' organisations and the broader environment for KTE activities, perceptions on the policymaking process, and the potential influencing factors on the process. The survey was sent to all health systems and policy researchers in Israel from academic institutions, hospital settings, government agencies, the four health insurance funds, and research institutes (n = 107). All responses were analyzed using descriptive statistics. For close-ended questions about level of agreement we combined together the two highest categories (agree or strongly agree) for analysis. Thirty-seven respondents participated in the survey. While many respondents felt that the use of HSPR may help raise awareness on policy issues, the majority of respondents felt that the actual use of HSPR was hindered for many reasons. While facilitators do exist to support the use of research evidence in policymaking, numerous barriers hinder the process such as challenges in government/provider relations, policymakers lacking the expertise for acquiring, assessing, and applying HSPR and priorities in the health system drawing attention away from HSPR. Furthermore, it is perceived by a majority of respondents that the health insurance funds

  18. What incentives influence employers to engage in workplace health interventions?

    Science.gov (United States)

    Martinsson, Camilla; Lohela-Karlsson, Malin; Kwak, Lydia; Bergström, Gunnar; Hellman, Therese

    2016-08-23

    To achieve a sustainable working life it is important to know more about what could encourage employers to increase the use of preventive and health promotive interventions. The objective of the study is to explore and describe the employer perspective regarding what incentives influence their use of preventive and health promotive workplace interventions. Semi-structured focus group interviews were carried out with 20 representatives from 19 employers across Sweden. The economic sectors represented were municipalities, government agencies, defence, educational, research, and development institutions, health care, manufacturing, agriculture and commercial services. The interviews were transcribed verbatim and the data were analysed using latent content analysis. Various incentives were identified in the analysis, namely: "law and provisions", "consequences for the workplace", "knowledge of worker health and workplace health interventions", "characteristics of the intervention", "communication and collaboration with the provider". The incentives seemed to influence the decision-making in parallel with each other and were not only related to positive incentives for engaging in workplace health interventions, but also to disincentives. This study suggests that the decision to engage in workplace health interventions was influenced by several incentives. There are those incentives that lead to a desire to engage in a workplace health intervention, others pertain to aspects more related to the intervention use, such as the characteristics of the employer, the provider and the intervention. It is important to take all incentives into consideration when trying to understand the decision-making process for workplace health interventions and to bridge the gap between what is produced through research and what is used in practice.

  19. Factors Influencing Acceptance of Electronic Health Records in Hospitals

    OpenAIRE

    Wilkins, Melinda A

    2009-01-01

    The study's aim was to examine factors that may influence health information managers in the adoption of electronic health records. The Technology Acceptance Model (TAM) served as theoretical foundation for this quantitative study. Hospital health information managers in Arkansas were queried as to the constructs of perceived usefulness, perceived ease of use, and behavior intention. The study population comprised 94 health information managers with a return rate of 74.5 percent. One manager ...

  20. Understanding multinational companies in public health systems, using a competitive advantage framework

    Directory of Open Access Journals (Sweden)

    Lethbridge Jane

    2011-07-01

    Full Text Available Abstract Background This paper discusses the findings of a study which developed five case studies of five multinational health care companies involved in public health care systems. Strategies were analysed in terms of attitude to marketing, pricing and regulation. The company strategies have been subjected to an analysis using Porter's Five Forces, a business strategy framework, which is unusual in health policy studies. Methods This paper shows how analysing company strategy using a business tool can contribute to understanding the strategies of global capital in national health systems. It shows how social science methodologies can draw from business methods to explain company strategies. Results The five companies considered in this paper demonstrate that their strategies have many dimensions, which fit into Porter's Five Forces of comparative advantage. More importantly the Five Forces can be used to identify factors that influence company entry into public health care systems. Conclusions The process of examining the strategic objectives of five health care companies shows that a business tool can help to explain the actions and motives of health care companies towards public health care systems, and so contribute to a better understanding of the strategies of global capital in national health systems. Health service commissioners need to understand this dynamic process, which will evolve as the nature of public health care systems change.

  1. Understanding multinational companies in public health systems, using a competitive advantage framework

    Science.gov (United States)

    2011-01-01

    Background This paper discusses the findings of a study which developed five case studies of five multinational health care companies involved in public health care systems. Strategies were analysed in terms of attitude to marketing, pricing and regulation. The company strategies have been subjected to an analysis using Porter's Five Forces, a business strategy framework, which is unusual in health policy studies. Methods This paper shows how analysing company strategy using a business tool can contribute to understanding the strategies of global capital in national health systems. It shows how social science methodologies can draw from business methods to explain company strategies. Results The five companies considered in this paper demonstrate that their strategies have many dimensions, which fit into Porter's Five Forces of comparative advantage. More importantly the Five Forces can be used to identify factors that influence company entry into public health care systems. Conclusions The process of examining the strategic objectives of five health care companies shows that a business tool can help to explain the actions and motives of health care companies towards public health care systems, and so contribute to a better understanding of the strategies of global capital in national health systems. Health service commissioners need to understand this dynamic process, which will evolve as the nature of public health care systems change. PMID:21722372

  2. System Identification of Wind Turbines for Structural Health Monitoring

    DEFF Research Database (Denmark)

    Perisic, Nevena

    Structural health monitoring is a multi-disciplinary engineering field that should allow the actual wind turbine maintenance programmes to evolve to the next level, hence increasing safety and reliability and decreasing turbines downtime. The main idea is to have a sensing system on the structure...... cases are considered, two practical problems from the wind industry are studied, i.e. monitoring of the gearbox shaft torque and the tower root bending moments. The second part of the thesis is focused on the influence of friction on the health of the wind turbine and on the nonlinear identification...... that monitors the system responses and notifies the operator when damages or degradations have been detected. However, some of the response signals that contain important information about the health of the wind turbine components cannot be directly measured, or measuring them is highly complex and costly...

  3. [Extraterrestrial influences on health and disease].

    Science.gov (United States)

    Sitar, J

    1994-02-14

    As to extraterrestrial influences on man in health and disease so far only the effect of the sun and moon are known. This concerns the effect of solar radiation of different wavelengths and the effect of corpuscular solar radiation which has an impact on the condition of the terrestrial magnetic field and electric conditions in the atmosphere. Moreover there is also a question of important influences of gravitation (tides). Here the influence of the position of the moon in relation to the connecting line between sun and earth is involved. In the course of the synodic month (from new moon to the next new moon) a semilunar periodicity of different medical and geomagnetic indicators as well as meteorological ones plays a part. Based on his own research and that of others the author reaches the conclusion that extraterrestrial and terrestrial influences are interrelated and exert a mutual influence on each other and that it is not sensible to separate them strictly. Investigation of all the mentioned influences is important not only for biomedical prognosis but also for basic geophysical and meteorological research. Perspectively it would be useful to plan model experiments. The author feels it is his duty to refuse publication of different horoscopes in the mass media, whatever the intention. In the lay public this may lead to popularization of astrology which has nothing in common with serious research.

  4. France: Health System Review.

    Science.gov (United States)

    Chevreul, Karine; Berg Brigham, Karen; Durand-Zaleski, Isabelle; Hernandez-Quevedo, Cristina

    2015-01-01

    This analysis of the French health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The French population has a good level of health, with the second highest life expectancy in the world for women. It has a high level of choice of providers, and a high level of satisfaction with the health system. However, unhealthy habits such as smoking and harmful alcohol consumption remain significant causes of avoidable mortality. Combined with the significant burden of chronic diseases, this has underscored the need for prevention and integration of services, although these have not historically been strengths of the French system. Although the French health care system is a social insurance system, it has historically had a stronger role for the state than other Bismarckian social insurance systems. Public financing of health care expenditure is among the highest in Europe and out-of-pocket spending among the lowest. Public insurance is compulsory and covers the resident population; it is financed by employee and employer contributions as well as increasingly through taxation. Complementary insurance plays a significant role in ensuring equity in access. Provision is mixed; providers of outpatient care are largely private, and hospital beds are predominantly public or private non-profit-making. Despite health outcomes being among the best in the European Union, social and geographical health inequities remain. Inequality in the distribution of health care professionals is a considerable barrier to equity. The rising cost of health care and the increasing demand for long-term care are also of concern. Reforms are ongoing to address these issues, while striving for equity in financial access; a long-term care reform including public coverage of long-term care is still pending. World Health Organization 2015 (acting as the host organization for, and secretariat of, the

  5. Health economics and health policy: experiences from New Zealand.

    Science.gov (United States)

    Cumming, Jacqueline

    2015-06-01

    Health economics has had a significant impact on the New Zealand health system over the past 30 years. In this paper, I set out a framework for thinking about health economics, give some historical background to New Zealand and the New Zealand health system, and discuss examples of how health economics has influenced thinking about the organisation of the health sector and priority setting. I conclude the paper with overall observations about the role of health economics in health policy in New Zealand, also identifying where health economics has not made the contribution it could and where further influence might be beneficial.

  6. Numbers, systems, people: how interactions influence integration. Insights from case studies of HIV and reproductive health services delivery in Kenya.

    Science.gov (United States)

    Mayhew, Susannah H; Sweeney, Sedona; Warren, Charlotte E; Collumbien, Martine; Ndwiga, Charity; Mutemwa, Richard; Lut, Irina; Colombini, Manuela; Vassall, Anna

    2017-11-01

    Drawing on rich data from the Integra evaluation of integrated HIV and reproductive-health services, we explored the interaction of systems hardware and software factors to explain why some facilities were able to implement and sustain integrated service delivery while others were not. This article draws on detailed mixed-methods data for four case-study facilities offering reproductive-health and HIV services between 2009 and 2013 in Kenya: (i) time-series client flow, tracking service uptake for 8841 clients; (ii) structured questionnaires with 24 providers; (iii) in-depth interviews with 17 providers; (iv) workload and facility data using a periodic activity review and cost-instruments; and (v) contextual data on external activities related to integration in study sites. Overall, our findings suggested that although structural factors like stock-outs, distribution of staffing and workload, rotation of staff can affect how integrated care is provided, all these factors can be influenced by staff themselves: both frontline and management. Facilities where staff displayed agency of decision making, worked as a team to share workload and had management that supported this, showed better integration delivery and staff were able to overcome some structural deficiencies to enable integrated care. Poor-performing facilities had good structural integration, but staff were unable to utilize this because they were poorly organized, unsupported or teams were dysfunctional. Conscientious objection and moralistic attitudes were also barriers.Integra has demonstrated that structural integration is not sufficient for integrated service delivery. Rather, our case studies show that in some cases excellent leadership and peer-teamwork enabled facilities to perform well despite resource shortages. The ability to provide support for staff to work flexibly to deliver integrated services and build resilient health systems to meet changing needs is particularly relevant as health

  7. What is health systems responsiveness? Review of existing knowledge and proposed conceptual framework

    Science.gov (United States)

    Mirzoev, Tolib; Kane, Sumit

    2017-01-01

    Responsiveness is a key objective of national health systems. Responsive health systems anticipate and adapt to existing and future health needs, thus contributing to better health outcomes. Of all the health systems objectives, responsiveness is the least studied, which perhaps reflects lack of comprehensive frameworks that go beyond the normative characteristics of responsive services. This paper contributes to a growing, yet limited, knowledge on this topic. Herewith, we review the current frameworks for understanding health systems responsiveness and drawing on these, as well as key frameworks from the wider public services literature, propose a comprehensive conceptual framework for health systems responsiveness. This paper should be of interest to different stakeholders who are engaged in analysing and improving health systems responsiveness. Our review shows that existing knowledge on health systems responsiveness can be extended along the three areas. First, responsiveness entails an actual experience of people’s interaction with their health system, which confirms or disconfirms their initial expectations of the system. Second, the experience of interaction is shaped by both the people and the health systems sides of this interaction. Third, different influences shape people’s interaction with their health system, ultimately affecting their resultant experiences. Therefore, recognition of both people and health systems sides of interaction and their key determinants would enhance the conceptualisations of responsiveness. Our proposed framework builds on, and advances, the core frameworks in the health systems literature. It positions the experience of interaction between people and health system as the centrepiece and recognises the determinants of responsiveness experience both from the health systems (eg, actors, processes) and the people (eg, initial expectations) sides. While we hope to trigger further thinking on the conceptualisation of health

  8. What is health systems responsiveness? Review of existing knowledge and proposed conceptual framework.

    Science.gov (United States)

    Mirzoev, Tolib; Kane, Sumit

    2017-01-01

    Responsiveness is a key objective of national health systems. Responsive health systems anticipate and adapt to existing and future health needs, thus contributing to better health outcomes. Of all the health systems objectives, responsiveness is the least studied, which perhaps reflects lack of comprehensive frameworks that go beyond the normative characteristics of responsive services. This paper contributes to a growing, yet limited, knowledge on this topic. Herewith, we review the current frameworks for understanding health systems responsiveness and drawing on these, as well as key frameworks from the wider public services literature, propose a comprehensive conceptual framework for health systems responsiveness. This paper should be of interest to different stakeholders who are engaged in analysing and improving health systems responsiveness. Our review shows that existing knowledge on health systems responsiveness can be extended along the three areas. First, responsiveness entails an actual experience of people's interaction with their health system, which confirms or disconfirms their initial expectations of the system. Second, the experience of interaction is shaped by both the people and the health systems sides of this interaction. Third, different influences shape people's interaction with their health system, ultimately affecting their resultant experiences. Therefore, recognition of both people and health systems sides of interaction and their key determinants would enhance the conceptualisations of responsiveness. Our proposed framework builds on, and advances, the core frameworks in the health systems literature. It positions the experience of interaction between people and health system as the centrepiece and recognises the determinants of responsiveness experience both from the health systems (eg, actors, processes) and the people (eg, initial expectations) sides. While we hope to trigger further thinking on the conceptualisation of health system

  9. Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes

    Directory of Open Access Journals (Sweden)

    Janya McCalman

    2018-03-01

    Full Text Available Continuous quality improvement (CQI processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.

  10. Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes

    Science.gov (United States)

    McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla

    2018-01-01

    Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally. PMID:29623271

  11. Factors influencing health care workers’ implementation of tuberculosis contact tracing in Kweneng, Botswana

    Science.gov (United States)

    Tlale, Lebapotswe; Frasso, Rosemary; Kgosiesele, Onalenna; Selemogo, Mpho; Mothei, Quirk; Habte, Dereje; Steenhoff, Andrew

    2016-01-01

    Introduction TB contact tracing rates remain low in high burden settings and reasons for this are not well known. We describe factors that influence health care workers' (HCW) implementation of TB contact tracing (CT) in a high TB burden district of Botswana. Methods Data were collected using questionnaires and in-depth interviews in 31 of the 52 health facilities in Kweneng East Health District. Responses were summarized using summary statistics and comparisons between HCW groups were done using parametric or non-parametric tests as per normality of the data distribution. Results One hundred and four HCWs completed questionnaires. Factors that influenced HCW TB contact tracing were their knowledge, attitudes and practices as well as personal factors including decreased motivation and lack of commitment. Patient factors included living further away from the clinic, unknown residential address and high rates of migration and mobility. Administrative factors included staff shortages, lack of transport, poor reporting of TB cases and poor medical infrastructure e.g. suboptimal laboratory services. A national HCW strike and a restructuring of the health system emerged as additional factors during in-depth interviews of TB coordinators. Conclusion Multiple factors lead to poor TB contact tracing in this district. Interventions to increase TB contact tracing will be informed by these findings. PMID:27800084

  12. Malta: Health system review.

    Science.gov (United States)

    Azzopardi Muscat, Natasha; Calleja, Neville; Calleja, Antoinette; Cylus, Jonathan

    2014-01-01

    This analysis of the Maltese health system reviews the developments in its organization and governance, health financing, health-care provision, health reforms and health system performance. The health system in Malta consists of a public sector, which is free at the point of service and provides a comprehensive basket of health services for all its citizens, and a private sector, which accounts for a third of total health expenditure and provides the majority of primary care. Maltese citizens enjoy one of the highest life expectancies in Europe. Nevertheless, non-communicable diseases pose a major concern with obesity being increasingly prevalent among both adults and children. The health system faces important challenges including a steadily ageing population, which impacts the sustainability of public finances. Other supply constraints stem from financial and infrastructural limitations. Nonetheless, there exists a strong political commitment to ensure the provision of a healthcare system that is accessible, of high quality, safe and also sustainable. This calls for strategic investments to underpin a revision of existing processes whilst shifting the focus of care away from hospital into the community. World Health Organization 2014 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  13. Influence of age on community health worker's knowledge and ...

    African Journals Online (AJOL)

    Influence of age on community health worker's knowledge and service provision for maternal, newborn, and child health in Morogoro region, Tanzania. ... However there was a statistically significant difference (p<0.05) in marital status, education levels, use of English language, number of dependants, and income from ...

  14. Ukraine: health system review.

    Science.gov (United States)

    Lekhan, Valery; Rudiy, Volodymyr; Shevchenko, Maryna; Nitzan Kaluski, Dorit; Richardson, Erica

    2015-03-01

    This analysis of the Ukrainian health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. Since the country gained independence from the Soviet Union in 1991, successive governments have sought to overcome funding shortfalls and modernize the health care system to meet the needs of the population's health. However, no fundamental reform of the system has yet been implemented and consequently it has preserved the main features characteristic of the Semashko model; there is a particularly high proportion of total health expenditure paid out of pocket (42.3 % in 2012), and incentives within the system do not focus on quality or outcomes. The most recent health reform programme began in 2010 and sought to strengthen primary and emergency care, rationalize hospitals and change the model of health care financing from one based on inputs to one based on outputs. Fundamental issues that hampered reform efforts in the past re-emerged, but conflict and political instability have proved the greatest barriers to reform implementation and the programme was abandoned in 2014. More recently, the focus has been on more pressing humanitarian concerns arising from the conflict in the east of Ukraine. It is hoped that greater political, social and economic stability in the future will provide a better environment for the introduction of deep reforms to address shortcomings in the Ukrainian health system. World Health Organization 2015 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  15. Austria: health system review.

    Science.gov (United States)

    Hofmarcher, Maria M; Quentin, Wilm

    2013-01-01

    This analysis of the Austrian health system reviews recent developments in organization and governance, health financing, health-care provision, health reforms and health-system performance. The Austrian health system provides universal coverage for a wide range of benefits and high-quality care. Free choice of providers and unrestricted access to all care levels (general practitioners, specialist physicians and hospitals) are characteristic features of the system. Unsurprisingly, population satisfaction is well above EU average. Income-related inequality in health has increased since 2005, although it is still relatively low compared to other countries. The health-care system has been shaped by both the federal structure of the state and a tradition of delegating responsibilities to self-governing stakeholders. On the one hand, this enables decentralized planning and governance, adjusted to local norms and preferences. On the other hand, it also leads to fragmentation of responsibilities and frequently results in inadequate coordination. For this reason, efforts have been made for several years to achieve more joint planning, governance and financing of the health-care system at the federal and regional level. As in any health system, a number of challenges remain. The costs of the health-care system are well above the EU15 average, both in absolute terms and as a percentage of GDP. There are important structural imbalances in healthcare provision, with an oversized hospital sector and insufficient resources available for ambulatory care and preventive medicine. This is coupled with stark regional differences in utilization, both in curative services (hospital beds and specialist physicians) and preventative services such as preventive health check-ups, outpatient rehabilitation, psychosocial and psychotherapeutic care and nursing. There are clear social inequalities in the use of medical services, such as preventive health check-ups, immunization or dentistry

  16. What incentives influence employers to engage in workplace health interventions?

    Directory of Open Access Journals (Sweden)

    Camilla Martinsson

    2016-08-01

    Full Text Available Abstract Background To achieve a sustainable working life it is important to know more about what could encourage employers to increase the use of preventive and health promotive interventions. The objective of the study is to explore and describe the employer perspective regarding what incentives influence their use of preventive and health promotive workplace interventions. Method Semi-structured focus group interviews were carried out with 20 representatives from 19 employers across Sweden. The economic sectors represented were municipalities, government agencies, defence, educational, research, and development institutions, health care, manufacturing, agriculture and commercial services. The interviews were transcribed verbatim and the data were analysed using latent content analysis. Results Various incentives were identified in the analysis, namely: “law and provisions”, “consequences for the workplace”, “knowledge of worker health and workplace health interventions”, “characteristics of the intervention”, “communication and collaboration with the provider”. The incentives seemed to influence the decision-making in parallel with each other and were not only related to positive incentives for engaging in workplace health interventions, but also to disincentives. Conclusions This study suggests that the decision to engage in workplace health interventions was influenced by several incentives. There are those incentives that lead to a desire to engage in a workplace health intervention, others pertain to aspects more related to the intervention use, such as the characteristics of the employer, the provider and the intervention. It is important to take all incentives into consideration when trying to understand the decision-making process for workplace health interventions and to bridge the gap between what is produced through research and what is used in practice.

  17. Analyzing the Historical Development and Transition of the Korean Health Care System.

    Science.gov (United States)

    Lee, Sang-Yi; Kim, Chul-Woung; Seo, Nam-Kyu; Lee, Seung Eun

    2017-08-01

    Many economically advanced countries have attempted to minimize public expenditures and pursue privatization based on the principles of neo-liberalism. However, Korea has moved contrary to this global trend. This study examines why and how the Korean health care system was formed, developed, and transformed into an integrated, single-insurer, National Health Insurance (NHI) system. We describe the transition in the Korean health care system using an analytical framework that incorporates such critical variables as government economic development strategies and the relationships among social forces, state autonomy, and state power. This study focuses on how the relationships among social forces can change as a nation's economic development or governing strategy changes in response to changes in international circumstances such as globalization. The corporatist Social Health Insurance (SHI) system (multiple insurers) introduced in 1977 was transformed into the single-insurer NHI in July 2000. These changes were influenced externally by globalization and internally by political democratization, keeping Korea's private-dominant health care provision system unchanged over several decades. Major changes such as integration reform occurred, when high levels of state autonomy were ensured. The state's power (its policy capability), based on health care infrastructures, acts to limit the direction of any change in the health care system because it is very difficult to build the infrastructure for a health care system in a short timeframe.

  18. Influence of family environment on children's oral health: a systematic review

    Directory of Open Access Journals (Sweden)

    Aline Rogéria Freire de Castilho

    2013-03-01

    Conclusion: Parents’ dental health habits influence their children's oral health. Oral health education programs aimed at preventive actions are needed to provide children not only with adequate oral health, but better quality of life. Special attention should be given to the entire family, concerning their lifestyle and oral health habits.

  19. The effectiveness of the health system in Serbia in 2014 and 2015 and mental health care indicators

    Directory of Open Access Journals (Sweden)

    Simonović Periša

    2016-01-01

    Full Text Available The World Health Organization emphasized the importance of mental health by including it in their definition of health as 'a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.' Mental health has direct influence to the quality of life of citizens as well as to productivity of economy. Therefore, both government and enterprises are interested for further improvement in this field. The European Health Consumer Index (EHCI was founded as a project in 2006, and it has been working ever since on comparison and ranking of the health systems of the European countries. Its main aim is the setting of standards for well-functioning and organization of health care from the perspective of patients (consumers - users of the health system. Assessment of the health system is based on pre-determined forty eight indicators, divided into six groups. The aim of this study was to assess the state of Serbian mental health care in 2014 and 2015 from the perspective of European health consumer index and propose recommendations for its improvement and functioning in accordance with the norms of European standards. The Republic of Serbia, according to the European Health Consumer Index, was ranked 33rd. in 2014 among European countries, with 473 points, while in 2015 was ranked 30 with 554 points. Mental health care indicators shows improvement in 2015 comparing with 2014. year.

  20. Occupational Influence on Women's Attitude Towards Oral Health in ...

    African Journals Online (AJOL)

    This paper investigated the influence of occupation on women's attitude towards oral health among women attending Primary Health Care (PHC) Centres in the Nkanu West Local Government Area of Enugu State of Nigeria. Three hundred and forty seven (347) women were selected from 2,608 women who formed the ...

  1. Why Social Relationships Are Important for Physical Health: A Systems Approach to Understanding and Modifying Risk and Protection.

    Science.gov (United States)

    Holt-Lunstad, Julianne

    2018-01-04

    Social relationships are adaptive and crucial for survival. This review presents existing evidence indicating that our social connections to others have powerful influences on health and longevity and that lacking social connection qualifies as a risk factor for premature mortality. A systems perspective is presented as a framework by which to move social connection into the realm of public health. Individuals, and health-relevant biological processes, exist within larger social contexts including the family, neighborhood and community, and society and culture. Applying the social ecological model, this review highlights the interrelationships of individuals within groups in terms of understanding both the causal mechanisms by which social connection influences physical health and the ways in which this influence can inform potential intervention strategies. A systems approach also helps identify gaps in our current understanding that may guide future research.

  2. Activating lay health influencers to promote tobacco cessation.

    Science.gov (United States)

    Muramoto, Myra L; Hall, John R; Nichter, Mark; Nichter, Mimi; Aickin, Mikel; Connolly, Tim; Matthews, Eva; Campbell, Jean Z; Lando, Harry A

    2014-05-01

    To evaluate the effect of tobacco cessation brief-intervention (BI) training for lay "health influencers," on knowledge, self-efficacy and the proportion of participants reporting BI delivery post-training. Randomized, community-based study comparing In-person or Web-based training, with mailed materials. In-person and Web-training groups had significant post-training cessation knowledge and self-efficacy gains. All groups increased the proportion of individuals reporting BIs at follow-up, with no significant between-group differences. Irrespective of participants' prior intervention experience, 80%-86% reported BIs within the past 90 days; 71%-79% reported >1 in the past 30. Web and In-person training significantly increase health influencer cessation knowledge and self-efficacy. With minimal prompting and materials, even persons without BI experience can be activated to encourage tobacco cessation.

  3. Examining the influence of family physician supply on district health system performance in South Africa: An ecological analysis of key health indicators.

    Science.gov (United States)

    Von Pressentin, Klaus B; Mash, Bob J; Esterhuizen, Tonya M

    2017-04-28

    The supply of appropriate health workers is a key building block in the World Health Organization's model of effective health systems. Primary care teams are stronger if they contain doctors with postgraduate training in family medicine. The contribution of such family physicians to the performance of primary care systems has not been evaluated in the African context. Family physicians with postgraduate training entered the South African district health system (DHS) from 2011. This study aimed to evaluate the impact of family physicians within the DHS of South Africa. The objectives were to evaluate the impact of an increase in family physician supply in each district (number per 10 000 population) on key health indicators. All 52 South African health districts were included as units of analysis. An ecological study evaluated the correlations between the supply of family physicians and routinely collected data on district performance for two time periods: 2010/2011 and 2014/2015. Five years after the introduction of the new generation of family physicians, this study showed no demonstrable correlation between family physician supply and improved health indicators from the macro-perspective of the district. The lack of a measurable impact at the level of the district is most likely because of the very low supply of family physicians in the public sector. Studies which evaluate impact closer to the family physician's circle of control may be better positioned to demonstrate a measurable impact in the short term.

  4. [Financing, organization, costs and services performance of the Argentinean health sub-systems.

    Science.gov (United States)

    Yavich, Natalia; Báscolo, Ernesto Pablo; Haggerty, Jeannie

    2016-01-01

    To analyze the relationship between health system financing and services organization models with costs and health services performance in each of Rosario's health sub-systems. The financing and organization models were characterized using secondary data. Costs were calculated using the WHO/SHA methodology. Healthcare quality was measured by a household survey (n=822). Public subsystem:Vertically integrated funding and primary healthcare as a leading strategy to provide services produced low costs and individual-oriented healthcare but with weak accessibility conditions and comprehensiveness. Private subsystem: Contractual integration and weak regulatory and coordination mechanisms produced effects opposed to those of the public sub-system. Social security: Contractual integration and strong regulatory and coordination mechanisms contributed to intermediate costs and overall high performance. Each subsystem financing and services organization model had a strong and heterogeneous influence on costs and health services performance.

  5. Tracing health system challenges in post-conflict Côte d'Ivoire from 1893 to 2013.

    Science.gov (United States)

    Gaber, Sabrina; Patel, Preeti

    2013-07-01

    While scholarship on health in conflict-affected countries is growing, there has been relatively little analysis of how armed conflict affects health systems in specific African countries, especially former French colonies. There is even less literature on the role of history in shaping health systems and how historical factors such as inequity may influence health impacts of armed conflict. Based on Côte d'Ivoire, this article argues that historical multidisciplinary analysis can provide valuable insight into the macro-level political, economic and social determinants of the health system over time. It explores how armed conflict has affected health services and exacerbates historically inherited challenges to the health system including unequal distribution of health services, bias towards curative care in urban areas, inadequate human resources and weak health governance. In the post-conflict period, this understanding may assist governments and other stakeholders to develop more appropriate health policies that address both urgent and long-term health needs.

  6. Greece: Health system review.

    Science.gov (United States)

    Economou, Charalambos

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The health status of the Greek population has strongly improved over the last few decades and seems to compare relatively favourably with other OECD and European Union (EU) countries. The health system is a mixture of public integrated, public contract and public reimbursement models, comprising elements from both the public and private sectors and incorporating principles of different organizational patterns. Access to services is based on citizenship as well as on occupational status.The system is financed by the state budget, social insurance contributions and private payments.The largest share of health expenditure constitutes private expenditure, mainly in the form of out of pocket payments which is also the element contributing most to the overall increase in health expenditure. The delivery of health care services is based on both public and private providers. The presence of private providers is more obvious in primary care,especially in diagnostic technologies, private physicians' practices and pharmaceuticals. Despite success in improving the health of the population, the Greek health care system faces serious structural problems concerning the organization, financing and delivery of services. It suffers from the absence of cost-containment measures and defined criteria for funding, resulting in sickness funds experiencing economic constraints and budget deficits. The high percentage of private expenditure goes against the principle of fair

  7. Poland health system review.

    Science.gov (United States)

    Sagan, Anna; Panteli, Dimitra; Borkowski, W; Dmowski, M; Domanski, F; Czyzewski, M; Gorynski, Pawel; Karpacka, Dorota; Kiersztyn, E; Kowalska, Iwona; Ksiezak, Malgorzata; Kuszewski, K; Lesniewska, A; Lipska, I; Maciag, R; Madowicz, Jaroslaw; Madra, Anna; Marek, M; Mokrzycka, A; Poznanski, Darius; Sobczak, Alicja; Sowada, Christoph; Swiderek, Maria; Terka, A; Trzeciak, Patrycja; Wiktorzak, Katarzyna; Wlodarczyk, Cezary; Wojtyniak, B; Wrzesniewska-Wal, Iwona; Zelwianska, Dobrawa; Busse, Reinhard

    2011-01-01

    Since the successful transition to a freely elected parliament and a market economy after 1989, Poland is now a stable democracy and is well represented within political and economic organizations in Europe and worldwide. The strongly centralized health system based on the Semashko model was replaced with a decentralized system of mandatory health insurance, complemented with financing from state and territorial self-government budgets. There is a clear separation of health care financing and provision: the National Health Fund (NFZ) the sole payer in the system is in charge of health care financing and contracts with public and non-public health care providers. The Ministry of Health is the key policy-maker and regulator in the system and is supported by a number of advisory bodies, some of them recently established. Health insurance contributions, borne entirely by employees, are collected by intermediary institutions and are pooled by the NFZ and distributed between the 16 regional NFZ branches. In 2009, Poland spent 7.4% of its gross domestic product (GDP) on health. Around 70% of health expenditure came from public sources and over 83.5% of this expenditure can be attributed to the (near) universal health insurance. The relatively high share of private expenditure is mostly represented by out-of-pocket (OOP) payments, mainly in the form of co-payments and informal payments. Voluntary health insurance (VHI) does not play an important role and is largely limited to medical subscription packages offered by employers. Compulsory health insurance covers 98% of the population and guarantees access to a broad range of health services. However, the limited financial resources of the NFZ mean that broad entitlements guaranteed on paper are not always available. Health care financing is overall at most proportional: while financing from health care contributions is proportional and budgetary subsidies to system funding are progressive, high OOP expenditures

  8. Bulgaria health system review.

    Science.gov (United States)

    Dimova, Antoniya; Rohova, Maria; Moutafova, Emanuela; Atanasova, Elka; Koeva, Stefka; Panteli, Dimitra; van Ginneken, Ewout

    2012-01-01

    In the last 20 years, demographic development in Bulgaria has been characterized by population decline, a low crude birth rate, a low fertility rate, a high mortality rate and an ageing population. A stabilizing political situation since the early 2000s and an economic upsurge since the mid-2000s were important factors in the slight increase of the birth and fertility rates and the slight decrease in standardized death rates. In general, Bulgaria lags behind European Union (EU) averages in most mortality and morbidity indicators. Life expectancy at birth reached 73.3 years in 2008 with the main three causes of death being diseases of the circulatory system, malignant neoplasms and diseases of the respiratory system. One of the most important risk factors overall is smoking, and the average standardized death rate for smoking-related causes in 2008 was twice as high as the EU15 average. The Bulgarian health system is characterized by limited statism. The Ministry of Health is responsible for national health policy and the overall organization and functioning of the health system and coordinates with all ministries with relevance to public health. The key players in the insurance system are the insured individuals, the health care providers and the third party payers, comprising the National Health Insurance Fund, the single payer in the social health insurance (SHI) system, and voluntary health insurance companies (VHICs). Health financing consists of a publicprivate mix. Health care is financed from compulsory health insurance contributions, taxes, outofpocket (OOP) payments, voluntary health insurance (VHI) premiums, corporate payments, donations, and external funding. Total health expenditure (THE) as a share of gross domestic product (GDP) increased from 5.3% in 1995 to 7.3% in 2008. At the latter date it consisted of 36.5% OOP payments, 34.8% SHI, 13.6% Ministry of Health expenditure, 9.4% municipality expenditure and 0.3% VHI. Informal payments in the health

  9. The Influence of Brittle Daniels System Characteristics on the Value of Load Monitoring Information

    DEFF Research Database (Denmark)

    Thöns, Sebastian; Schneider, Ronald

    This paper addresses the influence of deteriorating brittle Daniels system characteristics on the value of structural health monitoring (SHM). The value of SHM is quantified as the difference between the life cycle benefits with and without SHM. A value of SHM analysis is performed within...

  10. Profile: Agincourt Health and Socio-demographic Surveillance System

    Science.gov (United States)

    Kahn, Kathleen; Collinson, Mark A; Gómez-Olivé, F Xavier; Mokoena, Obed; Twine, Rhian; Mee, Paul; Afolabi, Sulaimon A; Clark, Benjamin D; Kabudula, Chodziwadziwa W; Khosa, Audrey; Khoza, Simon; Shabangu, Mildred G; Silaule, Bernard; Tibane, Jeffrey B; Wagner, Ryan G; Garenne, Michel L; Clark, Samuel J; Tollman, Stephen M

    2012-01-01

    The Agincourt health and socio-demographic surveillance system (HDSS), located in rural northeast South Africa close to the Mozambique border, was established in 1992 to support district health systems development led by the post-apartheid ministry of health. The HDSS (90 000 people), based on an annual update of resident status and vital events, now supports multiple investigations into the causes and consequences of complex health, population and social transitions. Observational work includes cohorts focusing on different stages along the life course, evaluation of national policy at population, household and individual levels and examination of household responses to shocks and stresses and the resulting pathways influencing health and well-being. Trials target children and adolescents, including promoting psycho-social well-being, preventing HIV transmission and reducing metabolic disease risk. Efforts to enhance the research platform include using automated measurement techniques to estimate cause of death by verbal autopsy, full ‘reconciliation’ of in- and out-migrations, follow-up of migrants departing the study area, recording of extra-household social connections and linkage of individual HDSS records with those from sub-district clinics. Fostering effective collaborations (including INDEPTH multi-centre work in adult health and ageing and migration and urbanization), ensuring cross-site compatibility of common variables and optimizing public access to HDSS data are priorities. PMID:22933647

  11. Perspectives on utilization of community based health information systems in Western Kenya.

    Science.gov (United States)

    Flora, Otieno Careena; Margaret, Kaseje; Dan, Kaseje

    2017-01-01

    Health information systems (HIS) are considered fundamental for the efficient delivery of high quality health care. However, a large number of legal and practical constraints influence the design and introduction of such systems. The inability to quantify and analyse situations with credible data and to use data in planning and managing service delivery plagues Africa. Establishing effective information systems and using this data for planning efficient health service delivery is essential to district health systems' performance improvement. Community Health Units in Kenya are central points for community data collection, analysis, dissemination and use. In Kenya, data tend to be collected for reporting purposes and not for decision-making at the point of collection. This paper describes the perspectives of local users on information use in various socio-economic contexts in Kenya. Information for this study was gathered through semi-structured interviews. The interviewees were purposefully selected from various community health units and public health facilities in the study area. The data were organized and analysed manually, grouping them into themes and categories. Information needs of the community included service utilization and health status information. Dialogue was the main way of information utilization in the community. However, health systems and personal challenges impeded proper collection and use of information. The challenges experienced in health information utilization may be overcome by linkages and coordination between the community and the health facilities. The personal challenges can be remedied using a motivational package that includes training of the Community Health Workers.

  12. Circumpolar Inuit health systems.

    Science.gov (United States)

    Ellsworth, Leanna; O'Keeffe, Annmaree

    2013-01-01

    The Inuit are an indigenous people totalling about 160,000 and living in 4 countries across the Arctic - Canada, Greenland, USA (Alaska) and Russia (Chukotka). In essence, they are one people living in 4 countries. Although there have been significant improvements in Inuit health and survival over the past 50 years, stark differences persist between the key health indicators for Inuit and those of the national populations in the United States, Canada and Russia and between Greenland and Denmark. On average, life expectancy in all 4 countries is lower for Inuit. Infant mortality rates are also markedly different with up to 3 times more infant deaths than the broader national average. Underlying these statistical differences are a range of health, social, economic and environmental factors which have affected Inuit health outcomes. Although the health challenges confronting the Inuit are in many cases similar across the Arctic, the responses to these challenges vary in accordance with the types of health systems in place in each of the 4 countries. Each of the 4 countries has a different health care system with varying degrees of accessibility and affordability for Inuit living in urban, rural and remote areas. To describe funding and governance arrangements for health services to Inuit in Canada, Greenland, USA (Alaska) and Russia (Chukotka) and to determine if a particular national system leads to better outcomes than any of the other 3 systems. Literature review. It was not possible to draw linkages between the different characteristics of the respective health systems, the corresponding financial investment and the systems' effectiveness in adequately serving Inuit health needs for several reasons including the very limited and inadequate collection of Inuit-specific health data by Canada, Alaska and Russia; and second, the data that are available do not necessarily provide a feasible point of comparison in terms of methodology and timing of the available data

  13. Conservation of resources theory and research use in health systems

    Directory of Open Access Journals (Sweden)

    Hobfoll Stevan E

    2010-10-01

    Full Text Available Abstract Background Health systems face challenges in using research evidence to improve policy and practice. These challenges are particularly evident in small and poorly resourced health systems, which are often in locations (in Canada and globally with poorer health status. Although organizational resources have been acknowledged as important in understanding research use resource theories have not been a focus of knowledge translation (KT research. What resources, broadly defined, are required for KT and how does their presence or absence influence research use? In this paper, we consider conservation of resources (COR theory as a theoretical basis for understanding the capacity to use research evidence in health systems. Three components of COR theory are examined in the context of KT. First, resources are required for research uptake. Second, threat of resource loss fosters resistance to research use. Third, resources can be optimized, even in resource-challenged environments, to build capacity for KT. Methods A scan of the KT literature examined organizational resources needed for research use. A multiple case study approach examined the three components of COR theory outlined above. The multiple case study consisted of a document review and key informant interviews with research team members, including government decision-makers and health practitioners through a retrospective analysis of four previously conducted applied health research studies in a resource-challenged region. Results The literature scan identified organizational resources that influence research use. The multiple case study supported these findings, contributed to the development of a taxonomy of organizational resources, and revealed how fears concerning resource loss can affect research use. Some resources were found to compensate for other resource deficits. Resource needs differed at various stages in the research use process. Conclusions COR theory contributes to

  14. Health System Measurement Project

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Health System Measurement Project tracks government data on critical U.S. health system indicators. The website presents national trend data as well as detailed...

  15. Factors influencing deliveries at health facilities in a rural Maasai Community in Magadi sub-County, Kenya.

    Science.gov (United States)

    Karanja, Sarah; Gichuki, Richard; Igunza, Patrick; Muhula, Samuel; Ofware, Peter; Lesiamon, Josephine; Leshore, Lepantas; Kyomuhangi-Igbodipe, Lenny Bazira; Nyagero, Josephat; Binkin, Nancy; Ojakaa, David

    2018-01-03

    In response to poor maternal, newborn, and child health indicators in Magadi sub-county, the "Boma" model was launched to promote health facility delivery by establishing community health units and training community health volunteers (CHVs) and traditional birth attendants (TBAs) as safe motherhood promoters. As a result, health facility delivery increased from 14% to 24%, still considerably below the national average (61%). We therefore conducted this study to determine factors influencing health facility delivery and describe barriers and motivators to the same. A mixed methods cross-sectional study involving a survey with 200 women who had delivered in the last 24 months, 3 focus group discussions with health providers, chiefs and CHVs and 26 in-depth interviews with mothers, key decision influencers and TBAs. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) using logistic regression were calculated to identify predictive factors for health facility delivery. Thematic analysis was done to describe barriers and motivators to the same. Of the women interviewed, 39% delivered at the health facility. Factors positively associated with health facility deliveries included belonging to the highest wealth quintiles [aOR 4.9 (95%CI 1.5-16.5)], currently not married [aOR 2.4 (95%CI 1.1-5.4)] and living near the health facility [aOR 2.2 (95%CI 1.1 = 4.4)]. High parity [aOR 0.7 (95%CI 0.5-0.9)] was negatively associated with health facility delivery. Barriers to health facility delivery included women not being final decision makers on place of birth, lack of a birth plan, gender of health provider, unfamiliar birthing position, disrespect and/or abuse, distance, attitude of health providers and lack of essential drugs and supplies. Motivators included proximity to health facility, mother's health condition, integration of TBAs into the health system, and health education/advice received. Belonging to the highest wealth quintile, currently not married and

  16. Consumers’ intention to use health recommendation systems to receive personalized nutrition advice

    Science.gov (United States)

    2013-01-01

    Background Sophisticated recommendation systems are used more and more in the health sector to assist consumers in healthy decision making. In this study we investigate consumers' evaluation of hypothetical health recommendation systems that provide personalized nutrition advice. We examine consumers' intention to use such a health recommendation system as a function of options related to the underlying system (e.g. the type of company that generates the advice) as well as intermediaries (e.g. general practitioner) that might assist in using the system. We further explore if the effect of both the system and intermediaries on intention to use a health recommendation system are mediated by consumers' perceived effort, privacy risk, usefulness and enjoyment. Methods 204 respondents from a consumer panel in the Netherlands participated. The data were collected by means of a questionnaire. Each respondent evaluated three hypothetical health recommendation systems on validated multi-scale measures of effort, privacy risk, usefulness, enjoyment and intention to use the system. To test the hypothesized relationships we used regression analyses. Results We find evidence that the options related to the underlying system as well as the intermediaries involved influence consumers' intention to use such a health recommendation system and that these effects are mediated by perceptions of effort, privacy risk, usefulness and enjoyment. Also, we find that consumers value usefulness of a system more and enjoyment less when a general practitioner advices them to use a health recommendation system than if they use it out of their own curiosity. Conclusions We developed and tested a model of consumers' intention to use a health recommendation system. We found that intermediaries play an important role in how consumers evaluate such a system over and above options of the underlying system that is used to generate the recommendation. Also, health-related information services seem to

  17. Consumers' intention to use health recommendation systems to receive personalized nutrition advice.

    Science.gov (United States)

    Wendel, Sonja; Dellaert, Benedict G C; Ronteltap, Amber; van Trijp, Hans C M

    2013-04-04

    Sophisticated recommendation systems are used more and more in the health sector to assist consumers in healthy decision making. In this study we investigate consumers' evaluation of hypothetical health recommendation systems that provide personalized nutrition advice. We examine consumers' intention to use such a health recommendation system as a function of options related to the underlying system (e.g. the type of company that generates the advice) as well as intermediaries (e.g. general practitioner) that might assist in using the system. We further explore if the effect of both the system and intermediaries on intention to use a health recommendation system are mediated by consumers' perceived effort, privacy risk, usefulness and enjoyment. 204 respondents from a consumer panel in the Netherlands participated. The data were collected by means of a questionnaire. Each respondent evaluated three hypothetical health recommendation systems on validated multi-scale measures of effort, privacy risk, usefulness, enjoyment and intention to use the system. To test the hypothesized relationships we used regression analyses. We find evidence that the options related to the underlying system as well as the intermediaries involved influence consumers' intention to use such a health recommendation system and that these effects are mediated by perceptions of effort, privacy risk, usefulness and enjoyment. Also, we find that consumers value usefulness of a system more and enjoyment less when a general practitioner advices them to use a health recommendation system than if they use it out of their own curiosity. We developed and tested a model of consumers' intention to use a health recommendation system. We found that intermediaries play an important role in how consumers evaluate such a system over and above options of the underlying system that is used to generate the recommendation. Also, health-related information services seem to rely on endorsement by the medical sector

  18. The role and uptake of private health insurance in different health care systems: are there lessons for developing countries?

    Science.gov (United States)

    Odeyemi, Isaac Ao; Nixon, John

    2013-01-01

    Social and national health insurance schemes are being introduced in many developing countries in moving towards universal health care. However, gaps in coverage are common and can only be met by out-of-pocket payments, general taxation, or private health insurance (PHI). This study provides an overview of PHI in different health care systems and discusses factors that affect its uptake and equity. A representative sample of countries was identified (United States, United Kingdom, The Netherlands, France, Australia, and Latvia) that illustrates the principal forms and roles of PHI. Literature describing each country's health care system was used to summarize how PHI is utilized and the factors that affect its uptake and equity. In the United States, PHI is a primary source of funding in conjunction with tax-based programs to support vulnerable groups; in the UK and Latvia, PHI is used in a supplementary role to universal tax-based systems; in France and Latvia, complementary PHI is utilized to cover gaps in public funding; in The Netherlands, PHI is supplementary to statutory private and social health insurance; in Australia, the government incentivizes the uptake of complementary PHI through tax rebates and penalties. The uptake of PHI is influenced by age, income, education, health care system typology, and the incentives or disincentives applied by governments. The effect on equity can either be positive or negative depending on the type of PHI adopted and its role within the wider health care system. PHI has many manifestations depending on the type of health care system used and its role within that system. This study has illustrated its common applications and the factors that affect its uptake and equity in different health care systems. The results are anticipated to be helpful in informing how developing countries may utilize PHI to meet the aim of achieving universal health care.

  19. Factors Influencing the Job Satisfaction of Health System Employees in Tabriz, Iran

    OpenAIRE

    Bagheri, Shokoufe; Kousha, Ahmad; Janati, Ali; Asghari-Jafarabadi, Mohammad

    2012-01-01

    Background: Employees can be counseled on how they feel about their job. If any particular dimension of their job is causing them dissatisfaction, they can be assisted to appropriately change it. In this study, we investigated the factors affecting job satisfaction from the perspective of employees working in the health system and thereby a quantitative measure of job satisfaction.Methods: Using eight focus group discussions (n=70), factors affecting job satisfaction of the employees were dis...

  20. Merging Air Quality and Public Health Decision Support Systems

    Science.gov (United States)

    Hudspeth, W. B.; Bales, C. L.

    2003-12-01

    The New Mexico Air Quality Mapper (NMAQM) is a Web-based, open source GIS prototype application that Earth Data Analysis Center is developing under a NASA Cooperative Agreement. NMAQM enhances and extends existing data and imagery delivery systems with an existing Public Health system called the Rapid Syndrome Validation Project (RSVP). RSVP is a decision support system operating in several medical and public health arenas. It is evolving to ingest remote sensing data as input to provide early warning of human health threats, especially those related to anthropogenic atmospheric pollutants and airborne pathogens. The NMAQM project applies measurements of these atmospheric pollutants, derived from both remotely sensed data as well as from in-situ air quality networks, to both forecasting and retrospective analyses that influence human respiratory health. NMAQM provides a user-friendly interface for visualizing and interpreting environmentally-linked epidemiological phenomena. The results, and the systems made to provide the information, will be applicable not only to decision-makers in the public health realm, but also to air quality organizations, demographers, community planners, and other professionals in information technology, and social and engineering sciences. As an accessible and interactive mapping and analysis application, it allows environment and health personnel to study historic data for hypothesis generation and trend analysis, and then, potentially, to predict air quality conditions from daily data acquisitions. Additional spin off benefits to such users include the identification of gaps in the distribution of in-situ monitoring stations, the dissemination of air quality data to the public, and the discrimination of local vs. more regional sources of air pollutants that may bear on decisions relating to public health and public policy.

  1. Mapping the Zambian prison health system: An analysis of key structural determinants.

    Science.gov (United States)

    Topp, Stephanie M; Moonga, Clement N; Luo, Nkandu; Kaingu, Michael; Chileshe, Chisela; Magwende, George; Henostroza, German

    2017-07-01

    Health and health service access in Zambian prisons are in a state of 'chronic emergency'. This study aimed to identify major structural barriers to strengthening the prison health systems. A case-based analysis drew on key informant interviews (n = 7), memos generated during workshops (n = 4) document review and investigator experience. Structural determinants were defined as national or macro-level contextual and material factors directly or indirectly influencing prison health services. The analysis revealed that despite an favourable legal framework, four major and intersecting structural factors undermined the Zambian prison health system. Lack of health financing was a central and underlying challenge. Weak health governance due to an undermanned prisons health directorate impeded planning, inter-sectoral coordination, and recruitment and retention of human resources for health. Outdated prison infrastructure simultaneously contributed to high rates of preventable disease related to overcrowding and lack of basic hygiene. These findings flag the need for policy and administrative reform to establish strong mechanisms for domestic prison health financing and enable proactive prison health governance, planning and coordination.

  2. Oil for health in sub-Saharan Africa: health systems in a 'resource curse' environment.

    Science.gov (United States)

    Calain, Philippe

    2008-10-21

    In a restricted sense, the resource curse is a theory that explains the inverse relationship classically seen between dependence on natural resources and economic growth. It defines a peculiar economic and political environment, epitomized by oil extraction in sub-Saharan Africa. Based on secondary research and illustrations from four oil-rich geographical areas (the Niger Delta region of Nigeria, Angola, southern Chad, Southern Sudan), I propose a framework for analysing the effects of the resource curse on the structure of health systems at sub-national levels. Qualitative attributes are emphasised. The role of the corporate sector, the influence of conflicts, and the value of classical mitigation measures (such as health impact assessments) are further examined. Health systems in a resource curse environment are classically fractured into tripartite components, including governmental health agencies, non-profit non-governmental organisations, and the corporate extractive sector. The three components entertain a range of contractual relationships generally based on operational considerations which are withdrawn from social or community values. Characterisation of agencies in this system should also include: values, operating principles, legitimacy and operational spaces. From this approach, it appears that community health is at the same time marginalized and instrumentalized toward economic and corporate interests in resource curse settings. From a public health point of view, the resource curse represents a fundamental failure of dominant development theories, rather than a delay in creating the proper economy and governance environment for social progress. The scope of research on the resource curse should be broadened to include more accurate or comprehensive indicators of destitution (including health components) and more open perspectives on causal mechanisms.

  3. Oil for health in sub-Saharan Africa: health systems in a 'resource curse' environment

    Directory of Open Access Journals (Sweden)

    Calain Philippe

    2008-10-01

    Full Text Available Abstract Background In a restricted sense, the resource curse is a theory that explains the inverse relationship classically seen between dependence on natural resources and economic growth. It defines a peculiar economic and political environment, epitomised by oil extraction in sub-Saharan Africa. Methods Based on secondary research and illustrations from four oil-rich geographical areas (the Niger Delta region of Nigeria, Angola, southern Chad, Southern Sudan, I propose a framework for analysing the effects of the resource curse on the structure of health systems at sub-national levels. Qualitative attributes are emphasised. The role of the corporate sector, the influence of conflicts, and the value of classical mitigation measures (such as health impact assessments are further examined. Results Health systems in a resource curse environment are classically fractured into tripartite components, including governmental health agencies, non-profit non-governmental organisations, and the corporate extractive sector. The three components entertain a range of contractual relationships generally based on operational considerations which are withdrawn from social or community values. Characterisation of agencies in this system should also include: values, operating principles, legitimacy and operational spaces. From this approach, it appears that community health is at the same time marginalised and instrumentalised toward economic and corporate interests in resource curse settings. Conclusion From a public health point of view, the resource curse represents a fundamental failure of dominant development theories, rather than a delay in creating the proper economy and governance environment for social progress. The scope of research on the resource curse should be broadened to include more accurate or comprehensive indicators of destitution (including health components and more open perspectives on causal mechanisms.

  4. "SAFE" LEVEL OF SOMATIC HEALTH IN INDICATORS REGULATION OF CARDIORESPIRATORY SYSTEM AT YOUNG MEN

    Directory of Open Access Journals (Sweden)

    Alexander P Romanchuk

    2015-12-01

    2Lviv State University Physical Culture The aim of this study was to determine the functional state cardiorespiratory system in males younger with "safe" level of somatic health (LSH. Were examined 104 males aged 20,6 ± 0,9 years, engaged in various sports, and had no existing acute and chronic diseases. The survey was conducted using spiroarteriocardiorhythmography (SACR. It is shown that in all studied systems of regulation, regulation except SBP probably marked differences between persons with "safe" and "low" LSH. At the same time, the comparison of "safe" and "medium" LSH differences relate only to the predominance of sympathetic influences on heart rate, decrease suprasegmental effects on DBP, reducing regulatory influences on spontaneous breath and their high-frequency components, reducing of baroreflex sensitivity and cardiac output. Key words: "safe" level of somatic health, regulation of the cardiorespiratory system.

  5. Estonia: health system review.

    Science.gov (United States)

    Lai, Taavi; Habicht, Triin; Kahur, Kristiina; Reinap, Marge; Kiivet, Raul; van Ginneken, Ewout

    2013-01-01

    This analysis of the Estonian health system reviews recent developments in organization and governance, health financing, health-care provision, health reforms and health system performance. Without doubt, the main issue has been the 2008 financial crisis. Although Estonia has managed the downturn quite successfully and overall satisfaction with the system remains high, it is hard to predict the longer-term effects of the austerity package. The latter included some cuts in benefits and prices, increased cost sharing for certain services, extended waiting times, and a reduction in specialized care. In terms of health outcomes, important progress was made in life expectancy, which is nearing the European Union (EU) average, and infant mortality. Improvements are necessary in smoking and alcohol consumption, which are linked to the majority of avoidable diseases. Although the health behaviour of the population is improving, large disparities between groups exist and obesity rates, particularly among young people, are increasing. In health care, the burden of out-of-pocket payments is still distributed towards vulnerable groups. Furthermore, the number of hospitals, hospital beds and average length of stay has decreased to the EU average level, yet bed occupancy rates are still below EU averages and efficiency advances could be made. Going forwards, a number of pre-crisis challenges remain. These include ensuring sustainability of health care financing, guaranteeing a sufficient level of human resources, prioritizing patient-centred health care, integrating health and social care services, implementing intersectoral action to promote healthy behaviour, safeguarding access to health care for lower socioeconomic groups, and, lastly, improving evaluation and monitoring tools across the health system. World Health Organization 2013 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  6. Sex differences in cardiovascular health: does sexism influence women's health?

    Science.gov (United States)

    Molix, Lisa

    2014-08-01

    This commentary provides a brief overview of theory and research that supports the idea that sexism may be related to the disproportionate negative cardiovascular health outcomes in women. It describes sexism as a stressor and outlines its association with a variety of health outcomes as evidence for why sex disparities should be examined within the context of pervasive inequities. To date, population-based studies have not explicitly examined the relationship between sexism and cardiovascular disease, but smaller studies have yielded fairly consistent results. It is suggested that future research should aim to examine the influence of 2 types of sexism (ie, hostile and benevolent) and that daily or within-day designs be used to assess cognitive, behavioral and physiological responses to everyday sexist experiences.

  7. Influence of hiking trainings on 13 years old adolescents’ health

    Directory of Open Access Journals (Sweden)

    K.V. Mulyk

    2015-08-01

    Full Text Available Purpose: determination of influence of hiking trainings on adolescents’ health. Material: the research covered adolescents, who train hiking for one year in hiking circles (20 boys and 16 girls and adolescents, who do not practice hiking trainings (18 boys and 20 girls. Age of participants was 13 years. The following indices were determined” Ketle -2 index, Robinson’s index, indices of Skibinskiy, Shapovalova, Ruffiet. Results: positive influence of hiking trainings on general health condition of adolescents was determined. It has been recommended to practice hiking at days off, summer holidays and during academic year. It was found that general health of group 2 adolescents (who did not practice hiking corresponds to level below middle (10-13 points. Adolescents of group 1 (who practice hiking level of general health reaches middle level (14-18 points. Conclusions: it is recommended to assess schoolchildren’s health in points. Besides, it is necessary to consider points of every separate index; it will permit to find weak points of adolescents organism’s functioning.

  8. Health-Seeking Influence Reflected by Online Health-Related Messages Received on Social Media: Cross-Sectional Survey.

    Science.gov (United States)

    Iftikhar, Rahila; Abaalkhail, Bahaa

    2017-11-16

    Major social networking platforms, such as Facebook, WhatsApp, and Twitter, have become popular means through which people share health-related information, irrespective of whether messages disseminated through these channels are authentic. This study aims to describe the demographic characteristics of patients that may demonstrate their attitudes toward medical information shared on social media networks. Second, we address how information found through social media affects the way people deal with their health. Third, we examine whether patients initiate or alter/discontinue their medications based on information derived from social media. We conducted a cross-sectional survey between April and June 2015 on patients attending outpatient clinics at King Abdulaziz University, Jeddah, Saudi Arabia. Patients who used social media (Facebook, WhatsApp, and Twitter) were included. We designed a questionnaire with closed-ended and multiple-choice questions to assess the type of social media platforms patients used and whether information received on these platforms influenced their health care decisions. We used chi-square test to establish the relationship between categorical variables. Of the 442 patients who filled in the questionnaires, 401 used Facebook, WhatsApp, or Twitter. The majority of respondents (89.8%, 397/442) used WhatsApp, followed by Facebook (58.6%, 259/442) and Twitter (42.3%, 187/442). In most cases, respondents received health-related messages from WhatsApp and approximately 42.6% (171/401) reported ever stopping treatment as advised on a social media platform. A significantly higher proportion of patients without heart disease (P=.001) and obese persons (P=.01) checked the authenticity of information received on social media. Social media messages influenced decision making among patients without heart disease (P=.04). Respondents without heart disease (P=.001) and obese persons (P=.01) were more likely to discuss health-related information

  9. Health-Seeking Influence Reflected by Online Health-Related Messages Received on Social Media: Cross-Sectional Survey

    Science.gov (United States)

    2017-01-01

    Background Major social networking platforms, such as Facebook, WhatsApp, and Twitter, have become popular means through which people share health-related information, irrespective of whether messages disseminated through these channels are authentic. Objective This study aims to describe the demographic characteristics of patients that may demonstrate their attitudes toward medical information shared on social media networks. Second, we address how information found through social media affects the way people deal with their health. Third, we examine whether patients initiate or alter/discontinue their medications based on information derived from social media. Methods We conducted a cross-sectional survey between April and June 2015 on patients attending outpatient clinics at King Abdulaziz University, Jeddah, Saudi Arabia. Patients who used social media (Facebook, WhatsApp, and Twitter) were included. We designed a questionnaire with closed-ended and multiple-choice questions to assess the type of social media platforms patients used and whether information received on these platforms influenced their health care decisions. We used chi-square test to establish the relationship between categorical variables. Results Of the 442 patients who filled in the questionnaires, 401 used Facebook, WhatsApp, or Twitter. The majority of respondents (89.8%, 397/442) used WhatsApp, followed by Facebook (58.6%, 259/442) and Twitter (42.3%, 187/442). In most cases, respondents received health-related messages from WhatsApp and approximately 42.6% (171/401) reported ever stopping treatment as advised on a social media platform. A significantly higher proportion of patients without heart disease (P=.001) and obese persons (P=.01) checked the authenticity of information received on social media. Social media messages influenced decision making among patients without heart disease (P=.04). Respondents without heart disease (P=.001) and obese persons (P=.01) were more likely to

  10. Influence of family environment on children's oral health: a systematic review.

    Science.gov (United States)

    Castilho, Aline Rogéria Freire de; Mialhe, Fábio Luiz; Barbosa, Taís de Souza; Puppin-Rontani, Regina Maria

    2013-01-01

    To review current models and scientific evidence on the influence of parents' oral health behaviors on their children's dental caries. MEDLINE articles published between 1980 and June, 2012. Original research articles on parents' oral health behavior were reviewed. A total of 218 citations were retrieved, and 13 articles were included in the analysis. The studies were eligible for review if they matched the following inclusion criteria: (1) they evaluated a possible association between dental caries and parents' oral-health-related behaviors, and (2) the study methodology included oral clinical examination. The main search terms were "oral health", "parental attitudes", "parental knowledge", and "dental caries". : 13 experimental studies contributed data to the synthesis. Original articles, reviews, and chapters in textbooks were also considered. Parents' dental health habits influence their children's oral health. Oral health education programs aimed at preventive actions are needed to provide children not only with adequate oral health, but better quality of life. Special attention should be given to the entire family, concerning their lifestyle and oral health habits. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  11. [The health system of Ecuador].

    Science.gov (United States)

    Lucio, Ruth; Villacrés, Nilhda; Henríquez, Rodrigo

    2011-01-01

    This paper describes the health conditions in Ecuador and, in more detail, the characteristics of the Ecuadorian health system, including its structure and coverage, its financial sources, the physical, material and human resources available, and the stewardship activities developed by the Ministry of Public Health. It also describes the structure and content of its health information system, and the participation of citizens in the operation and evaluation of the health system. The paper ends with a discussion of the most recent policy innovations implemented in the Ecuadorian system, including the incorporation of a chapter on health into the new Constitution which recognizes the protection of health as a human right, and the construction of the Comprehensive Public Health Network.

  12. Why bother about health? A study on the factors that influence health information seeking behaviour among Malaysian healthcare consumers.

    Science.gov (United States)

    Jaafar, Noor Ismawati; Ainin, Sulaiman; Yeong, Mun Wai

    2017-08-01

    The general improvement of socio-economic conditions has resulted in people becoming more educated to make better-informed decisions in health related matters. Individual's perspective on health increases with better understanding of ways to improve lifestyle for better health and living. With the increase in lifestyle related diseases that lead to health problems, there is an increase in the availability of healthcare information. Thus, it is important to identify the factors that influence information seeking behaviour in the area of healthcare and lifestyle. This exploratory study examines the relationship between the factors that affect online health information-seeking behaviour among healthcare product in the capital city of Malaysia. Survey questionnaire was used to collect empirical data. A survey was conducted among 300 healthcare consumers in three main cities in Malaysia where questionnaires were personally distributed through snowball sampling. A total of 271 questionnaire forms were used in the analysis. Health Behaviour of the consumers influences Health Information Seeking Behaviour. And this relationship is strongly affected by Gender whereby the affect is strongly among females compared to males. The findings indicate that Health Behaviour influences Health Information Seeking Behaviour. Marketers can find out which target segment of population to target when devising information channels for consumers, especially through the Internet. However, message that promotes positive health behaviour to a target audience who already has positive Health Behaviour increase the motivation to Health Information Seeking Behaviour. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Circumpolar Inuit health systems

    Directory of Open Access Journals (Sweden)

    Leanna Ellsworth

    2013-08-01

    Full Text Available Background . The Inuit are an indigenous people totalling about 160,000 and living in 4 countries across the Arctic – Canada, Greenland, USA (Alaska and Russia (Chukotka. In essence, they are one people living in 4 countries. Although there have been significant improvements in Inuit health and survival over the past 50 years, stark differences persist between the key health indicators for Inuit and those of the national populations in the United States, Canada and Russia and between Greenland and Denmark. On average, life expectancy in all 4 countries is lower for Inuit. Infant mortality rates are also markedly different with up to 3 times more infant deaths than the broader national average. Underlying these statistical differences are a range of health, social, economic and environmental factors which have affected Inuit health outcomes. Although the health challenges confronting the Inuit are in many cases similar across the Arctic, the responses to these challenges vary in accordance with the types of health systems in place in each of the 4 countries. Each of the 4 countries has a different health care system with varying degrees of accessibility and affordability for Inuit living in urban, rural and remote areas. Objective . To describe funding and governance arrangements for health services to Inuit in Canada, Greenland, USA (Alaska and Russia (Chukotka and to determine if a particular national system leads to better outcomes than any of the other 3 systems. Study design . Literature review. Results . It was not possible to draw linkages between the different characteristics of the respective health systems, the corresponding financial investment and the systems’ effectiveness in adequately serving Inuit health needs for several reasons including the very limited and inadequate collection of Inuit-specific health data by Canada, Alaska and Russia; and second, the data that are available do not necessarily provide a feasible point of

  14. Influencing factors of mental health of medical students in China.

    Science.gov (United States)

    Yang, Fan; Meng, Heng; Chen, Hui; Xu, Xin-hao; Liu, Zhuo; Luo, Ai; Feng, Zhan-chun

    2014-06-01

    This study investigated the mental health status of medical students in China, and analyzed the influencing factors in order to provide evidence for mental health education for medical students. A stratified cluster sampling method was used to recruit medical students from Huazhong University of Science and Technology, China. The questionnaire survey on general information and Symptom Checklist 90 (SCL-90) were used for investigation and analysis. The results showed among the 1137 valid questionnaires, 278 (24.45%) participants had SCL-90 score ≥ 160. The top three mental problems of medical students were obsessive-compulsive disorder, interpersonal sensitivity and depression in terms of the factor score ≥ 2.5 and the number of participants who reflected on the diseases. The third-year medical students had the worst mental health status, and fifth-year medical students had the best mental health status. Students from rural area had more psychological problems than those from urban area; furthermore, students with high professional satisfaction, those who were the single child of the family, non-poor students, and those whose parents had high education level had better mental health status. It was concluded that the mental health of medical students is not optimistic in China. Medical students have some mental health problems of different degrees. Factors that influence the mental health of medical students include academic pressure, professional satisfaction level and family environment.

  15. Health systems research in the time of health system reform in India: a review.

    Science.gov (United States)

    Rao, Krishna D; Arora, Radhika; Ghaffar, Abdul

    2014-08-09

    Research on health systems is an important contributor to improving health system performance. Importantly, research on program and policy implementation can also create a culture of public accountability. In the last decade, significant health system reforms have been implemented in India. These include strengthening the public sector health system through the National Rural Health Mission (NRHM), and expansion of government-sponsored insurance schemes for the poor. This paper provides a situation analysis of health systems research during the reform period. We reviewed 9,477 publications between 2005 and 2013 in two online databases, PubMed and IndMED. Articles were classified according to the WHO classification of health systems building blocks. Our findings indicate the number of publications on health systems progressively increased every year from 92 in 2006 to 314 in 2012. The majority of papers were on service delivery (40%), with fewer on information (16%), medical technology and vaccines (15%), human resources (11%), governance (5%), and financing (8%). Around 70% of articles were lead by an author based in India, the majority by authors located in only four states. Several states, particularly in eastern and northeastern India, did not have a single paper published by a lead author located in a local institution. Moreover, many of these states were not the subject of a single published paper. Further, a few select institutions produced the bulk of research. Of the foreign author lead papers, 77% came from five countries (USA, UK, Canada, Australia, and Switzerland). The growth of published research during the reform period in India is a positive development. However, bulk of this research is produced in a few states and by a few select institutions Further strengthening health systems research requires attention to neglected health systems domains like human resources, financing, and governance. Importantly, research capacity needs to be strengthened in

  16. Building health research systems to achieve better health

    Directory of Open Access Journals (Sweden)

    González Block Miguel

    2006-11-01

    Full Text Available Abstract Health research systems can link knowledge generation with practical concerns to improve health and health equity. Interest in health research, and in how health research systems should best be organised, is moving up the agenda of bodies such as the World Health Organisation. Pioneering health research systems, for example those in Canada and the UK, show that progress is possible. However, radical steps are required to achieve this. Such steps should be based on evidence not anecdotes. Health Research Policy and Systems (HARPS provides a vehicle for the publication of research, and informed opinion, on a range of topics related to the organisation of health research systems and the enormous benefits that can be achieved. Following the Mexico ministerial summit on health research, WHO has been identifying ways in which it could itself improve the use of research evidence. The results from this activity are soon to be published as a series of articles in HARPS. This editorial provides an account of some of these recent key developments in health research systems but places them in the context of a distinguished tradition of debate about the role of science in society. It also identifies some of the main issues on which 'research on health research' has already been conducted and published, in some cases in HARPS. Finding and retaining adequate financial and human resources to conduct health research is a major problem, especially in low and middle income countries where the need is often greatest. Research ethics and agenda-setting that responds to the demands of the public are issues of growing concern. Innovative and collaborative ways are being found to organise the conduct and utilisation of research so as to inform policy, and improve health and health equity. This is crucial, not least to achieve the health-related Millennium Development Goals. But much more progress is needed. The editorial ends by listing a wide range of topics

  17. The role and uptake of private health insurance in different health care systems: are there lessons for developing countries?

    Directory of Open Access Journals (Sweden)

    Odeyemi IA

    2013-03-01

    Full Text Available Isaac AO Odeyemi,1 John Nixon21Senior Director and Head of Health Economics and Outcomes Research, Astellas Pharma UK Ltd, Chertsey, UK; 2Teaching Associate in Health Economics, Department of Economics and Related Studies, University of York, York, UKBackground: Social and national health insurance schemes are being introduced in many developing countries in moving towards universal health care. However, gaps in coverage are common and can only be met by out-of-pocket payments, general taxation, or private health insurance (PHI. This study provides an overview of PHI in different health care systems and discusses factors that affect its uptake and equity.Methods: A representative sample of countries was identified (United States, United Kingdom, The Netherlands, France, Australia, and Latvia that illustrates the principal forms and roles of PHI. Literature describing each country's health care system was used to summarize how PHI is utilized and the factors that affect its uptake and equity.Results: In the United States, PHI is a primary source of funding in conjunction with tax-based programs to support vulnerable groups; in the UK and Latvia, PHI is used in a supplementary role to universal tax-based systems; in France and Latvia, complementary PHI is utilized to cover gaps in public funding; in The Netherlands, PHI is supplementary to statutory private and social health insurance; in Australia, the government incentivizes the uptake of complementary PHI through tax rebates and penalties. The uptake of PHI is influenced by age, income, education, health care system typology, and the incentives or disincentives applied by governments. The effect on equity can either be positive or negative depending on the type of PHI adopted and its role within the wider health care system.Conclusion: PHI has many manifestations depending on the type of health care system used and its role within that system. This study has illustrated its common applications

  18. Impact of laboratory accreditation on patient care and the health system.

    Science.gov (United States)

    Peter, Trevor F; Rotz, Philip D; Blair, Duncan H; Khine, Aye-Aye; Freeman, Richard R; Murtagh, Maurine M

    2010-10-01

    Accreditation is emerging as a preferred framework for building quality medical laboratory systems in resource-limited settings. Despite the low numbers of laboratories accredited to date, accreditation has the potential to improve the quality of health care for patients through the reduction of testing errors and attendant decreases in inappropriate treatment. Accredited laboratories can become more accountable and less dependent on external support. Efforts made to achieve accreditation may also lead to improvements in the management of laboratory networks by focusing attention on areas of greatest need and accelerating improvement in areas such as supply chain, training, and instrument maintenance. Laboratory accreditation may also have a positive influence on performance in other areas of health care systems by allowing laboratories to demonstrate high standards of service delivery. Accreditation may, thus, provide an effective mechanism for health system improvement yielding long-term benefits in the quality, cost-effectiveness, and sustainability of public health programs. Further studies are needed to strengthen the evidence on the benefits of accreditation and to justify the resources needed to implement accreditation programs aimed at improving the performance of laboratory systems.

  19. 'BRICS without straw'? A systematic literature review of newly emerging economies' influence in global health.

    Science.gov (United States)

    Harmer, Andrew; Xiao, Yina; Missoni, Eduardo; Tediosi, Fabrizio

    2013-04-15

    Since 2010, five newly emerging economies collectively known as 'BRICS' (Brazil, India, Russia, China and South Africa) have caught the imagination, and scholarly attention, of political scientists, economists and development specialists. The prospect of a unified geopolitical bloc, consciously seeking to re-frame international (and global) health development with a new set of ideas and values, has also, if belatedly, begun to attract the attention of the global health community. But what influence, if any, do the BRICS wield in global health, and, if they do wield influence, how has that influence been conceptualized and recorded in the literature? We conducted a systematic literature review in (March-December 2012) of documents retrieved from the databases EMBASE, PubMed/Medline, Global Health, and Google Scholar, and the websites of relevant international organisations, research institutions and philanthropic organisations. The results were synthesised using a framework of influence developed for the review from the political science literature. Our initial search of databases and websites yielded 887 documents. Exclusion criteria narrowed the number of documents to 71 journal articles and 23 reports. Two researchers using an agreed set of inclusion criteria independently screened the 94 documents, leaving just 7 documents. We found just one document that provided sustained analysis of the BRICS' collective influence; the overwhelming tendency was to describe individual BRICS countries influence. Although influence was predominantly framed by BRICS countries' material capability, there were examples of institutional and ideational influence - particularly from Brazil. Individual BRICS countries were primarily 'opportunity seekers' and region mobilisers but with potential to become 'issue leaders' and region organisers. Though small in number, the written output on BRICS influence in global health has increased significantly since a similar review conducted in

  20. Development and validation of an instrument to assess perceived social influence on health behaviors

    Science.gov (United States)

    HOLT, CHERYL L.; CLARK, EDDIE M.; ROTH, DAVID L.; CROWTHER, MARTHA; KOHLER, CONNIE; FOUAD, MONA; FOUSHEE, RUSTY; LEE, PATRICIA A.; SOUTHWARD, PENNY L.

    2012-01-01

    Assessment of social influence on health behavior is often approached through a situational context. The current study adapted an existing, theory-based instrument from another content domain to assess Perceived Social Influence on Health Behavior (PSI-HB) among African Americans, using an individual difference approach. The adapted instrument was found to have high internal reliability (α = .81–.84) and acceptable testretest reliability (r = .68–.85). A measurement model revealed a three-factor structure and supported the theoretical underpinnings. Scores were predictive of health behaviors, particularly among women. Future research using the new instrument may have applied value assessing social influence in the context of health interventions. PMID:20522506

  1. "Not on the agenda": A qualitative study of influences on health services use among poor young women who use drugs in Cape Town, South Africa.

    Science.gov (United States)

    Myers, Bronwyn; Carney, Tara; Wechsberg, Wendee M

    2016-04-01

    Poor young women who use alcohol and other drugs (AODs) in Cape Town, South Africa, need access to health services to prevent HIV. Efforts to link young women to services are hampered by limited information on what influences service initiation. We explored perceptions of factors that influence poor AOD-using young women's use of health services. We conducted four focus groups with young women (aged 16-21) who used AODs and were recruited from two township communities in Cape Town. We also conducted 14 in-depth interviews with health and social welfare service planners and providers. Discussion topics included young women's use of health services and perceived influences on service use. Qualitative data were analysed using a framework approach. The findings highlighted structural, contextual, and systemic influences on the use of health services by young women who use AODs. First, young women were absent from the health agenda, which had an impact on the provision of women-specific services. Resource constraints and gender inequality were thought to contribute to this absence. Second, gender inequality and stigma toward young women who used AODs led to their social exclusion from education and employment opportunities and health care. Third, community poverty resulted in the emergence of perverse social capital and social disorder that limited social support for treatment. Fourth, the health care system was unresponsive to the multiple service needs of these young women. To reach young women who use AODs, interventions need to take cognisance of young women's risk environment and health systems need to adapt to respond better to their needs. For these interventions to be effective, gender must be placed on the policy agenda. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. [Health services research for the public health service (PHS) and the public health system].

    Science.gov (United States)

    Hollederer, A; Wildner, M

    2015-03-01

    There is a great need for health services research in the public health system and in the German public health service. However, the public health service is underrepresented in health services research in Germany. This has several structural, historical and disciplinary-related reasons. The public health service is characterised by a broad range of activities, high qualification requirements and changing framework conditions. The concept of health services research is similar to that of the public health service and public health system, because it includes the principles of multidisciplinarity, multiprofessionalism and daily routine orientation. This article focuses on a specified system theory based model of health services research for the public health system and public health service. The model is based on established models of the health services research and health system research, which are further developed according to specific requirements of the public health service. It provides a theoretical foundation for health services research on the macro-, meso- and microlevels in public health service and the public health system. Prospects for public health service are seen in the development from "old public health" to "new public health" as well as in the integration of health services research and health system research. There is a significant potential for development in a better linkage between university research and public health service as is the case for the "Pettenkofer School of Public Health Munich". © Georg Thieme Verlag KG Stuttgart · New York.

  3. Exploring the drivers of health and healthcare access in Zambian prisons: a health systems approach.

    Science.gov (United States)

    Topp, Stephanie M; Moonga, Clement N; Luo, Nkandu; Kaingu, Michael; Chileshe, Chisela; Magwende, George; Heymann, S Jody; Henostroza, German

    2016-11-01

    Prison populations in sub-Saharan Africa (SSA) experience a high burden of disease and poor access to health care. Although it is generally understood that environmental conditions are dire and contribute to disease spread, evidence of how environmental conditions interact with facility-level social and institutional factors is lacking. This study aimed to unpack the nature of interactions and their influence on health and healthcare access in the Zambian prison setting. We conducted in-depth interviews of a clustered random sample of 79 male prisoners across four prisons, as well as 32 prison officers, policy makers and health care workers. Largely inductive thematic analysis was guided by the concepts of dynamic interaction and emergent behaviour, drawn from the theory of complex adaptive systems. A majority of inmates, as well as facility-based officers reported anxiety linked to overcrowding, sanitation, infectious disease transmission, nutrition and coercion. Due in part to differential wealth of inmates and their support networks on entering prison, and in part to the accumulation of authority and material wealth within prison, we found enormous inequity in the standard of living among prisoners at each site. In the context of such inequities, failure of the Zambian prison system to provide basic necessities (including adequate and appropriate forms of nutrition, or access to quality health care) contributed to high rates of inmate-led and officer-led coercion with direct implications for health and access to healthcare. This systems-oriented analysis provides a more comprehensive picture of the way resource shortages and human interactions within Zambian prisons interact and affect inmate and officer health. While not a panacea, our findings highlight some strategic entry-points for important upstream and downstream reforms including urgent improvement in the availability of human resources for health; strengthening of facility-based health services systems

  4. The development of health law as a way to change traditional attitudes in national legal systems. The influence of international human rights law: what is left for the national legislator?

    Science.gov (United States)

    Birmontiene, Toma

    2010-03-01

    The development of health law as a sovereign subject of law could be seen as a correlative result of the development of international human rights law. From the perspectives of human rights law, health law gives us a unique possibility to change the traditional point of reference - from the regulation of medical procedures, to the protection of human rights as the main objective of law. At the end of the twentieth and the beginning of this century, human rights law and the most influential international instrument--the European Convention on Human Rights (and the jurisprudence of the ECHR) has influenced health care so much that it has became difficult to draw a line between these subjects. Health law sometimes directly influences and even aspires to change the content of Convention rights that are considered to be traditional. However, certain problems of law linked to health law are decided without influencing the essence of rights protected by the Convention, but just by construing the particularities of application of a certain right. In some cases by further developing the requirements of protection of individual rights that are also regulated by the health law, the ECHR even "codifies" some fields of health law (e.g., the rights of persons with mental disorders). The recognition of worthiness and diversity of human rights and the development of their content raise new objectives for national legislators when they regulate the national legal system. Here the national legislator is often put into a quandary whether to implement the standards of human rights that are recognized by the international community, or to refuse to do so, taking account of the interests of a certain group of the electorate.

  5. Building institutions for an effective health system: lessons from China's experience with rural health reform.

    Science.gov (United States)

    Bloom, Gerald

    2011-04-01

    This paper is concerned with the management of health system changes aimed at substantially increasing the access to safe and effective health services. It argues that an effective health sector relies on trust-based relationships between users, providers and funders of health services, and that one of the major challenges governments face is to construct institutional arrangements within which these relationships can be embedded. It presents the case of China, which is implementing an ambitious health reform, drawing on a series of visits to rural counties by the author over a 10-year period. It illustrates how the development of reform strategies has been a response both to the challenges arising from the transition to a market economy and the result of actions by different actors, which have led to the gradual creation of increasingly complex institutions. The overall direction of change has been strongly influenced by the efforts made by the political leadership to manage a transition to a modern economy which provides at least some basic benefits to all. The paper concludes that the key lessons for other countries from China's experience with health system reform are less about the detailed design of specific interventions than about its approach to the management of institution-building in a context of complexity and rapid change. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Health workers' perceptions of private-not-for-profit health facilities' organizational culture and its influence on retention in Uganda.

    Science.gov (United States)

    Shumba, Constance Sibongile; Kielmann, Karina; Witter, Sophie

    2017-12-06

    An in-depth understanding of how organizational culture is experienced by health workers (HWs), and influences their decisions to leave their jobs is a fundamental, yet under-examined, basis for forming effective retention strategies. This research examined HWs' working experiences and perceptions of organisational culture within private-not-for-profit, largely mission-based hospitals, and how this influenced retention. Thirty-two HWs, including managers, in 19 health facilities in Uganda were interviewed using a semi-structured topic guide. Interview transcripts were analysed using thematic content analysis. Interviews showed that the organizational culture was predominantly hierarchical, with non-participative management styles which emphasized control and efficiency. HWs and managers held different perceptions of the organizational culture. While the managers valued results and performance, HWs valued team work, recognition and participative management. The findings of this study indicate that organizational culture influences retention of HWs in health facilities and provide a useful context to inform health care managers in the PNFP sub-sector in Uganda and similar contexts. To improve retention of HWs, a gradual shift in organizational culture will be necessary, focussing on the values, beliefs and perceptions which have the greatest influence on observable behaviour.

  7. Thinking shift on health systems: from blueprint health programmes towards resilience of health systems Comment on "Constraints to applying systems thinking concepts in health systems: A regional perspective from surveying stakeholders in Eastern Mediterranean countries".

    Science.gov (United States)

    Blanchet, Karl

    2015-03-03

    International health is still highly dominated by equilibrium approaches. The emergence of systems thinking in international health provides a great avenue to develop innovative health interventions adapted to changing contexts. The public health community, nevertheless, has the responsibility to translate concepts related to systems thinking and complexity into concrete research methods and interventions. One possibility is to consider the properties of systems such as resilience and adaptability as entry points to better understand how health systems react to shocks. © 2015 by Kerman University of Medical Sciences.

  8. Health policy, health systems research and analysis capacity ...

    African Journals Online (AJOL)

    Introduction: Health Policy and Systems Research and Analysis (HPSR&A) is an applied science that deals with complexity as it tries to provide lessons, tools and methods to understand and improve health systems and health policy. It is defined by the kinds of questions asked rather than a particular methodology.

  9. The impact of prospective pricing on the information system in the health care industry.

    Science.gov (United States)

    Matta, K F

    1988-02-01

    The move from a retrospective payment system (value added) to a prospective payment system (diagnostic related) has not only influenced the health care business but also changed their information systems' requirements. The change in requirements can be attributed both to an increase in data processing tasks and also to an increase in the need for information to more effectively manage the organization. A survey was administered to capture the response of health care institutions, in the area of information systems, to the prospective payment system. The survey results indicate that the majority of health care institutions have responded by increasing their information resources, both in terms of hardware and software, and have moved to integrate the medical and financial data. In addition, the role of the information system has changed from a cost accounting system to one intended to provide a competitive edge in a highly competitive marketing environment.

  10. Influencing factors in the health promoting behaviors of Urinary system based on health belief model in pregnant women in Bushehr 2013-14

    Directory of Open Access Journals (Sweden)

    Farzaneh Noroozi

    2015-07-01

    Full Text Available Background: Urinary tract infection is the second most common complication of pregnancy that will follow with maternal and fetal complications. The aim of this study was to identify factors affecting the urinary system health promoting behaviors in pregnant women based on the health belief model. Materials and methods: The present study is a descriptive - analytic study was performed on 250 pregnant women referred to health centers of Bushehr. The tools for collecting information was a multi sectional questionnaire consisting of demographic information, measurement of urinary system health behavior, knowledge and health belief model constructs, which its validity and reliability were ensured previously. Data analysis was performed with SPSS version 20 by using correlation coefficient and linear regression tests. Results: The mean age of subjects 27/4±4/4 years.The relationship between demographic variables and health behavior wasn’t found. The most people (179 equivalents to 71/6% had medium level of knowledge about urinary tract infection, and only 44 women (17.6% had appropriate awareness. Mean score of preventive behaviors was significant difference between different levels of knowledge (p =0/026, self efficacy (p=0/000 and perceived barriers (p=0/002. In multivariate ANOVA, only the self efficacy had strong positive relationship with the preventing behaviors of urinary tract infection (p=0/000. Conclusion: Based on these results, the necessity of education based on health belief model with an emphasis on increasing the efficacy is necessary.

  11. A review on systematic reviews of health information system studies.

    Science.gov (United States)

    Lau, Francis; Kuziemsky, Craig; Price, Morgan; Gardner, Jesse

    2010-01-01

    The purpose of this review is to consolidate existing evidence from published systematic reviews on health information system (HIS) evaluation studies to inform HIS practice and research. Fifty reviews published during 1994-2008 were selected for meta-level synthesis. These reviews covered five areas: medication management, preventive care, health conditions, data quality, and care process/outcome. After reconciliation for duplicates, 1276 HIS studies were arrived at as the non-overlapping corpus. On the basis of a subset of 287 controlled HIS studies, there is some evidence for improved quality of care, but in varying degrees across topic areas. For instance, 31/43 (72%) controlled HIS studies had positive results using preventive care reminders, mostly through guideline adherence such as immunization and health screening. Key factors that influence HIS success included having in-house systems, developers as users, integrated decision support and benchmark practices, and addressing such contextual issues as provider knowledge and perception, incentives, and legislation/policy.

  12. Observation of influences of mental health promotion and mental intervention on mental health status of professionals

    OpenAIRE

    Jiang, Shu-Qiang; Zhang, Jian-Ling

    2015-01-01

    Objective: To observe the influences of mental health promotion and mental intervention on mental health status of professionals. Method: 2878 professionals for physical examination were selected and randomly divided into treatment group and control group, with 1443 professionals and 1435 professionals, respectively. Then, the difference of mental health status before and after mental intervention between two groups was compared. Results: In treatment group, the proportion of people with heal...

  13. Contradictions in digital health engagement: An activity tracker's ambiguous influence on vulnerable young adults' engagement in own health.

    Science.gov (United States)

    Kanstrup, Anne Marie; Bertelsen, Pernille; Jensen, Martin B

    2018-01-01

    Activity trackers are designed to support individuals in monitoring and increasing their physical activity. The use of activity trackers among individuals diagnosed with depression and anxiety has not yet been examined. This pilot study investigates how this target group engages with an activity tracker during a 10-week health intervention aimed to increase their physical activity level and improve their physical and mental health. Two groups of 11 young adults (aged 18-29 years) diagnosed with depression or anxiety participated in the digital health intervention. The study used mixed methods to investigate the research question. Quantitative health data were used to assess the intervention's influence on the participants' health and qualitative data provided insights into the participants' digital health experience. The study demonstrated an ambiguous influence from the use of an activity tracker with positive physical and mental health results, but a fading and even negative digital health engagement and counterproductive competition. The ambiguous results identify a need for (1) developing strategies for health professionals to provide supervised use of activity trackers and support the target groups' abilities to convert health information about physical activity into positive health strategies, and (2) designing alternatives for health promoting IT targeted users who face challenges and need motivation beyond self-tracking and competition.

  14. Biological, psychological and social processes that explain celebrities? influence on patients? health-related behaviors

    OpenAIRE

    Hoffman, Steven J; Tan, Charlie

    2015-01-01

    Background: Celebrities can have substantial influence as medical advisors. However, their impact on public health is equivocal: depending on the advice’s validity and applicability, celebrity engagements can benefit or hinder efforts to educate patients on evidence-based practices and improve their health literacy. This meta-narrative analysis synthesizes multiple disciplinary insights explaining the influence celebrities have on people’s health-related behaviors. Methods: Systematic searche...

  15. Factors Influencing Compliance and Health Seeking Behaviour for Hypertension in Mukono and Buikwe in Uganda: A Qualitative Study.

    Science.gov (United States)

    Musinguzi, Geofrey; Anthierens, Sibyl; Nuwaha, Fred; Van Geertruyden, Jean-Pierre; Wanyenze, Rhoda K; Bastiaens, Hilde

    2018-01-01

    Hypertension is a global public health challenge and a leading risk factor for cardiovascular morbidity and mortality. Hypertension control rates are low worldwide, and delay in seeking care is associated with increased mortality. In a qualitative study, known hypertensive patients were interviewed to explore factors influencing compliance and health seeking behaviour (HSB). Data was analyzed following a semantic thematic analysis approach. Patients sought various channels of care for their hypertension. Self-medication and access to antihypertensive drugs with or without prescription were common as well as use of herbal remedies. Regular monitoring of blood pressure was not a common practice. Factors influencing HSB were related to health systems and the patient socioeconomic and structural environment. The main system issues were related to availability and attitudes of staff and shortage of supplies and medicines. The patient factors were related to awareness, perceived severity, perceived effectiveness of therapy, adverse effects, and perceived fears of lifelong dependence on medicines. The patient socioeconomic status played a role as did the marketing of traditional medicine. Patients seek varied channels of care for their hypertension. Strategies to address the multifactorial dimensions that affect HSB are needed to improve hypertension control in this population.

  16. Advancing the application of systems thinking in health: analysing the contextual and social network factors influencing the use of sustainability indicators in a health system--a comparative study in Nepal and Somaliland.

    Science.gov (United States)

    Blanchet, Karl; Palmer, Jennifer; Palanchowke, Raju; Boggs, Dorothy; Jama, Ali; Girois, Susan

    2014-08-26

    Health systems strengthening is becoming a key component of development agendas for low-income countries worldwide. Systems thinking emphasizes the role of diverse stakeholders in designing solutions to system problems, including sustainability. The objective of this paper is to compare the definition and use of sustainability indicators developed through the Sustainability Analysis Process in two rehabilitation sectors, one in Nepal and one in Somaliland, and analyse the contextual factors (including the characteristics of system stakeholder networks) influencing the use of sustainability data. Using the Sustainability Analysis Process, participants collectively clarified the boundaries of their respective systems, defined sustainability, and identified sustainability indicators. Baseline indicator data was gathered, where possible, and then researched again 2 years later. As part of the exercise, system stakeholder networks were mapped at baseline and at the 2-year follow-up. We compared stakeholder networks and interrelationships with baseline and 2-year progress toward self-defined sustainability goals. Using in-depth interviews and observations, additional contextual factors affecting the use of sustainability data were identified. Differences in the selection of sustainability indicators selected by local stakeholders from Nepal and Somaliland reflected differences in the governance and structure of the present rehabilitation system. At 2 years, differences in the structure of social networks were more marked. In Nepal, the system stakeholder network had become more dense and decentralized. Financial support by an international organization facilitated advancement toward self-identified sustainability goals. In Somaliland, the small, centralised stakeholder network suffered a critical rupture between the system's two main information brokers due to competing priorities and withdrawal of international support to one of these. Progress toward self

  17. “Not on the agenda”: A qualitative study of influences on health services use among poor young women who use drugs in Cape Town, South Africa

    Science.gov (United States)

    Myers, Bronwyn; Carney, Tara; Wechsberg, Wendee M.

    2016-01-01

    Background Poor young women who use alcohol and other drugs (AODs) in Cape Town, South Africa, need access to health services to prevent HIV. Efforts to link young women to services are hampered by limited information on what influences service initiation. We explored perceptions of factors that influence poor AOD-using young women’s use of health services. Methods We conducted four focus groups with young women (aged 16 to 21) who used AODs and were recruited from two township communities in Cape Town. We also conducted 14 in-depth interviews with health and social welfare service planners and providers. Discussion topics included young women’s use of health services and perceived influences on service use. Qualitative data were analysed using a framework approach. Results The findings highlighted structural, contextual, and systemic influences on the use of health services by young women who use AODs. First, young women were absent from the health agenda, which had an impact on the provision of women-specific services. Resource constraints and gender inequality were thought to contribute to this absence. Second, gender inequality and stigma toward young women who used AODs led to their social exclusion from education and employment opportunities and health care. Third, community poverty resulted in the emergence of perverse social capital and social disorder that limited social support for treatment. Fourth, the health care system was unresponsive to the multiple service needs of these young women. Conclusion To reach young women who use AODs, interventions need to take cognisance of young women’s risk environment and health systems need to adapt to respond better to their needs. For these interventions to be effective, gender must be placed on the policy agenda. PMID:26797188

  18. Four centuries on from Bacon: progress in building health research systems to improve health systems?

    Science.gov (United States)

    Hanney, Stephen R; González-Block, Miguel A

    2014-09-23

    In 1627, Francis Bacon's New Atlantis described a utopian society in which an embryonic research system contributed to meeting the needs of the society. In this editorial, we use some of the aspirations described in New Atlantis to provide a context within which to consider recent progress in building health research systems to improve health systems and population health. In particular, we reflect on efforts to build research capacity, link research to policy, identify the wider impacts made by the science, and generally build fully functioning research systems to address the needs identified. In 2014, Health Research Policy and Systems has continued to publish one-off papers and article collections covering a range of these issues in both high income countries and low- and middle-income countries. Analysis of these contributions, in the context of some earlier ones, is brought together to identify achievements, challenges and possible ways forward. We show how 2014 is likely to be a pivotal year in the development of ways to assess the impact of health research on policies, practice, health systems, population health, and economic benefits.We demonstrate how the increasing focus on health research systems will contribute to realising the hopes expressed in the World Health Report, 2013, namely that all nations would take a systematic approach to evaluating the outputs and applications resulting from their research investment.

  19. The influence of COPD on health-related quality of life independent of the influence of comorbidity.

    Science.gov (United States)

    van Manen, Jeannette G; Bindels, Patrick J E; Dekker, Friedo W; Bottema, Bernardus J A M; van der Zee, Jaring S; Ijzermans, C Joris; Schadé, Egbert

    2003-12-01

    The goal of this study was to determine the influence of chronic obstructive pulmonary disease (COPD) on health-related quality of life (HRQL) independent of comorbidity. Patients with COPD in general practice, >/=40 years, were selected. To recruit controls, a random sample of persons without COPD and >/=40 years, was taken. HRQL was assessed with the SF-36 and comorbidity was determined by questionnaire. The influence of COPD on HRQL independent of comorbidity (represented by adjusted regression coefficients) was significant for physical functioning (-27.6), role functioning due to physical problems (-21.6), vitality (-14.4), and general health (-25.7), and was minor and not significant for social functioning (-5.6), mental health (-1.3), role functioning due to emotional problems (-2.7), and bodily pain (-2.5). Comorbidity contributed significantly to the HRQL of all domains (-7.6 to -27.1). COPD patients can be impaired in all domains of HRQL. However, impairments in physical functioning, vitality, and general health are related to COPD and to some extent to comorbidity, while impairments in social and emotional functioning do not seem to be related to COPD, but only to comorbidity.

  20. Henry Ford Health Systems

    Science.gov (United States)

    Henry Ford Health Systems evolved from a hospital into a system delivering care to 2.5 million patients and includes the Cancer Epidemiology, Prevention and Control Program, which focuses on epidemiologic and public health aspects of cancer.

  1. Relative Influence Of Sociodemographic Variables On Oral Health ...

    African Journals Online (AJOL)

    This paper reports the results of a study to investigate the relative influence of some sociodemographic variables on oral hygiene and health of primary school children in Ibadan, Nigeria. The pupils were from two different socioeconomic strata of the society and their ages ranged between 7 and 16 years. They were ...

  2. Sex Differences in Cardiovascular Health: Does Sexism Influence Women’s Health?

    Science.gov (United States)

    Molix, Lisa

    2014-01-01

    This commentary provides a brief overview of theory and research that supports the idea that sexism may be related to the disproportionate negative cardiovascular health outcomes in women. It describes the sexism as a stressor and outlines its association with a variety of health outcomes as evidence for why sex disparities should be examined within the context of pervasive inequities. To date, population-based studies have not explicitly examined the relationship between sexism and CVD but smaller studies have yielded fairly consistent results. It is suggested that future research should aim to examine the influence of two types of sexism (i.e., hostile and benevolent) and that daily or within-day designs be employed to assess cognitive, behavioral, and physiological responses to everyday sexist experiences. PMID:25054736

  3. Factors Influencing Health Beliefs Among People in South West ...

    African Journals Online (AJOL)

    Administrator

    Items 9 - 16 ... Similarly, a natural phenomenon, e.g., ... disasters, crop failures and theft, or loss) in which ill-health is ... are blamed on conflicts with spouses, children, family, friends, ..... cohort effects and influence of western education on their.

  4. Bridging the gaps in the Health Management Information System in the context of a changing health sector

    Directory of Open Access Journals (Sweden)

    Nyamtema Angelo S

    2010-06-01

    Full Text Available Abstract Background The Health Management Information System (HMIS is crucial for evidence-based policy-making, informed decision-making during planning, implementation and evaluation of health programs; and for appropriate use of resources at all levels of the health system. This study explored the gaps and factors influencing HMIS in the context of a changing health sector in Tanzania. Methods A cross sectional descriptive study was conducted in 11 heath facilities in Kilombero district between January and February 2008. A semi-structured questionnaire was used to interview 43 health workers on their knowledge, attitude, practice and factors for change on HMIS and HMIS booklets from these facilities were reviewed for completeness. Results Of all respondents, 81% had never been trained on HMIS, 65% did not properly define this system, 54% didn't know who is supposed to use the information collected and 42% did not use the collected data for planning, budgeting and evaluation of services provision. Although the attitude towards the system was positive among 91%, the reviewed HMIS booklets were never completed in 25% - 55% of the facilities. There were no significant differences in knowledge, attitude and practice on HMIS between clinicians and nurses. The most common type of HMIS booklets which were never filled were those for deliveries (55%. The gaps in the current HMIS were linked to lack of training, inactive supervision, staff workload pressure and the lengthy and laborious nature of the system. Conclusions This research has revealed a state of poor health data collection, lack of informed decision-making at the facility level and the factors for change in the country's HMIS. It suggests need for new innovations including incorporation of HMIS in the ongoing reviews of the curricula for all cadres of health care providers, development of more user-friendly system and use of evidence-based John Kotter's eight-step process for implementing

  5. A qualitative evaluation of medication management services in six Minnesota health systems.

    Science.gov (United States)

    Sorensen, Todd D; Pestka, Deborah; Sorge, Lindsay A; Wallace, Margaret L; Schommer, Jon

    2016-03-01

    The initiation, establishment, and sustainability of medication management programs in six Minnesota health systems are described. Six Minnesota health systems with well-established medication management programs were invited to participate in this study: Essentia Health, Fairview Health Services, HealthPartners, Hennepin County Medical Center, Mayo Clinic, and Park Nicollet Health Services. Qualitative methods were employed by conducting group interviews with key staff from each institution who were influential in the development of medication management services within their organization. Kotter's theory of eight steps for leading organizational change served as the framework for the question guide. The interviews were audio recorded, transcribed, and analyzed for recurring and emergent themes. A total of 13 distinct themes were associated with the successful integration of medication management services across the six healthcare systems. Identified themes clustered within three stages of Kotter's model for leading organizational change: creating a climate for change, engaging and enabling the whole organization, and implementing and sustaining change. The 13 themes included (1) external influences, (2) pharmacists as an untapped resource, (3) principles and professionalism, (4) organizational culture, (5) momentum champions, (6) collaborative relationships, (7) service promotion, (8) team-based care, (9) implementation strategies, (10) overcoming challenges, (11) supportive care model process, (12) measuring and reporting results, and (13) sustainability strategies. A qualitative survey of six health systems that successfully implemented medication management services in ambulatory care clinics revealed that a supportive culture and team-based collaborative care are among the themes identified as necessary for service sustainability. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  6. Health related quality of life and influencing factors among welders.

    Directory of Open Access Journals (Sweden)

    Jingxiang Qin

    Full Text Available BACKGROUND: Occupational exposure to welding fumes is a serious occupational health problem all over the world. Welders are exposed to many occupational hazards; these hazards might cause some occupational diseases. The aim of the study was to assess the health related quality of life (HRQL of electric welders in Shanghai China and explore influencing factors to HRQL of welders. METHODS: 301 male welders (without pneumoconiosis and 305 non-dust male workers in Shanghai were enrolled in this study. Short Form-36 (SF-36 health survey questionnaires were applied in this cross-sectional study. Socio-demographic, working and health factors were also collected. Multiple stepwise regress analysis was used to identify significant factors related to the eight dimension scores. RESULTS: Six dimensions including role-physical (RP, bodily pain (BP, general health (GH, validity (VT, social function (SF, and mental health (MH were significantly worse in welders compared to non-dust workers. Multiple stepwise regress analysis results show that native place, monthly income, quantity of children, drinking, sleep time, welding type, use of personal protective equipment (PPE, great events in life, and some symptoms including dizziness, discomfort of cervical vertebra, low back pain, cough and insomnia may be influencing factors for HRQL of welders. Among these factors, only sleep time and the use of PPE were salutary. CONCLUSIONS: Some dimensions of HRQL of these welders have been affected. Enterprises which employ welders should take measures to protect the health of these people and improve their HRQL.

  7. Using Behavior Over Time Graphs to Spur Systems Thinking Among Public Health Practitioners.

    Science.gov (United States)

    Calancie, Larissa; Anderson, Seri; Branscomb, Jane; Apostolico, Alexsandra A; Lich, Kristen Hassmiller

    2018-02-01

    Public health practitioners can use Behavior Over Time (BOT) graphs to spur discussion and systems thinking around complex challenges. Multiple large systems, such as health care, the economy, and education, affect chronic disease rates in the United States. System thinking tools can build public health practitioners' capacity to understand these systems and collaborate within and across sectors to improve population health. BOT graphs show a variable, or variables (y axis) over time (x axis). Although analyzing trends is not new to public health, drawing BOT graphs, annotating the events and systemic forces that are likely to influence the depicted trends, and then discussing the graphs in a diverse group provides an opportunity for public health practitioners to hear each other's perspectives and creates a more holistic understanding of the key factors that contribute to a trend. We describe how BOT graphs are used in public health, how they can be used to generate group discussion, and how this process can advance systems-level thinking. Then we describe how BOT graphs were used with groups of maternal and child health (MCH) practitioners and partners (N = 101) during a training session to advance their thinking about MCH challenges. Eighty-six percent of the 84 participants who completed an evaluation agreed or strongly agreed that they would use this BOT graph process to engage stakeholders in their home states and jurisdictions. The BOT graph process we describe can be applied to a variety of public health issues and used by practitioners, stakeholders, and researchers.

  8. The Influence Of Organizational Culture On Management Information System

    Directory of Open Access Journals (Sweden)

    Arlis Dewi Kuraesin

    2017-03-01

    Full Text Available This article aims to know the culture of the organization and management accounting information system based on existing theories. The management information system is a collection of sub-systems which are interconnected with each other to work together in harmony to achieve one goal of process data into information needed by management in decision making. An important factor influencing the use of information systems is Cultural Organization. Management Information system success is influenced by several factors one of which is the organizations culture. Organizational culture has a very strong influence on the overall organizational and individual behavior due to the information system is a major component of the organization are influenced substantially by organizational culture.

  9. ‘BRICS without straw’? A systematic literature review of newly emerging economies’ influence in global health

    Science.gov (United States)

    2013-01-01

    Background Since 2010, five newly emerging economies collectively known as ‘BRICS’ (Brazil, India, Russia, China and South Africa) have caught the imagination, and scholarly attention, of political scientists, economists and development specialists. The prospect of a unified geopolitical bloc, consciously seeking to re-frame international (and global) health development with a new set of ideas and values, has also, if belatedly, begun to attract the attention of the global health community. But what influence, if any, do the BRICS wield in global health, and, if they do wield influence, how has that influence been conceptualized and recorded in the literature? Methods We conducted a systematic literature review in (March-December 2012) of documents retrieved from the databases EMBASE, PubMed/Medline, Global Health, and Google Scholar, and the websites of relevant international organisations, research institutions and philanthropic organisations. The results were synthesised using a framework of influence developed for the review from the political science literature. Results Our initial search of databases and websites yielded 887 documents. Exclusion criteria narrowed the number of documents to 71 journal articles and 23 reports. Two researchers using an agreed set of inclusion criteria independently screened the 94 documents, leaving just 7 documents. We found just one document that provided sustained analysis of the BRICS’ collective influence; the overwhelming tendency was to describe individual BRICS countries influence. Although influence was predominantly framed by BRICS countries’ material capability, there were examples of institutional and ideational influence - particularly from Brazil. Individual BRICS countries were primarily ‘opportunity seekers’ and region mobilisers but with potential to become ‘issue leaders’ and region organisers. Conclusion Though small in number, the written output on BRICS influence in global health has

  10. Integrated Systems Health Management for Intelligent Systems

    Science.gov (United States)

    Figueroa, Fernando; Melcher, Kevin

    2011-01-01

    The implementation of an integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive at an accurate and reliable assessment of its health. In this paper, concepts, procedures, and approaches are presented as a foundation for implementing an intelligent systems ]relevant ISHM capability. The capability stresses integration of DIaK from all elements of a system. Both ground-based (remote) and on-board ISHM capabilities are compared and contrasted. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems.

  11. Strengthening Rehabilitation in Health Systems Worldwide by Integrating Information on Functioning in National Health Information Systems.

    Science.gov (United States)

    Stucki, Gerold; Bickenbach, Jerome; Melvin, John

    2017-09-01

    A complete understanding of the experience of health requires information relevant not merely to the health indicators of mortality and morbidity but also to functioning-that is, information about what it means to live in a health state, "the lived experience of health." Not only is functioning information relevant to healthcare and the overall objectives of person-centered healthcare but to the successful operation of all components of health systems.In light of population aging and major epidemiological trends, the health strategy of rehabilitation, whose aim has always been to optimize functioning and minimize disability, will become a key health strategy. The increasing prominence of the rehabilitative strategy within the health system drives the argument for the integration of functioning information as an essential component in national health information systems.Rehabilitation professionals and researchers have long recognized in WHO's International Classification of Functioning, Disability and Health the best prospect for an internationally recognized, sufficiently complete and powerful information reference for the documentation of functioning information. This paper opens the discussion of the promise of integrating the ICF as an essential component in national health systems to secure access to functioning information for rehabilitation, across health systems and countries.

  12. Interrogating resilience in health systems development.

    Science.gov (United States)

    van de Pas, Remco; Ashour, Majdi; Kapilashrami, Anuj; Fustukian, Suzanne

    2017-11-01

    The Fourth Global Symposium on Health Systems Research was themed around 'Resilient and responsive health systems for a changing world.' This commentary is the outcome of a panel discussion at the symposium in which the resilience discourse and its use in health systems development was critically interrogated. The 2014-15 Ebola outbreak in West-Africa added momentum for the wider adoption of resilient health systems as a crucial element to prepare for and effectively respond to crisis. The growing salience of resilience in development and health systems debates can be attributed in part to development actors and philanthropies such as the Rockefeller Foundation. Three concerns regarding the application of resilience to health systems development are discussed: (1) the resilience narrative overrules certain democratic procedures and priority setting in public health agendas by 'claiming' an exceptional policy space; (2) resilience compels accepting and maintaining the status quo and excludes alternative imaginations of just and equitable health systems including the socio-political struggles required to attain those; and (3) an empirical case study from Gaza makes the case that resilience and vulnerability are symbiotic with each other rather than providing a solution for developing a strong health system. In conclusion, if the normative aim of health policies is to build sustainable, universally accessible, health systems then resilience is not the answer. The current threats that health systems face demand us to imagine beyond and explore possibilities for global solidarity and justice in health. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. The influence of social anchorage on the gender difference in the use of mental health services.

    Science.gov (United States)

    Drapeau, Aline; Boyer, Richard; Lesage, Alain

    2009-07-01

    Overall, women are more likely than men to seek professional care when they face light or moderate mental health problems. This difference is usually attributed to culture-related factors, but neither women nor men form a homogeneous cultural group. The help-seeking behavior may reflect not only the cultural values and expectations associated with a specific gender but also those associated with specific social roles endorsed by women and men. In addition, the influence of these culture-related factors on the help-seeking behavior is constrained by barriers to care, which apply similarly to women and men. In consequence, the gender difference in the use of mental health services should vary across social roles and types of service. This hypothesis was tested on data from the cycle 1.2 of the Canadian Community Health Survey. Logistic regression analyses show that, although women are more likely than men to use mental health services, this gender difference is larger for general services than for psychiatric and psychological services whose access in Canada is constrained, respectively, by systemic and financial barriers to care. They also suggest that holding the role of worker tends to foster the use of psychological services in women, especially in married women, and to a lesser degree in men, whereas it tends to hinder the use of general and psychiatric services in men but to exert no or less influence in women. Thus, professional anchorage seems to be an important source of the societal norms that influence the decision of women and men to seek or not to seek medical care for mental health problems.

  14. Bioaerosols in the Earth system: Climate, health, and ecosystem interactions

    Energy Technology Data Exchange (ETDEWEB)

    Fröhlich-Nowoisky, Janine; Kampf, Christopher J.; Weber, Bettina; Huffman, J. Alex; Pöhlker, Christopher; Andreae, Meinrat O.; Lang-Yona, Naama; Burrows, Susannah M.; Gunthe, Sachin S.; Elbert, Wolfgang; Su, Hang; Hoor, Peter; Thines, Eckhard; Hoffmann, Thorsten; Després, Viviane R.; Pöschl, Ulrich

    2016-12-01

    Aerosols of biological origin play a vital role in the Earth system, particularly in the in-teractions between atmosphere, biosphere, climate, and public health. Airborne bacteria, fungal spores, pollen, and other bioparticles are essential for the reproduction and spread of organisms across various ecosystems, and they can cause or enhance human, animal, and plant diseases. Moreover, they can serve as nuclei for cloud droplets, ice crystals, and precipitation, thus influencing the hydrological cycle and climate. The actual formation, abundance, composition, and effects of biological aerosols and the atmospheric microbi-ome are, however, not yet well characterized and constitute a large gap in the scientific understanding of the interaction and co-evolution of life and climate in the Earth system. This review presents an overview of the state of bioaerosol research and highlights recent advances in terms of bioaerosol identification, characterization, transport, and transfor-mation processes, as well as their interactions with climate, health, and ecosystems, focus-ing on the role bioaerosols play in the Earth system.

  15. Public health systems under attack in Canada: Evidence on public health system performance challenges arbitrary reform.

    Science.gov (United States)

    Guyon, Ak'ingabe; Perreault, Robert

    2016-10-20

    Public health is currently being weakened in several Canadian jurisdictions. Unprecedented and arbitrary cuts to the public health budget in Quebec in 2015 were a striking example of this. In order to support public health leaders and citizens in their capacity to advocate for evidence-informed public health reforms, we propose a knowledge synthesis of elements of public health systems that are significantly associated with improved performance. Research consistently and significantly associates four elements of public health systems with improved productivity: 1) increased financial resources, 2) increased staffing per capita, 3) population size between 50,000 and 500,000, and 4) specific evidence-based organizational and administrative features. Furthermore, increased financial resources and increased staffing per capita are significantly associated with improved population health outcomes. We contend that any effort at optimization of public health systems should at least be guided by these four evidence-informed factors. Canada already has existing capacity in carrying out public health systems and services research. Further advancement of our academic and professional expertise on public health systems will allow Canadian public health jurisdictions to be inspired by the best public health models and become stronger advocates for public health's resources, interventions and outcomes when they need to be celebrated or defended.

  16. Open architecture for health care systems: the European RICHE experience.

    Science.gov (United States)

    Frandji, B

    1997-01-01

    Groupe RICHE is bringing to the market of health IT the Open Systems approach allowing a new generation of health information systems to arise with benefit for patients, health care professionals, hospital managers, agencies and citizens. Groupe RICHE is a forum for exchanging information, expertise around open systems in health care. It is open to any organisation interested by open systems in health care and wanting to participate and influence the work done by its user, marketing and technical committees. The Technical Committee is in charge of the maintenance of the architecture and impact the results of industrial experiences on new releases. Any Groupe RICHE member is entitled to participate to this process. This unique approach in Europe allows health care professionals to benefit from applications supporting their business processes, including providing a cooperative working environment, a shared electronic record, in an integrated system where the information is entered only once, customised according to the user needs and available to the administrative applications. This allows Hospital managers to satisfy their health care professionals, to smoothly migrate from their existing environment (protecting their investment), to choose products in a competitive environment, being able to mix and match system components and services from different suppliers, being free to change suppliers without having to replace their existing system (minimising risk), in line with national and regional strategies. For suppliers, this means being able to commercialise products well fitted to their field of competence in a large market, reducing investments and increasing returns. The RICHE approach also allows agencies to define a strategy, allowing to create a supporting infrastructure, organising the market leaving enough freedom to health care organisations and suppliers. Such an approach is based on the definition of an open standard architecture. The RICHE esprit project

  17. System health monitoring

    International Nuclear Information System (INIS)

    Reneke, J.A.; Fryer, M.O.

    1995-01-01

    Well designed large systems include many instrument taking data. These data are used in a variety of ways. They are used to control the system and its components, to monitor system and component health, and often for historical or financial purposes. This paper discusses a new method of using data from low level instrumentation to monitor system and component health. The method uses the covariance of instrument outputs to calculate a measure of system change. The method involves no complicated modeling since it is not a parameter estimation algorithm. The method is iterative and can be implemented on a computer in real time. Examples are presented for a metal lathe and a high efficiency particulate air (HEPA) filter. It is shown that the proposed method is quite sensitive to system changes such as wear out and failure. The method is useful for low level system diagnostics and fault detection

  18. Military Health System Transformation Implications on Health Information Technology Modernization.

    Science.gov (United States)

    Khan, Saad

    2018-03-01

    With the recent passage of the National Defense Authorization Act for Fiscal Year 2017, Congress has triggered groundbreaking Military Health System organizational restructuring with the Defense Health Agency assuming responsibility for managing all hospitals and clinics owned by the Army, Navy, and Air Force. This is a major shift toward a modern value-based managed care system, which will require much greater military-civilian health care delivery integration to be in place by October 2018. Just before the National Defense Authorization Act for Fiscal Year 2017 passage, the Department of Defense had already begun a seismic shift and awarded a contract for the new Military Health System-wide electronic health record system. In this perspective, we discuss the implications of the intersection of two large-scope and large-scale initiatives, health system transformation, and information technology modernization, being rolled out in the largest and most complex federal agency and potential risk mitigating steps. The Military Health System will require an expanded unified clinical leadership to spearhead short-term transformation; furthermore, developing, organizing, and growing a cadre of informatics expertise to expand the use and diffusion of novel solutions such as health information exchanges, data analytics, and others to transcend organizational barriers are still needed to achieve the long-term aim of health system reform as envisioned by the National Defense Authorization Act for Fiscal Year 2017.

  19. Gender differences in the influence of economic, lifestyle, and psychosocial factors on later-life health.

    Science.gov (United States)

    Prus, Steven G; Gee, Ellen

    2003-01-01

    Gender differences in exposure to social resources play a significant role in influencing gender inequalities in health. A related question--and our focus--asks whether these inequalities are also influenced by gendered vulnerabilities to social forces. Specifically, this paper examines the differential impact of social forces on the health of elderly (65+) men and women. Multiple linear regression analysis is used to estimate gender differences in the influence of socioeconomic, lifestyle, and psychosocial factors on both self-rated health and overall functional health using data from the 1994-1995 National Population Health Survey. Key findings include: 1) the relationship between income and health is significant for older women only, whereas the converse holds for education; 2) having an acceptable body weight is positively associated with health for elderly women only; and 3) stress-related factors are stronger determinants of health for older women. Our findings shed light on the processes of healthy aging for men and women, and suggest that interventions to improve the health of elderly Canadians need to be gender-specific.

  20. Mobile technologies and geographic information systems to improve health care systems: a literature review.

    Science.gov (United States)

    Nhavoto, José António; Grönlund, Ake

    2014-05-08

    A growing body of research has employed mobile technologies and geographic information systems (GIS) for enhancing health care and health information systems, but there is yet a lack of studies of how these two types of systems are integrated together into the information infrastructure of an organization so as to provide a basis for data analysis and decision support. Integration of data and technical systems across the organization is necessary for efficient large-scale implementation. The aim of this paper is to identify how mobile technologies and GIS applications have been used, independently as well as in combination, for improving health care. The electronic databases PubMed, BioMed Central, Wiley Online Library, Scopus, Science Direct, and Web of Science were searched to retrieve English language articles published in international academic journals after 2005. Only articles addressing the use of mobile or GIS technologies and that met a prespecified keyword strategy were selected for review. A total of 271 articles were selected, among which 220 concerned mobile technologies and 51 GIS. Most articles concern developed countries (198/271, 73.1%), and in particular the United States (81/271, 29.9%), United Kingdom (31/271, 11.4%), and Canada (14/271, 5.2%). Applications of mobile technologies can be categorized by six themes: treatment and disease management, data collection and disease surveillance, health support systems, health promotion and disease prevention, communication between patients and health care providers or among providers, and medical education. GIS applications can be categorized by four themes: disease surveillance, health support systems, health promotion and disease prevention, and communication to or between health care providers. Mobile applications typically focus on using text messaging (short message service, SMS) for communication between patients and health care providers, most prominently reminders and advice to patients. These

  1. The impact of BPO on cost reduction in mid-sized health care systems.

    Science.gov (United States)

    Perry, Andy; Kocakülâh, Mehmet C

    2010-01-01

    At the convergence of two politico-economic "hot topics" of the day--outsourcing and the cost of health care-lie opportunities for mid-sized health systems to innovate, collaborate, and reduce overhead. Competition in the retail health care market can serve as both an impetus and an inhibitor to such measures, though. Here we are going to address the motivations, influences, opportunities, and limitations facing mid-sized, US non-profit health systems in business process outsourcing (BPO). Advocates cite numerous benefits to BPO, particularly in cost reduction and strategy optimization. BPO can elicit cost savings due to specialization among provider firms, returns to scale and technology, standardization and automation, and gains in resource arbitrage (off-shoring capabilities). BPO can also free an organization of non-critical tasks and focus resources on core competencies (treating patients). The surge in BPO utilization has rarely extended to the back-office functions of many mid-sized health systems. Health care providers, still a largely fragmented bunch with many rural, independent non-profit systems, have not experienced the consolidation and organizational scale growth to make BPO as attractive as other industries. Smaller firms, spurning merger and acquisition pressure from large, tertiary health systems, often wish to retain their autonomy and identity; hence, they face a competitive cost disadvantage compared to their larger competitors. This article examines the functional areas for these health systems in which BPO is not currently utilized and dissects the various methods available in which to practice BPO. We assess the ongoing adoption of BPO in these areas as well as the barriers to adoption, and identify the key processes that best represent opportunity for success. An emphasis is placed on a collaborative model with other health systems compared to a single system, unilateral BPO arrangement.

  2. Mental Health Mobile Apps: From Infusion to Diffusion in the Mental Health Social System.

    Science.gov (United States)

    East, Marlene Lynette; Havard, Byron C

    2015-01-01

    The roles of mental health educators and professionals in the diffusion of mental health mobile apps are addressed in this viewpoint article. Mental health mobile apps are emerging technologies that fit under the broad heading of mobile health (mHealth). mHealth, encompassed within electronic health (eHealth), reflects the use of mobile devices for the practice of public health. Well-designed mental health mobile apps that present content in interactive, engaging, and stimulating ways can promote cognitive learning, personal growth, and mental health enhancement. As key influencers in the mental health social system, counselor educators and professional associations may either help or hinder diffusion of beneficial mHealth technologies. As mental health mobile apps move towards ubiquity, research will continue to be conducted. The studies published thus far, combined with the potential of mental health mobile apps for learning and personal growth, offer enough evidence to compel mental health professionals to infuse these technologies into education and practice. Counselor educators and professional associations must use their influential leadership roles to train students and practitioners in how to research, evaluate, and integrate mental health mobile apps into practice. The objectives of this article are to (1) increase awareness of mHealth and mental health mobile apps, (2) demonstrate the potential for continued growth in mental health mobile apps based on technology use and acceptance theory, mHealth organizational initiatives, and evidence about how humans learn, (3) discuss evidence-based benefits of mental health mobile apps, (4) examine the current state of mHealth diffusion in the mental health profession, and (5) offer solutions for impelling innovation diffusion by infusing mental health mobile apps into education, training, and clinical settings. This discussion has implications for counselor educators, mental health practitioners, associations

  3. Health-system reform and universal health coverage in Latin America.

    Science.gov (United States)

    Atun, Rifat; de Andrade, Luiz Odorico Monteiro; Almeida, Gisele; Cotlear, Daniel; Dmytraczenko, T; Frenz, Patricia; Garcia, Patrícia; Gómez-Dantés, Octavio; Knaul, Felicia M; Muntaner, Carles; de Paula, Juliana Braga; Rígoli, Felix; Serrate, Pastor Castell-Florit; Wagstaff, Adam

    2015-03-28

    Starting in the late 1980s, many Latin American countries began social sector reforms to alleviate poverty, reduce socioeconomic inequalities, improve health outcomes, and provide financial risk protection. In particular, starting in the 1990s, reforms aimed at strengthening health systems to reduce inequalities in health access and outcomes focused on expansion of universal health coverage, especially for poor citizens. In Latin America, health-system reforms have produced a distinct approach to universal health coverage, underpinned by the principles of equity, solidarity, and collective action to overcome social inequalities. In most of the countries studied, government financing enabled the introduction of supply-side interventions to expand insurance coverage for uninsured citizens--with defined and enlarged benefits packages--and to scale up delivery of health services. Countries such as Brazil and Cuba introduced tax-financed universal health systems. These changes were combined with demand-side interventions aimed at alleviating poverty (targeting many social determinants of health) and improving access of the most disadvantaged populations. Hence, the distinguishing features of health-system strengthening for universal health coverage and lessons from the Latin American experience are relevant for countries advancing universal health coverage. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. The influence of prison climate on the mental health of adult prisoners: a literature review.

    Science.gov (United States)

    Goomany, A; Dickinson, T

    2015-08-01

    Little is known about how the prison environment may impact upon the mental health of adult prisoners. This paper highlights that prisoners perceive that the prison environment has a negative influence upon their mental health. However, a small number regarded prison as a place of respite, which afforded structure and an opportunity to access health services. There is a need for more research in this area specifically relating to the impact the prison climate may have upon those from black and minority ethic groups. Nurses must recognize the aspects of the prison environment that may impact upon the mental health of prisoners and demonstrate innovation and imagination in their application of interventions. Little is known regarding how the prison environment may affect the mental health of adult prisoners. Consequently, there is a need to investigate how this setting may exacerbate mental distress among this community. This literature review explores how the prison climate influences the mental health of adult prisoners. A thematic synthesis approach was used to elicit data relating to the aspects of the prison climate, which influence the mental health of prisoners. Four primary themes emerged from the synthesis: social, emotional, organizational and physical aspects. Prisoners perceive the prison climate to have a negative influence upon their mental health. However, perceived positively, prison was regarded as a place of respite, which afforded structure and an opportunity to access health services. There is limited research available specifically exploring the potential impact of the prison climate upon those from black and ethnic minorities groups. Nurses must recognize the aspects of the prison environment that may impact upon the mental health of prisoners and demonstrate innovation and imagination in their application of interventions. Additionally nurses need to take an active role in influencing and structuring the political agenda, which governs the

  5. factors influencing the choice of health care providing facility among

    African Journals Online (AJOL)

    In the public sector ... Objectives: This study aimed to assess the factors influencing choice and satisfaction with health service providers among local ... the consumer of healthcare services cannot control. ..... Acquisition of Stable Food.

  6. Biological, psychological and social processes that explain celebrities' influence on patients' health-related behaviors.

    Science.gov (United States)

    Hoffman, Steven J; Tan, Charlie

    2015-01-01

    Celebrities can have substantial influence as medical advisors. However, their impact on public health is equivocal: depending on the advice's validity and applicability, celebrity engagements can benefit or hinder efforts to educate patients on evidence-based practices and improve their health literacy. This meta-narrative analysis synthesizes multiple disciplinary insights explaining the influence celebrities have on people's health-related behaviors. Systematic searches of electronic databases BusinessSource Complete, Communication & Mass Media Complete, Humanities Abstracts, ProQuest Political Science, PsycINFO, PubMed, and Sociology Abstracts were conducted. Retrieved articles were used to inform a conceptual analysis of the possible processes accounting for the substantial influence celebrities may have as medical advisors. Fourteen mechanisms of celebrity influence were identified. According to the economics literature, celebrities distinguish endorsed items from competitors and can catalyze herd behavior. Marketing studies tell us that celebrities' characteristics are transferred to endorsed products, and that the most successful celebrity advisors are those viewed as credible, a perception they can create with their success. Neuroscience research supports these explanations, finding that celebrity endorsements activate brain regions involved in making positive associations, building trust and encoding memories. The psychology literature tells us that celebrity advice conditions people to react positively toward it. People are also inclined to follow celebrities if the advice matches their self-conceptions or if not following it would generate cognitive dissonance. Sociology explains how celebrities' advice spreads through social networks, how their influence is a manifestation of people's desire to acquire celebrities' social capital, and how they affect the ways people acquire and interpret health information. There are clear and deeply rooted biological

  7. The Netherlands: health system review

    NARCIS (Netherlands)

    Schäfer, W.; Kroneman, M.; Boerma, W.; van den Berg, M.; Westert, G.; Devillé, W.; van Ginneken, E.

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of health systems and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of

  8. Identifying Twitter influencer profiles for health promotion in Saudi Arabia.

    Science.gov (United States)

    Albalawi, Yousef; Sixsmith, Jane

    2017-06-01

    New media platforms, such as Twitter, provide the ideal opportunity to positively influence the health of large audiences. Saudi Arabia has one of the highest number of Twitter users of any country, some of whom are very influential in setting agendas and contributing to the dissemination of ideas. Those opinion leaders, both individuals and organizations, influential in the new media environment have the potential to raise awareness of health issues, advocate for health and potentially instigate change at a social level. To realize the potential of the new media platforms for public health, the function of opinion leaders is key. This study aims to identify and profile the most influential Twitter accounts in Saudi Arabia. Multiple measures, including: number of followers and four influence scores, were used to evaluate Twitter accounts. The data were then filtered and analysed using ratio and percentage calculations to identify the most influential users. In total, 99 Saudi Twitter accounts were classified, resulting in the identification of 25 religious men/women, 16 traditional media, 14 sports related, 10 new media, 6 political, 6 company and 4 health accounts. The methods used to identify the key influential Saudi accounts can be applied to inform profile development of Twitter users in other countries. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Factors Influencing Compliance and Health Seeking Behaviour for Hypertension in Mukono and Buikwe in Uganda: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Geofrey Musinguzi

    2018-01-01

    Full Text Available Background and Methods. Hypertension is a global public health challenge and a leading risk factor for cardiovascular morbidity and mortality. Hypertension control rates are low worldwide, and delay in seeking care is associated with increased mortality. Methods. In a qualitative study, known hypertensive patients were interviewed to explore factors influencing compliance and health seeking behaviour (HSB. Data was analyzed following a semantic thematic analysis approach. Results. Patients sought various channels of care for their hypertension. Self-medication and access to antihypertensive drugs with or without prescription were common as well as use of herbal remedies. Regular monitoring of blood pressure was not a common practice. Factors influencing HSB were related to health systems and the patient socioeconomic and structural environment. The main system issues were related to availability and attitudes of staff and shortage of supplies and medicines. The patient factors were related to awareness, perceived severity, perceived effectiveness of therapy, adverse effects, and perceived fears of lifelong dependence on medicines. The patient socioeconomic status played a role as did the marketing of traditional medicine. Conclusion. Patients seek varied channels of care for their hypertension. Strategies to address the multifactorial dimensions that affect HSB are needed to improve hypertension control in this population.

  10. (PLWHA): influence of social support, self-esteem, health locus

    African Journals Online (AJOL)

    Coping among people living with HIV/AIDS (PLWHA): influence of social support, self-esteem, health locus of control and gender. ... approach, social support should be in the front burner, society should be sensitized to the importance of social support that is culturally appropriate and behaviour modification focused.

  11. Introduction on health recommender systems.

    Science.gov (United States)

    Sanchez-Bocanegra, C L; Sanchez-Laguna, F; Sevillano, J L

    2015-01-01

    People are looking for appropriate health information which they are concerned about. The Internet is a great resource of this kind of information, but we have to be careful if we don't want to get harmful info. Health recommender systems are becoming a new wave for apt health information as systems suggest the best data according to the patients' needs.The main goals of health recommender systems are to retrieve trusted health information from the Internet, to analyse which is suitable for the user profile and select the best that can be recommended, to adapt their selection methods according to the knowledge domain and to learn from the best recommendations.A brief definition of recommender systems will be given and an explanation of how are they incorporated in the health sector. A description of the main elementary recommender methods as well as their most important problems will also be made. And, to finish, the state of the art will be described.

  12. Efficiency of health care system at the sub-state level in Madhya Pradesh, India.

    Science.gov (United States)

    Purohit, Brijesh C

    2010-01-01

    This paper attempts a sub-state-level analysis of health system for a low-income Indian state, namely, Madhya Pradesh. The objective of our study is to establish efficiency parameters that may help health policy makers to improve district-level and thus state-level health system performance. It provides an idealized yardstick to evaluate the performance of the health sector by using stochastic frontier technique. The study was carried out in two stages of estimation, and our results suggest that life expectancy in the Indian state could be enhanced considerably by correcting the factors that are adversely influencing sub-state-level health system efficiency. Our results indicate that main factors within the health system for discrepancy in interdistrict performance are inequitable distribution of supplies, availability of skilled attention at birth, and inadequate staffing relative to patient load of rural population at primary health centers. Overcoming these factors through additional resources in the deficient districts, mobilized partly from grants in aid and partly from patient welfare societies, may help the state to improve life expectancy speedily and more equitably. Besides the direct inputs from the health sector, a more conducive environment for gender development, reducing inequality in opportunities for women in health, education and other rights may provide the necessary impetus towards reducing maternal morbidity and mortality and add to overall life expectancy in the state.

  13. Health information systems to improve health care: A telemedicine case study

    Directory of Open Access Journals (Sweden)

    Liezel Cilliers

    2013-03-01

    Full Text Available Background: E-health has been identified as an integral part of the future of South African public healthcare. Telemedicine was first introduced in South Africa in 1997 and since then the cost of running the Telemedicine projects has increased substantially. Despite these efforts to introduce the system, only 34% of the Telemedicine sites in South Africa are functional at present. Objectives: Literature has suggested that one of the barriers to the successful implementation of health information systems is the user acceptance by health care workers of systems such as Telemedicine. This study investigated the user acceptance of Telemedicine in the public health care system in the Eastern Cape Province, making use of the Unified Theory of the Use and Acceptance of Technology. Method: The study employed a quantitative survey approach. A questionnaire was developed making use of existing literature and was distributed to various clinics around the province where Telemedicine has been implemented. Statistics were produced making use of Statistical Package for the Social Sciences (SPSS. Results: In general, the health care workers did understand the value and benefit of health information systems to improve the effectiveness and efficiency of the health care system. The barriers to the effective implementation of a health information system include the lack of knowledge and the lack of awareness regarding the Telemedicine system. This in turn means that the user is apprehensive when making use of the system thus contributing to less frequent usage. Conclusion: Health care workers do acknowledge that information systems can help to increase the effectiveness of the health care system. In general, the acceptance of Telemedicine in the Eastern Cape Department of Health is positive, but in order to integrate it into standard work practices, more must be done with regards to the promotion and education of telemedicine.

  14. The role of health system governance in strengthening the rural health insurance system in China.

    Science.gov (United States)

    Yuan, Beibei; Jian, Weiyan; He, Li; Wang, Bingyu; Balabanova, Dina

    2017-05-23

    Systems of governance play a key role in the operation and performance of health systems. In the past six decades, China has made great advances in strengthening its health system, most notably in establishing a health insurance system that enables residents of rural areas to achieve access to essential services. Although there have been several studies of rural health insurance schemes, these have focused on coverage and service utilization, while much less attention has been given to the role of governance in designing and implementing these schemes. Information from publications and policy documents relevant to the development of two rural health insurance policies in China was obtained, analysed, and synthesise. 92 documents on CMS (Cooperative Medical Scheme) or NCMS (New Rural Cooperative Medical Scheme) from four databases searched were included. Data extraction and synthesis of the information were guided by a framework that drew on that developed by the WHO to describe health system governance and leadership. We identified a series of governance practices that were supportive of progress, including the prioritisation by the central government of health system development and certain health policies within overall national development; strong government commitment combined with a hierarchal administrative system; clear policy goals coupled with the ability for local government to adopt policy measures that take account of local conditions; and the accumulation and use of the evidence generated from local practices. However these good practices were not seen in all governance domains. For example, poor collaboration between different government departments was shown to be a considerable challenge that undermined the operation of the insurance schemes. China's success in achieving scale up of CMS and NCMS has attracted considerable interest in many low and middle income countries (LMICs), especially with regard to the schemes' designs, coverage, and funding

  15. [Mental health status in railway female workers and its occupational influencing factors].

    Science.gov (United States)

    Ji, F L; Liu, Z M; Liu, Z S; Zou, J F; Yu, W L; Li, H M; Li, J; Kong, L M; Jiang, Q

    2018-02-20

    Objective: To investigate the mental health status of railway female workers and related influencing factors, and to provide a scientific strategy for labor protection regulations in railway female workers. Methods: Cluster sampling was used to select 5033 female workers from Jinan, Nanning, Qinghai-Tibet, and Wuhan railway systems in China from January to August, 2016. A uniform reproductive health questionnaire, as well as the Symptom Checklist-90 (SCL-90) , was used to investigate their general information (age, marital status, education level, and family income) , work type (day shift, night shift, or work on shift) , work position, and the presence or absence of exposure to occupational hazardous factors. The score on each factor of SCL-90 and the positive rate of mental health status were calculated. Results: The positive rate of mental health status was 10.6% in railway female workers. The workers exposed to occupational hazardous factors had a significantly higher positive rate of mental health status than those not exposed to occupational hazardous factors (14.20% vs 8.02%, P mental health status between workers with different ages, marital status, education levels, histories of abortion, or annual family income levels ( P mental health problems ( OR =1.797, 95% CI : 1.393-2.318; OR =0.641, 95% CI : 0.498-0.827; OR =0.586, 95% CI : 0.439-0.783; OR =0.580, 95% CI : 0.378-0.890) . Conclusion: Railway female workers have lower levels of mental health than the general population and are under significant occupational stress. Exposure to occupational hazardous factors, night shift, overwork, and carrying heavy objects are associated with the development of mental health problems in railway female workers.

  16. Influence of Maternal Health Literacy on Healthy Pregnancy and ...

    African Journals Online (AJOL)

    The present study investigated the influence of maternal health literacy on healthy pregnancy and pregnancy outcomes. It was carried out among 231 pregnant women and nursing mothers using the descriptive survey research design of the expost-facto type. Three hypotheses were tested by using pearson product moment ...

  17. Public Policy and Health Informatics.

    Science.gov (United States)

    Bell, Katherine

    2018-04-05

    To provide an overview of the history of electronic health policy and identify significant laws that influence health informatics. US Department of Health and Human Services. The development of health information technology has influenced the process for delivering health care. Public policy and regulations are an important part of health informatics and establish the structure of electronic health systems. Regulatory bodies of the government initiate policies to ease the execution of electronic health record implementation. These same bureaucratic entities regulate the system to protect the rights of the patients and providers. Nurses should have an overall understanding of the system behind health informatics and be able to advocate for change. Nurses can utilize this information to optimize the use of health informatics and campaign for safe, effective, and efficient health information technology. Copyright © 2018 Elsevier Inc. All rights reserved.

  18. Influence of 'soft' versus 'scientific' health information framing and contradictory information on consumers' health inferences and attitudes towards a food supplement

    DEFF Research Database (Denmark)

    Aschemann-Witzel, Jessica; Grunert, Klaus G

    2015-01-01

    It is a requirement that health claims be scientifically founded. However, their phrasing is criticised for being unappealing and cumbersome to communicate to consumers. Instead, it has been found that consumers respond favourably to non-scientifically phrased ‘soft’ health information. We aimed...... were presented in a between subjects experimental design conducted in the US and Denmark. Furthermore, respondents were shown mock-up media reports contradicting the earlier information and asked to repeat their assessment of health inferences and their attitude. This was done to assess how robust...... consumers’ health inferences and attitudes are in an environment of contradictory information. Results show that the soft information positively influences health inferences and attitudes in Denmark, while in the US, scientific information positively influences health inferences but not attitudes. Faced...

  19. A qualitative study of systemic influences on paramedic decision making: care transitions and patient safety.

    Science.gov (United States)

    O'Hara, Rachel; Johnson, Maxine; Siriwardena, A Niroshan; Weyman, Andrew; Turner, Janette; Shaw, Deborah; Mortimer, Peter; Newman, Chris; Hirst, Enid; Storey, Matthew; Mason, Suzanne; Quinn, Tom; Shewan, Jane

    2015-01-01

    Paramedics routinely make critical decisions about the most appropriate care to deliver in a complex system characterized by significant variation in patient case-mix, care pathways and linked service providers. There has been little research carried out in the ambulance service to identify areas of risk associated with decisions about patient care. The aim of this study was to explore systemic influences on decision making by paramedics relating to care transitions to identify potential risk factors. An exploratory multi-method qualitative study was conducted in three English National Health Service (NHS) Ambulance Service Trusts, focusing on decision making by paramedic and specialist paramedic staff. Researchers observed 57 staff across 34 shifts. Ten staff completed digital diaries and three focus groups were conducted with 21 staff. Nine types of decision were identified, ranging from emergency department conveyance and specialist emergency pathways to non-conveyance. Seven overarching systemic influences and risk factors potentially influencing decision making were identified: demand; performance priorities; access to care options; risk tolerance; training and development; communication and feedback and resources. Use of multiple methods provided a consistent picture of key systemic influences and potential risk factors. The study highlighted the increased complexity of paramedic decisions and multi-level system influences that may exacerbate risk. The findings have implications at the level of individual NHS Ambulance Service Trusts (e.g. ensuring an appropriately skilled workforce to manage diverse patient needs and reduce emergency department conveyance) and at the wider prehospital emergency care system level (e.g. ensuring access to appropriate patient care options as alternatives to the emergency department). © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  20. E-health, health systems and social innovation

    DEFF Research Database (Denmark)

    Brem, Alexander; Sliwa, Sophie Isabel; Agarwal, Nivedita

    2017-01-01

    This paper explores telecare as one of the practical applications in the field of e-health. Using 11 expert interviews the study evaluates development of cross-national analogies between the different institutional contexts of health systems in Germany, Austria, and Denmark. Telecare is treated a...... to be driving socially innovative solutions. Implications for research and practice, as well as future research directions, are elaborated....... as a set of ideas regarding future processes in health and home care services, involving technological solutions, starting to change stakeholders' behaviour, work practices, and social roles. A system-centric framework is proposed to evaluate the interdependencies between telecare, the changing...

  1. Factors influencing perceived sustainability of Dutch community health programs.

    Science.gov (United States)

    Vermeer, A J M; Van Assema, P; Hesdahl, B; Harting, J; De Vries, N K

    2015-09-01

    We assessed the perceived sustainability of community health programs organized by local intersectoral coalitions, as well as the factors that collaborating partners think might influence sustainability. Semi-structured interviews were conducted among 31 collaborating partners of 5 community health programs in deprived neighborhoods in the southern part of the Netherlands. The interview guide was based on a conceptual framework that includes factors related to the context, the leading organization, leadership, the coalition, collaborating partners, interventions and outcomes. Interviews were recorded, transcribed and content analyzed using NVivo 8.0. Participants in each of the programs varied in their perceptions of the sustainability of the program, but those people collaborating in pre-existing neighborhood structures expressed relatively high faith in their continuation. The participating citizens in particular believed that these structures would continue to address the health of the community in the future. We found factors from all categories of the conceptual framework that were perceived to influence sustainability. The program leaders appeared to be crucial to the programs, as they were frequently mentioned in close interaction with other factors. Program leaders should use a motivating and supportive leadership style and should act as 'program champions'. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. [Networks of experiences on community health as an information system in health promotion: lessons learned in Aragon (Spain)].

    Science.gov (United States)

    Gállego-Diéguez, Javier; Aliaga Traín, Pilar; Benedé Azagra, Carmen Belén; Bueno Franco, Manuel; Ferrer Gracia, Elisa; Ipiéns Sarrate, José Ramón; Muñoz Nadal, Pilar; Plumed Parrilla, Manuela; Vilches Urrutia, Begoña

    2016-11-01

    Networks of community health experiences promote interaction and knowledge management in health promotion among their participants. These networks integrate both professionals and social agents who work directly on the ground in small environments, with defined objectives and inclusion criteria and voluntary participation. In this article, networks in Aragon (Spain) are reviewed in order to analyse their role as an information system. The Health Promotion Projects Network of Aragon (Red Aragonesa de Proyectos de Promoción de la Salud, RAPPS) was launched in 1996 and currently includes 73 projects. The average duration of projects is 12.7 years. RAPPS interdisciplinary teams involve 701 people, of which 89.6% are professionals and 10.6% are social agents. The Aragon Health Promoting Schools Network (Red Aragonesa de Escuelas Promotoras de Salud, RAEPS) integrates 134 schools (24.9% of Aragon). The schools teams involve 829 teachers and members of the school community, students (35.2%), families (26.2%) and primary care health professionals (9.8%). Experiences Networks boost citizen participation, have an influence in changing social determinants and contribute to the formulation of plans and regional strategies. Networks can provide indicators for a health promotion information and monitoring system on: capacity building services in the territory, identifying assets and models of good practice, cross-sectoral and equity initiatives. Experiences Networks represent an opportunity to create a health promotion information system, systematising available information and establishing quality criteria for initiatives. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Exploratory scoping of the literature on factors that influence oral health workforce planning and management in developing countries.

    Science.gov (United States)

    Knevel, Rjm; Gussy, M G; Farmer, J

    2017-05-01

    The purpose of this study was to scope the literature that exists about factors influencing oral health workforce planning and management in developing countries (DCs). The Arksey and O'Malley method for conducting a scoping review was used. A replicable search strategy was applied, using three databases. Factors influencing oral health workforce planning and management in DCs identified in the eligible articles were charted. Four thousand citations were identified; 41 papers were included for review. Most included papers were situational analyses. Factors identified were as follows: lack of data, focus on the restorative rather than preventive care in practitioner education, recent increase in number of dental schools (mostly private) and dentistry students, privatization of dental care services which has little impact on care maldistribution, and debates about skill mix and scope of practice. Oral health workforce management in the eligible studies has a bias towards dentist-led systems. Due to a lack of country-specific oral health related data in developing or least developed countries (LDCs), oral health workforce planning often relies on data and modelling from other countries. Approaches to oral health workforce management and planning in developing or LDCs are often characterized by approaches to increase numbers of dentists, thus not ameliorating maldistribution of service accessibility. Governments appear to be reducing support for public and preventative oral healthcare, favouring growth in privatized dental services. Changes to professional education are necessary to trigger a paradigm shift to the preventive approach and to improve relationships between different oral healthcare provider roles. This needs to be premised on greater appreciation of preventive care in health systems and funding models. © 2016 The Authors. International Journal of Dental Hygiene Published by John Wiley & Sons Ltd.

  4. Examining the influence of country-level and health system factors on nursing and physician personnel production.

    Science.gov (United States)

    Squires, Allison; Uyei, S Jennifer; Beltrán-Sánchez, Hiram; Jones, Simon A

    2016-08-15

    A key component to achieving good patient outcomes is having the right type and number of healthcare professionals with the right resources. Lack of investment in infrastructure required for producing and retaining adequate numbers of health professionals is one reason, and contextual factors related to socioeconomic development may further explain the trend. Therefore, this study sought to explore the relationships between country-level contextual factors and healthcare human resource production (defined as worker-to-population ratio) across 184 countries. This exploratory observational study is grounded in complexity theory as a guiding framework. Variables were selected through a process that attempted to choose macro-level indicators identified by the interdisciplinary literature as known or likely to affect the number of healthcare workers in a country. The combination of these variables attempts to account for the gender- and class-sensitive identities of physicians and nurses. The analysis consisted of 1 year of publicly available data, using the most recently available year for each country where multiple regressions assessed how context may influence health worker production. Missing data were imputed using the ICE technique in STATA and the analyses rerun in R as an additional validity and rigor check. The models explained 63 % of the nurse/midwife-to-population ratio (pseudo R (2) = 0.627, p = 0.0000) and 73 % of the physician-to-population ratio (pseudo R (2) = 0.729, p = 0.0000). Average years of school in a country's population, emigration rates, beds-per-1000 population, and low-income country statuses were consistently statistically significant predictors of production, with percentage of public and private sector financing of healthcare showing mixed effects. Our study demonstrates that the strength of political, social, and economic institutions does impact human resources for health production and lays a foundation for studying

  5. Embedded Sensor Systems for Health - A Step Towards Personalized Health.

    Science.gov (United States)

    Lindén, Maria; Björkman, Mats

    2018-01-01

    The demography is changing towards older people, and the challenge to provide an appropriate care is well known. Sensor systems, combined with IT solutions are recognized as one of the major tools to handle this situation. Embedded Sensor Systems for Health (ESS-H) is a research profile at Mälardalen University in Sweden, focusing on embedded sensor systems for health technology applications. The research addresses several important issues: to provide sensor systems for health monitoring at home, to provide sensor systems for health monitoring at work, to provide safe and secure infrastructure and software testing methods for physiological data management. The user perspective is important in order to solve real problems and to develop systems that are easy and intuitive to use. One of the overall aims is to enable health trend monitoring in home environments, thus being able to detect early deterioration of a patient. Sensor systems, signal processing algorithms, and decision support algorithms have been developed. Work on development of safe and secure infrastructure and software testing methods are important for an embedded sensor system aimed for health monitoring, both in home and in work applications. Patient data must be sent and received in a safe and secure manner, also fulfilling the integrity criteria.

  6. Environmental health surveillance system; Kankyo hoken surveillance system

    Energy Technology Data Exchange (ETDEWEB)

    Ono, M. [National Inst. for Environmental Studies, Tsukuba (Japan)

    1998-02-01

    The Central Environmental Pollution Prevention Council pointed out the necessity to establish an environmental health surveillance system (hereinafter referred to as System) in its report `on the first type district specified by the Environmental Pollution Caused Health Damages Compensation Act,` issued in 1986. A study team, established in Environment Agency, has been discussing to establish System since 1986. This paper outlines System, and some of the pilot surveillance results. It is not aimed at elucidation of the cause-effect relationships between health and air pollution but at discovery of problems, in which the above relationships in a district population are monitored periodically and continuously from long-term and prospective viewpoints, in order to help take necessary measures in the early stage. System is now collecting the data of the chronic obstructive lung diseases on a nation-wide scale through health examinations of 3-year-old and preschool children and daily air pollution monitoring. 6 refs., 3 figs., 1 tab.

  7. Governance of Health Systems Comment on “A Network Based Theory of Health Systems and Cycles of Well-Being”

    OpenAIRE

    Blanchet, Karl

    2013-01-01

    Health systems research aims to understand the governance of health systems (i.e. how health systems function and perform and how their actors interact with each other). This can be achieved by applying innovative methodologies and concepts that are going to capture the complexity and dynamics of health systems when they are affected by shocks. The capacity of health systems to adapt to shocks (i.e. the resilience of health systems) is a new area of investigation. Social network analysis is a...

  8. The right to health, health systems development and public health policy challenges in Chad.

    Science.gov (United States)

    Azétsop, Jacquineau; Ochieng, Michael

    2015-02-15

    There is increasing consensus that the right to health can provide ethical, policy and practical groundings for health systems development. The goals of the right to health are congruent with those of health systems development, which are about strengthening health promotion organizations and actions so as to improve public health. The poor shape and performance of health systems in Chad question the extent of realization of the right to health. Due to its comprehensiveness and inclusiveness, the right to health has the potential of being an organizational and a normative backbone for public health policy and practice. It can then be understood and studied as an integral component of health systems development. This paper uses a secondary data analysis of existing documents by the Ministry of Public Health, Institut National de la Statistique, des Etudes Economiques et Démographiques (INSEED), the Ministry of Economy and Agence Française de Cooperation to analyze critically the shape and performance of health systems in Chad based on key concepts and components of the right to health contained in article 12 of the International Covenant on Economic, Social and Cultural Rights, and on General Comment 14. The non-realization of the right to health, even in a consistently progressive manner, raises concerns about the political commitment of state officials to public health, about the justice of social institutions in ensuring social well-being and about individual and public values that shape decision-making processes. Social justice, democratic rule, transparency, accountability and subsidiarity are important groundings for ensuring community participation in public affairs and for monitoring the performance of public institutions. The normative ideals of health systems development are essentially democratic in nature and are rooted in human rights and in ethical principles of human dignity, equality, non-discrimination and social justice. These ideals are grounded

  9. Hawaii's public mental health system.

    Science.gov (United States)

    VanderVoort, Debra J

    2005-03-01

    The following article addresses the nature of and problems with the public mental health system in Hawaii. It includes a brief history of Hawaii's public mental health system, a description and analysis of this system, economic factors affecting mental health, as well as a needs assessment of the elderly, individuals with severe mental illness, children and adolescents, and ethnically diverse individuals. In addition to having the potential to increase suicide rates and unnecessarily prolong personal suffering, problems in the public mental health system such as inadequate services contribute to an increase in social problems including, but not limited to, an increase in crime rates (e.g., domestic violence, child abuse), divorce rates, school failure, and behavioral problems in children. The population in need of mental health services in Hawaii is under served, with this inadequacy of services due to economic limitations and a variety of other factors.

  10. The Influence of Health Care Policies on Children's Health and Development. Social Policy Report. Volume 29, Number 4

    Science.gov (United States)

    Perrin, James M.; Boat, Thomas F.; Kelleher, Kelly J.

    2016-01-01

    Rates of health insurance for children have improved significantly over the past few decades, and more children have insurance than ever before in U.S. history. Health care does improve child health and well-being, but growing understanding of social and community influences has led health care practitioners to work toward more comprehensive and…

  11. Factors influencing consumer adoption of USB-based Personal Health Records in Taiwan

    Directory of Open Access Journals (Sweden)

    Jian Wen-Shan

    2012-08-01

    Full Text Available Abstract Background Usually patients receive healthcare services from multiple hospitals, and consequently their healthcare data are dispersed over many facilities’ paper and electronic-based record systems. Therefore, many countries have encouraged the research on data interoperability, access, and patient authorization. This study is an important part of a national project to build an information exchange environment for cross-hospital digital medical records carried out by the Department of Health (DOH of Taiwan in May 2008. The key objective of the core project is to set up a portable data exchange environment in order to enable people to maintain and own their essential health information. This study is aimed at exploring the factors influencing behavior and adoption of USB-based Personal Health Records (PHR in Taiwan. Methods Quota sampling was used, and structured questionnaires were distributed to the outpatient department at ten medical centers which participated in the DOH project to establish the information exchange environment across hospitals. A total of 3000 questionnaires were distributed and 1549 responses were collected, out of those 1465 were valid, accumulating the response rate to 48.83%. Results 1025 out of 1465 respondents had expressed their willingness to apply for the USB-PHR. Detailed analysis of the data reflected that there was a remarkable difference in the “usage intention” between the PHR adopters and non-adopters (χ2 =182.4, p  Conclusions Higher Usage Intentions, Perceived Usefulness and Subjective Norm of patients were found to be the key factors influencing PHR adoption. Thus, we suggest that government and hospitals should promote the potential usefulness of PHR, and physicians should encourage patients' to adopt the PHR.

  12. [eHealth in Peru: implementation of policies to strengthen health information systems].

    Science.gov (United States)

    Curioso, Walter H

    2014-01-01

    Health information systems play a key role in enabling high quality, complete health information to be available in a timely fashion for operational and strategic decision-making that makes it possible to save lives and improve the health and quality of life of the population. In many countries, health information systems are weak, incomplete, and fragmented. However, there is broad consensus in the literature of the need to strengthen health information systems in countries around the world. The objective of this paper is to present the essential components of the conceptual framework to strengthen health information systems in Peru. It describes the principal actions and strategies of the Ministry of Health of Peru during the process of strengthening health information systems. These systems make it possible to orient policies for appropriate decision-making in public health.

  13. Intimate partner violence influence on deliveries assisted by skilled health personnel.

    Science.gov (United States)

    Refaat, Amany

    2013-01-01

    Millennium Development Goal 5 calls for increasing proportions of deliveries assisted by skilled health personnel to reduce maternal mortality. This study aims to identifying the implication of exposure to intimate partner violence on these proportions. This study used domestic violence modules data of Demographic and Health Surveys of six countries from 2005 to 2007. Proportions of assisted deliveries were examined by sociodemographic characteristics and exposure to intimate partner violence in the studied countries. Influence on the proportion was examined against exposure to intimate partner violence through odds ratio and 95% of logistic regression analysis after controlling for women age, residence (urban/rural), household wealth level, economic level of country, educational level and working status of women and their husbands/partners. Data sets of 18,507 participants over 20 years of age showed that almost three-quarters (73%) of women had deliveries assisted by skilled health personnel. One-third of the women were ever exposed to intimate partner violence (37%) and 9% of them to the severe level. Exposure to intimate partner violence statistically significantly lowered this proportion to 69% (odds ratio: 0.73; 95% confidence interval: 0.67-0.78) meanwhile severe violence lowered it to 65% (odds ratio 0.64; 95% confidence interval: 0.58-0.72). When running multiple regression analysis, exposure to intimate partner violence retained its statistically significant decreasing influence on proportions and was not biased by the other stronger socioeconomic characteristics. Intimate partner violence has an independent influence on reducing assisted deliveries by skilled health personnel. Programs working for increasing proportions of assisted deliveries by skilled health personnel are recommended to integrate protection women from violence.

  14. Does health status influence intention regarding screening mammography?

    International Nuclear Information System (INIS)

    Park, Keeho; Park, Jong-Hyock; Park, Jae-Hyun; Kim, Hui-Jeong; Park, Bo-Yoon

    2010-01-01

    We analyzed information surveyed from a community-based sample of Korean women older than 40 years of age to understand the relationships between health status and screening behavior. In a cross-sectional population-based study, a two-stage, geographically stratified household-based sampling design was used for assembly of a probability sample of women aged 40-69 years living in Gunpo in Korea, resulting in a total sample size of 503 women. The primary outcome variable for this analysis was the respondent's intention to obtain a mammogram. Predictor variables included health status and other factors known to influence the use of cancer screening, such as age, education, income, marital status and the presence of co-morbid illnesses. Health status was assessed by using the EuroQol (EQ-5D). The median EQ visual analogue scale score was 75.0, ranging from 20 to 100. In bivariate analyses, the percentage of women reporting to have intention toward mammography use decreased with worsening health status. Women who had problems with mobility or anxiety/depression showed lower intention to undergo future screening mammography. Multivariate logistic regression confirmed that health status was significantly associated with intention toward mammography use. Anxiety or depression was an independent predictor of future screening mammography use. Health status is significantly associated with intention regarding screening mammography use. Physicians or other health professionals should be aware that health status is an important component for health promotion, and should pay more attention to clients' possible vulnerability in screening mammography use due to their poor health status. (author)

  15. Testing the theory of holism: A study of family systems and adolescent health

    Directory of Open Access Journals (Sweden)

    Valerie Michaelson

    2016-12-01

    Full Text Available Holism is an ancient theory that can be applied contemporarily to adolescent health and its determinants. This theory suggests that there is value in considering factors that influence health together as integrated wholes, in addition to consideration of individual components. Characteristics of families are fundamental determinants of health and provide opportunity for exploration of this theory. In a “proof-of-concept” analysis we therefore: (1 developed a multidimensional, composite (holistic measure to be used to characterize family systems; and (2 related this measure and its individual components to adolescent health outcomes, in order to test the theory of holism. Cross-sectional analyses of survey reports from the 2014 Canadian Health Behaviour in School-aged Children study (weighted n = 19,333 were performed. Factor analysis was used to confirm the psychometric properties of the holistic measure to describe a family system (the “holistic measure”. Associations between this holistic measure, its individual components, and various indicators of health were examined descriptively and using binomial regression. The holistic measure (4 items, α = 0.62; RMSEA = .04; SRMR = 0.01; AGFI = 0.99 included components describing family: material wealth, meal practices, neighbourhood social capital, and social connections. It was consistently associated with various health behaviours, and social and emotional health outcomes. In 22/24 comparisons, this holistic measure related to positive health outcomes more strongly than did its individual components; for negative health outcomes this occurred in 20/24 comparisons. Study findings suggest that it is possible to assess family systems holistically. Such systems are strongly associated with adolescent health outcomes, and there is etiological and theoretical value in considering family systems as integrated wholes.

  16. Health care financing and the sustainability of health systems.

    Science.gov (United States)

    Liaropoulos, Lycourgos; Goranitis, Ilias

    2015-09-15

    The economic crisis brought an unprecedented attention to the issue of health system sustainability in the developed world. The discussion, however, has been mainly limited to "traditional" issues of cost-effectiveness, quality of care, and, lately, patient involvement. Not enough attention has yet been paid to the issue of who pays and, more importantly, to the sustainability of financing. This fundamental concept in the economics of health policy needs to be reconsidered carefully. In a globalized economy, as the share of labor decreases relative to that of capital, wage income is increasingly insufficient to cover the rising cost of care. At the same time, as the cost of Social Health Insurance through employment contributions rises with medical costs, it imperils the competitiveness of the economy. These reasons explain why spreading health care cost to all factors of production through comprehensive National Health Insurance financed by progressive taxation of income from all sources, instead of employer-employee contributions, protects health system objectives, especially during economic recessions, and ensures health system sustainability.

  17. The influence of COPD on health-related quality of life independent of the influence of comorbidity.

    NARCIS (Netherlands)

    Manen, J.G. van; Bindels, P.J.E.; Dekker, F.W.; Bottema, B.J.A.M.; Zee, J.S. van der; IJzermans, C.J.; Schadé, E.

    2003-01-01

    BACKGROUND/OBJECTIVES: The goal of this study was to determine the influence of chronic obstructive pulmonary disease (COPD) on health-related quality of life (HRQL) independent of comorbidity. METHODS: Patients with COPD in general practice, >/=40 years, were selected. To recruit controls, a random

  18. Towards an evaluation framework for information quality management (IQM) practices for health information systems--evaluation criteria for effective IQM practices.

    Science.gov (United States)

    Mohammed, Siti Asma; Yusof, Maryati Mohd

    2013-04-01

    Poor information quality (IQ) must be understood as a business problem rather than systems problem. In health care organization, what is required is an effective quality management that continuously manages and reviews the factors influencing IQ in health information systems (HIS) so as to achieve the desired outcomes. Hence, in order to understand the issues of information quality management (IQM) practices in health care organizations, a more holistic evaluation study should be undertaken to investigate the IQM practices in health care organizations. It is the aim of this paper to identify the significant evaluation criteria that influence the production of good IQ in HIS. Six selected frameworks and best practices both from health informatics and information systems literature have been reviewed to identify the evaluation criteria from the perspective of human, organizational and technological factors. From the review, it was found that human and organization factors are of greater significance in influencing HIS IQ. Our review depicts that there is still shortage in finding a comprehensive IQM evaluation framework. Thus, the criteria from the frameworks reviewed can be used in combination for more comprehensive evaluation criteria. Integrated IQM evaluation criteria for HIS are then proposed in this study. Poor IQ is the result of complex interdependency within sociotechnical factors in health care organization and lack of formal and structured IQM practices. Thus, a feedback mechanism such as evaluation is needed to understand the issues in depth in the future. © 2012 Blackwell Publishing Ltd.

  19. Influence of Health Education on Prevention of Drug Abuse ...

    African Journals Online (AJOL)

    This study was undertaken to investigate the influence of health education on prevention of drug abuse. 192 adolescents comprising of male and females, randomly selected from two secondary schools and a university were used as sample with ages ranging from 12-22years with a mean of 17years. The questionnaire ...

  20. [The national health system in Peru].

    Science.gov (United States)

    Sánchez-Moreno, Francisco

    2014-01-01

    In 1975, a group of professionals in Peru who were experts on national health systems began a process that led the country to be the first in South America to initiate a modern organization of the health system. This pioneering development meant that the creation of the National Health Services System [in Peru] in 1978 occurred before the health system reforms in Chile (1980), Brazil (1990), Colombia (1993), and Ecuador (2008). This encouraging start has had permanent reformist fluctuations since then, with negative development because of the lack of a State policy. Current features of the Peruvian system are inefficient performance, discontinuity, and lack of assessment, which creates a major setback in comparison with other health systems in America. In the 21st century, significant technical efforts have been missed to modernize the system and its functions. The future is worrying and the role of new generations will be decisive.

  1. Health Systems Sustainability and Rare Diseases.

    Science.gov (United States)

    Ferrelli, Rita Maria; De Santis, Marta; Egle Gentile, Amalia; Taruscio, Domenica

    2017-01-01

    The paper is addressing aspects of health system sustainability for rare diseases in relation to the current economic crisis and equity concerns. It takes into account the results of the narrative review carried out in the framework of the Joint Action for Rare Diseases (Joint RD-Action) "Promoting Implementation of Recommendations on Policy, Information and Data for Rare Diseases", that identified networks as key factors for health systems sustainability for rare diseases. The legal framework of European Reference Networks and their added value is also presented. Networks play a relevant role for health systems sustainability, since they are based upon, pay special attention to and can intervene on health systems knowledge development, partnership, organizational structure, resources, leadership and governance. Moreover, sustainability of health systems can not be separated from the analysis of the context and the action on it, including fiscal equity. As a result of the financial crisis of 2008, cuts of public health-care budgets jeopardized health equity, since the least wealthy suffered from the greatest health effects. Moreover, austerity policies affected economic growth much more adversely than previously believed. Therefore, reducing public health expenditure not only is going to jeopardise citizens' health, but also to hamper fair and sustainable development.

  2. Environmental Public Health Tracking: a cost-effective system for characterizing the sources, distribution and public health impacts of environmental hazards.

    Science.gov (United States)

    Saunders, P J; Middleton, J D; Rudge, G

    2017-09-01

    The contemporary environment is a complex of interactions between physical, biological, socio-economic systems with major impacts on public health. However, gaps in our understanding of the causes, extent and distribution of these effects remain. The public health community in Sandwell West Midlands has collaborated to successfully develop, pilot and establish the first Environmental Public Health Tracking (EPHT) programme in Europe to address this 'environmental health gap' through systematically linking data on environmental hazards, exposures and diseases. Existing networks of environmental, health and regulatory agencies developed a suite of innovative methods to routinely share, integrate and analyse data on hazards, exposures and health outcomes to inform interventions. Effective data sharing and horizon scanning systems have been established, novel statistical methods piloted, plausible associations framed and tested, and targeted interventions informed by local concerns applied. These have influenced changes in public health practice. EPHT is a powerful tool for identifying and addressing the key environmental public health impacts at a local level. Sandwell's experience demonstrates that it can be established and operated at virtually no cost. The transfer of National Health Service epidemiological skills to local authorities in 2013 provides an opportunity to expand the programme to fully exploit its potential. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  3. The influence of health system organizational structure and culture on integration of health services: the example of HIV service monitoring in South Africa.

    Science.gov (United States)

    Kawonga, Mary; Blaauw, Duane; Fonn, Sharon

    2016-11-01

    Administrative integration of disease control programmes (DCPs) within the district health system has been a health sector reform priority in South Africa for two decades. The reforms entail district managers assuming authority for the planning and monitoring of DCPs in districts, with DCP managers providing specialist support. There has been little progress in achieving this, and a dearth of research exploring why. Using a case study of HIV programme monitoring and evaluation (M&E), this article explores whether South Africa's health system is configured to support administrative integration. The article draws on data from document reviews and interviews with 54 programme and district managers in two of nine provinces, exploring their respective roles in decision-making regarding HIV M&E system design and in using HIV data for monitoring uptake of HIV interventions in districts. Using Mintzberg's configurations framework, we describe three organizational parameters: (a) extent of centralization (whether district managers play a role in decisions regarding the design of the HIV M&E system); (b) key part of the organization (extent to which sub-national programme managers vs district managers play the central role in HIV monitoring in districts); and (c) coordination mechanisms used (whether highly formalized and rules-based or more output-based to promote agency). We find that the health system can be characterized as Mintzberg's machine bureaucracy. It is centralized and highly formalized with structures, management styles and practices that promote programme managers as lead role players in the monitoring of HIV interventions within districts. This undermines policy objectives of district managers assuming this leadership role. Our study enhances the understanding of organizational factors that may limit the success of administrative integration reforms and suggests interventions that may mitigate this. © The Author 2016. Published by Oxford University Press in

  4. Czechoslovakia's changing health care system.

    Science.gov (United States)

    Raffel, M W; Raffel, N K

    1992-01-01

    Before World War II, Czechoslovakia was among the most developed European countries with an excellent health care system. After the Communist coup d'etat in 1948, the country was forced to adapt its existing health care system to the Soviet model. It was planned and managed by the government, financed by general tax money, operated in a highly centralized, bureaucratic fashion, and provided service at no direct charge at the time of service. In recent years, the health care system had been deteriorating as the health of the people had also been declining. Life expectancy, infant mortality rates, and diseases of the circulatory system are higher than in Western European countries. In 1989, political changes occurred in Czechoslovakia that made health care reform possible. Now health services are being decentralized, and the ownership of hospitals is expected to be transferred to communities, municipalities, churches, charitable groups, or private entities. Almost all health leaders, including hospital directors and hospital department heads, have been replaced. Physicians will be paid according to the type and amount of work performed. Perhaps the most important reform is the establishment of an independent General Health Care Insurance Office financed directly by compulsory contributions from workers, employers, and government that will be able to negotiate with hospitals and physicians to determine payment for services.

  5. Systemic diseases and their treatments in the elderly: impact on oral health.

    Science.gov (United States)

    Ghezzi, E M; Ship, J A

    2000-01-01

    The lifespan of the US population is increasing, with the elderly desiring successful aging. This goal is jeopardized as multiple systemic conditions and their treatments become more prevalent with age, causing impaired systemic and oral health and influencing an older person's quality of life. To obtain successful aging, a compression of morbidity must be obtained through prevention and management of disease. This paper describes the most common systemic diseases causing morbidity and mortality in persons aged 65+ years: diseases of the heart, malignant neoplasms, cerebrovascular diseases, chronic obstructive pulmonary disease, pneumonia, influenza, diabetes mellitus, trauma, Alzheimer's disease, renal diseases, septicemia, and liver diseases. Disease prevalence and the impact of medications and other therapeutic measures used to treat these conditions are discussed. Oral sequelae are reviewed with guidelines for early detection of these deleterious consequences, considerations for oral treatment, and patient management. An understanding of the impact of systemic diseases and treatment on oral health is imperative for dental practitioners to appropriately treat and manage older patients with these conditions. With a focus on early detection and prevention, oral health care providers can improve the quality of life of this population and aid in the attainment of successful aging.

  6. [A Maternal Health Care System Based on Mobile Health Care].

    Science.gov (United States)

    Du, Xin; Zeng, Weijie; Li, Chengwei; Xue, Junwei; Wu, Xiuyong; Liu, Yinjia; Wan, Yuxin; Zhang, Yiru; Ji, Yurong; Wu, Lei; Yang, Yongzhe; Zhang, Yue; Zhu, Bin; Huang, Yueshan; Wu, Kai

    2016-02-01

    Wearable devices are used in the new design of the maternal health care system to detect electrocardiogram and oxygen saturation signal while smart terminals are used to achieve assessments and input maternal clinical information. All the results combined with biochemical analysis from hospital are uploaded to cloud server by mobile Internet. Machine learning algorithms are used for data mining of all information of subjects. This system can achieve the assessment and care of maternal physical health as well as mental health. Moreover, the system can send the results and health guidance to smart terminals.

  7. The Contextualized Technology Adaptation Process (CTAP): Optimizing Health Information Technology to Improve Mental Health Systems.

    Science.gov (United States)

    Lyon, Aaron R; Wasse, Jessica Knaster; Ludwig, Kristy; Zachry, Mark; Bruns, Eric J; Unützer, Jürgen; McCauley, Elizabeth

    2016-05-01

    Health information technologies have become a central fixture in the mental healthcare landscape, but few frameworks exist to guide their adaptation to novel settings. This paper introduces the contextualized technology adaptation process (CTAP) and presents data collected during Phase 1 of its application to measurement feedback system development in school mental health. The CTAP is built on models of human-centered design and implementation science and incorporates repeated mixed methods assessments to guide the design of technologies to ensure high compatibility with a destination setting. CTAP phases include: (1) Contextual evaluation, (2) Evaluation of the unadapted technology, (3) Trialing and evaluation of the adapted technology, (4) Refinement and larger-scale implementation, and (5) Sustainment through ongoing evaluation and system revision. Qualitative findings from school-based practitioner focus groups are presented, which provided information for CTAP Phase 1, contextual evaluation, surrounding education sector clinicians' workflows, types of technologies currently available, and influences on technology use. Discussion focuses on how findings will inform subsequent CTAP phases, as well as their implications for future technology adaptation across content domains and service sectors.

  8. The Contextualized Technology Adaptation Process (CTAP): Optimizing Health Information Technology to Improve Mental Health Systems

    Science.gov (United States)

    Lyon, Aaron R.; Wasse, Jessica Knaster; Ludwig, Kristy; Zachry, Mark; Bruns, Eric J.; Unützer, Jürgen; McCauley, Elizabeth

    2015-01-01

    Health information technologies have become a central fixture in the mental healthcare landscape, but few frameworks exist to guide their adaptation to novel settings. This paper introduces the Contextualized Technology Adaptation Process (CTAP) and presents data collected during Phase 1 of its application to measurement feedback system development in school mental health. The CTAP is built on models of human-centered design and implementation science and incorporates repeated mixed methods assessments to guide the design of technologies to ensure high compatibility with a destination setting. CTAP phases include: (1) Contextual evaluation, (2) Evaluation of the unadapted technology, (3) Trialing and evaluation of the adapted technology, (4) Refinement and larger-scale implementation, and (5) Sustainment through ongoing evaluation and system revision. Qualitative findings from school-based practitioner focus groups are presented, which provided information for CTAP Phase 1, contextual evaluation, surrounding education sector clinicians’ workflows, types of technologies currently available, and influences on technology use. Discussion focuses on how findings will inform subsequent CTAP phases, as well as their implications for future technology adaptation across content domains and service sectors. PMID:25677251

  9. [Caffeine--common ingredient in a diet and its influence on human health].

    Science.gov (United States)

    Wierzejska, Regina

    2012-01-01

    Caffeine is widely consumed by people of all ages. In the last period a market of caffeine-containing products, particularly energy drinks and food supplements increased. Caffeine for years is under discussion, whether has positive whether adverse impact on health. Children are a group of special anxieties. Caffeine is a stimulant of central nervous system and therefore is probably the most commonly used psychoactive substance in the world. The physiological effect of caffeine and the lack of nutrition value causes a great interest its impact on health, especially with reference to the risk of cardiovascular diseases. Results of scientific research are not clear. The influence of caffeine on the human body is conditioned with the individual metabolism of caffeine which also depends on many endogenic and environmental factors. According to the current knowledge moderate caffeine intake by healthy adults at a dose level of 400 mg a day is not associated with adverse effects, but it also depends on other health determinants of a lifestyle. Excessive caffeine consumption can cause negative health consequences such as psychomotor agitation, insomnia, headache, gastrointestinal complaints. Adverse effect of caffeine intoxication is classified in World Health Organization's International Classification of Diseases (ICD-10). Metabolism of caffeine by pregnant woman is slowed down. Caffeine and its metabolites pass freely across the placenta into a fetus. For this reason pregnant women should limit caffeine intake. Children and adolescents should also limit daily caffeine consumption. It results from the influence of caffeine on the central nervous system in the period of rapid growth and the final stage of brain development, calcium balance and sleep duration. Average daily caffeine consumption in European countries ranging from 280-490 mg. The highest caffeine intake is in Scandinavian countries what results from the great consumption of the coffee. As far as caffeine

  10. Influence of nutritional variables and obesity on health and metabolism.

    Science.gov (United States)

    Azevedo, Fernanda Reis de; Brito, Bruna Cristina

    2012-01-01

    Obesity is a recurring theme in current scientific literature. This can easily be explained by its exponential increase in all layers of society. The popularity of this subject has also given rise to associated questions, which have achieved greater prominence in health-related publications. In order to assess what has been studied in the field of obesity and nutrition, an overview of all articles published on these subjects in some of the main Brazilian scientific journals over the past two years was performed. Among the subthemes selected for this study, those related to childhood obesity attracted attention due to their greater frequency. These were subdivided into: prevalence, intrauterine and breastfeeding influences that may lead to the development of this condition, impact on quality of life, cardiovascular system and metabolism, and possible prevention strategies. Furthermore, issues related to obesity in adults were explored, such as risk factors and new strategies for prevention, with special attention given to the many studies evaluating different aspects of bariatric surgery. Finally, the subject of malnutrition and the impact of the deficiency of specific micronutrients such as selenium, vitamin D, and vitamin B12 were assessed. Based on the results, it was possible to assess the actual importance of obesity and nutrition in health maintenance, and also the several lines of research regarding these issues. Thus, it is essential to create new methods, which must be quick and efficient, to update health professionals involved in the treatment of obesity.

  11. The Influence of Suicide Prevention Gatekeeper Training on Resident Assistants' Mental Health

    Science.gov (United States)

    Becker, Martin A. Swanbrow; Drum, David J.

    2015-01-01

    This study explored the mental health influence on resident assistants associated with their training in suicide prevention and their subsequent role as campus mental health gatekeepers. Despite considerable prior personal experience with their own suicidal thinking as well as with others who have thoughts of suicide, a multiple regression…

  12. Health care delivery systems.

    NARCIS (Netherlands)

    Stevens, F.; Zee, J. van der

    2007-01-01

    A health care delivery system is the organized response of a society to the health problems of its inhabitants. Societies choose from alternative health care delivery models and, in doing so, they organize and set goals and priorities in such a way that the actions of different actors are effective,

  13. Occupational sitting: practitioner perceptions of health risks, intervention strategies and influences.

    Science.gov (United States)

    Gilson, Nicholas; Straker, Leon; Parry, Sharon

    2012-12-01

    Workplace practitioners are well placed to provide practical insights on sedentary behaviour issues in the workplace. This study consulted occupational health and safety (OHS) practitioners, examining their perceptions of sedentary health risks and views on strategies and influences to reduce and break prolonged occupational sitting. Three focus groups were conducted with convenience samples of OHS practitioners (n=34; 6 men; 46.4 ± 9.6 years) attending an Australian national conference in November 2010. Open-ended questions concerning health risks, sitting reduction strategies and influences were posed by lead researchers and practitioners invited to express opinions, viewpoints and experiences. Audio-recordings and summary notes of focus group discussions were reviewed by researchers to identify key response themes. OHS practitioners were well informed about the chronic disease and musculoskeletal risks associated with prolonged occupational sitting, but noted the importance of not replacing one workplace health issue (too much sitting) with another (too much standing). Ideas for strategies were diverse and explored the dichotomy between providing choices for employees to stand and move more (e.g. sit-stand desks), as opposed to obligating change through adapting job and office design (e.g. centralising printers and scanners). Productivity concerns were cited as a major influence for change. OHS practitioners also highlighted the value of using cross-disciplinary expertise to bridge the gap between research and practice. This study identified that OHS practitioners in Australia have a good understanding of the risks of prolonged occupational sitting and potential strategies to manage these risks.

  14. [Factors Influencing Participation in Financial Incentive Programmes of Health Insurance Funds. Results of the Study 'German Health Update'].

    Science.gov (United States)

    Jordan, S; von der Lippe, E; Starker, A; Hoebel, J; Franke, A

    2015-11-01

    The statutory health insurance can offer their insured incentive programmes that will motivate for healthy behaviour through a financial or material reward. This study will show results about what factors influence financial incentive programme participation (BPT) including all sorts of statutory health insurance funds and taking into account gender differences. For the cross-sectional analysis, data were used from 15,858 participants in the study 'Germany Health Update' (GEDA) from 2009, who were insured in the statutory health insurance. The selection of potential influencing variables for a BPT is based on the "Behavioural Model for Health Service Use" of Andersen. Accordingly, various factors were included in logistic regression models, which were calculated separately by gender: predisposing factors (age, education, social support, and health awareness), enabling factors (income, statutory health insurance fund, and family physician), and need factors (smoking, fruit and vegetable consumption, sports, body mass index, and general health status). In consideration of all factors, for both sexes, BPT is associated with age, health awareness, education, use of a family physician, smoking, and sports activities. In addition, income, body mass index, and diet are significant in women and social support and kind of statutory health insurance fund in men. It is found that predisposing, enabling and need factors are relevant. Financial incentive programmes reach population groups with greatest need less than those groups who already have a health-conscious behaviour, who receive a reward for this. In longitudinal studies, further research on financial incentive programmes should investigate the existence of deadweight effects and whether incentive programmes can contribute to the reduction of the inequity in health. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Measuring health systems strength and its impact: experiences from the African Health Initiative.

    Science.gov (United States)

    Sherr, Kenneth; Fernandes, Quinhas; Kanté, Almamy M; Bawah, Ayaga; Condo, Jeanine; Mutale, Wilbroad

    2017-12-21

    Health systems are essential platforms for accessible, quality health services, and population health improvements. Global health initiatives have dramatically increased health resources; however, funding to strengthen health systems has not increased commensurately, partially due to concerns about health system complexity and evidence gaps demonstrating health outcome improvements. In 2009, the African Health Initiative of the Doris Duke Charitable Foundation began supporting Population Health Implementation and Training Partnership projects in five sub-Saharan African countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) to catalyze significant advances in strengthening health systems. This manuscript reflects on the experience of establishing an evaluation framework to measure health systems strength, and associate measures with health outcomes, as part of this Initiative. Using the World Health Organization's health systems building block framework, the Partnerships present novel approaches to measure health systems building blocks and summarize data across and within building blocks to facilitate analytic procedures. Three Partnerships developed summary measures spanning the building blocks using principal component analysis (Ghana and Tanzania) or the balanced scorecard (Zambia). Other Partnerships developed summary measures to simplify multiple indicators within individual building blocks, including health information systems (Mozambique), and service delivery (Rwanda). At the end of the project intervention period, one to two key informants from each Partnership's leadership team were asked to list - in rank order - the importance of the six building blocks in relation to their intervention. Though there were differences across Partnerships, service delivery and information systems were reported to be the most common focus of interventions, followed by health workforce and leadership and governance. Medical products, vaccines and technologies, and

  16. Intimate partner violence influence on deliveries assisted by skilled health personnel

    Directory of Open Access Journals (Sweden)

    Amany Refaat

    2013-10-01

    Full Text Available Objective: Millennium Development Goal 5 calls for increasing proportions of deliveries assisted by skilled health personnel to reduce maternal mortality. This study aims to identifying the implication of exposure to intimate partner violence on these proportions. Methodology: This study used domestic violence modules data of Demographic and Health Surveys of six countries from 2005 to 2007. Proportions of assisted deliveries were examined by sociodemographic characteristics and exposure to intimate partner violence in the studied countries. Influence on the proportion was examined against exposure to intimate partner violence through odds ratio and 95% of logistic regression analysis after controlling for women age, residence (urban/rural, household wealth level, economic level of country, educational level and working status of women and their husbands/partners. Results: Data sets of 18,507 participants over 20 years of age showed that almost three-quarters (73% of women had deliveries assisted by skilled health personnel. One-third of the women were ever exposed to intimate partner violence (37% and 9% of them to the severe level. Exposure to intimate partner violence statistically significantly lowered this proportion to 69% (odds ratio: 0.73; 95% confidence interval: 0.67–0.78 meanwhile severe violence lowered it to 65% (odds ratio 0.64; 95% confidence interval: 0.58–0.72. When running multiple regression analysis, exposure to intimate partner violence retained its statistically significant decreasing influence on proportions and was not biased by the other stronger socioeconomic characteristics. Conclusion and recommendations: Intimate partner violence has an independent influence on reducing assisted deliveries by skilled health personnel. Programs working for increasing proportions of assisted deliveries by skilled health personnel are recommended to integrate protection women from violence.

  17. The Perception of Time: Influences on Physical and Mental Health

    Directory of Open Access Journals (Sweden)

    Cristián Rodrigo Oyanadel Véliz

    2011-01-01

    Full Text Available With a broad understanding of time perception, the dimensions positive past, negative past, fatalistic present, hedonistic present and future were grouped in profiles to assess relations with physical and mental health. Using a quasi-experimental design, 50 subjects matched for age and sex completed the Zimbardo Time Perspective Inventory and the SF-36, with 3 measures of time estimation. Pearson correlations and ANOVA showed significant relationships between dimensions, physical and mental health, and estimation. Three profiles were obtained, with the balanced one (BTP having the best health indicators. These results support the idea that it is good to have a balanced profile that implies a positive attitude to the past, future orientation, and enjoying pleasant experiences. Also, health is influenced by time estimation

  18. Health system factors influencing management of multidrug-resistant tuberculosis in four European Union countries - learning from country experiences

    Directory of Open Access Journals (Sweden)

    Gerard de Vries

    2017-04-01

    Full Text Available Abstract Background In the European Union and European Economic Area only 38% of multidrug-resistant tuberculosis patients notified in 2011 completed treatment successfully at 24 months’ evaluation. Socio-economic factors and patient factors such as demographic characteristics, behaviour and attitudes are associated with treatment outcomes. Characteristics of healthcare systems also affect health outcomes. This study was conducted to identify and better understand the contribution of health system components to successful treatment of multidrug-resistant tuberculosis. Methods We selected four European Union countries to provide for a broad range of geographical locations and levels of treatment success rates of the multidrug-resistant tuberculosis cohort in 2009. We conducted semi-structured interviews following a conceptual framework with representatives from policy and planning authorities, healthcare providers and civil society organisations. Responses were organised according to the six building blocks of the World Health Organization health systems framework. Results In the four included countries, Austria, Bulgaria, Spain, and the United Kingdom, the following healthcare system factors were perceived as key to achieving good treatment results for patients with multidrug-resistant tuberculosis: timely diagnosis of drug-resistant tuberculosis; financial systems that ensure access to a full course of treatment and support for multidrug-resistant tuberculosis patients; patient-centred approaches with strong intersectoral collaboration that address patients’ emotional and social needs; motivated and dedicated healthcare workers with sufficient mandate and means to support patients; and cross-border management of multidrug-resistant tuberculosis to secure continuum of care between countries. Conclusion We suggest that the following actions may improve the success of treatment for multidrug-resistant tuberculosis patients: deployment of

  19. Strengthening global health security by embedding the International Health Regulations requirements into national health systems.

    Science.gov (United States)

    Kluge, Hans; Martín-Moreno, Jose Maria; Emiroglu, Nedret; Rodier, Guenael; Kelley, Edward; Vujnovic, Melitta; Permanand, Govin

    2018-01-01

    The International Health Regulations (IHR) 2005, as the overarching instrument for global health security, are designed to prevent and cope with major international public health threats. But poor implementation in countries hampers their effectiveness. In the wake of a number of major international health crises, such as the 2014 Ebola and 2016 Zika outbreaks, and the findings of a number of high-level assessments of the global response to these crises, it has become clear that there is a need for more joined-up thinking between health system strengthening activities and health security efforts for prevention, alert and response. WHO is working directly with its Member States to promote this approach, more specifically around how to better embed the IHR (2005) core capacities into the main health system functions. This paper looks at how and where the intersections between the IHR and the health system can be best leveraged towards developing greater health system resilience. This merging of approaches is a key component in pursuit of Universal Health Coverage and strengthened global health security as two mutually reinforcing agendas.

  20. The emergence of a health insurance system in a developing country: the case of South Korea.

    Science.gov (United States)

    Cho, S

    1989-12-01

    In an attempt to understand the social forces and the economic and political conditions under which new social policies emerge in developing countries, this study outlines factors affecting the introduction of the health insurance system in South Korea. The emergence of the South Korean health insurance system was influenced by changing labor needs of the industrial sector, increasing social expectations, external and international pressures, increasing medical costs, and class conflict. These pressures compelled the South Korean government to respond to demands for the introduction of new social welfare policies in the 1970s. In the case of South Korea, the new health insurance system resulted from the government's attempts to cope with political, economic, and social pressures rather than from an ideological commitment to the well-being of the population. The resulting insurance system was a way to maintain the social order and legitimacy of the regime, and a means to promote the health of groups important to defense or production.

  1. Canada: Health system review.

    Science.gov (United States)

    Marchildon, Gregory

    2013-01-01

    Canada is a high-income country with a population of 33 million people. Its economic performance has been solid despite the recession that began in 2008. Life expectancy in Canada continues to rise and is high compared with most OECD countries; however, infant and maternal mortality rates tend to be worse than in countries such as Australia, France and Sweden. About 70% of total health expenditure comes from the general tax revenues of the federal, provincial and territorial governments. Most public revenues for health are used to provide universal medicare (medically necessary hospital and physician services that are free at the point of service for residents) and to subsidise the costs of outpatient prescription drugs and long-term care. Health care costs continue to grow at a faster rate than the economy and government revenue, largely driven by spending on prescription drugs. In the last five years, however, growth rates in pharmaceutical spending have been matched by hospital spending and overtaken by physician spending, mainly due to increased provider remuneration. The governance, organization and delivery of health services is highly decentralized, with the provinces and territories responsible for administering medicare and planning health services. In the last ten years there have been no major pan-Canadian health reform initiatives but individual provinces and territories have focused on reorganizing or fine tuning their regional health systems and improving the quality, timeliness and patient experience of primary, acute and chronic care. The medicare system has been effective in providing Canadians with financial protection against hospital and physician costs. However, the narrow scope of services covered under medicare has produced important gaps in coverage and equitable access may be a challenge in these areas. World Health Organization 2013 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and

  2. Institutional analysis of health system governance.

    Science.gov (United States)

    Abimbola, Seye; Negin, Joel; Martiniuk, Alexandra L; Jan, Stephen

    2017-11-01

    It is important that researchers who study health system governance have a set of collective understandings of the meanings of governance, which can then inform the methods used in research. We present an institutional framing and definition of health system governance; that is, governance refers to making, changing, monitoring and enforcing the rules that govern the demand and supply of health services. This pervasive, relational view of governance is to be preferred to approaches that focus primarily on structures of governments and health care organizations, because health system governance involves communities and service users, and because governments in many low- and middle-income countries tend to under-govern. Therefore, the study of health system governance requires institutional analysis; an approach that focuses not only on structures, but also on the rules (both formal and informal) governing demand and supply relations. Using this 'structure-relations' lens, and based on our field experience, we discuss how this focus could be applied to the three approaches to framing and studying health system governance that we identified in the literature. In order of decreasing focus on structures ('hardware') and increasing focus on relations ('software'), they are: (1) the government-centred approach, which focuses on the role of governments, above or to the exclusion of non-government health system actors; (2) the building-block approach, which focuses on the internal workings of health care organizations, and treats governance as one of the several building blocks of organizations; and (3) the institutional approach, which focuses on how the rules governing social and economic interactions are made, changed, monitored and enforced. Notably, either or both qualitative and quantitative methods may be used by researchers in efforts to incorporate the analysis of how rules determine relations among health system actors into these three approaches to health system

  3. The State Public Health Laboratory System.

    Science.gov (United States)

    Inhorn, Stanley L; Astles, J Rex; Gradus, Stephen; Malmberg, Veronica; Snippes, Paula M; Wilcke, Burton W; White, Vanessa A

    2010-01-01

    This article describes the development since 2000 of the State Public Health Laboratory System in the United States. These state systems collectively are related to several other recent public health laboratory (PHL) initiatives. The first is the Core Functions and Capabilities of State Public Health Laboratories, a white paper that defined the basic responsibilities of the state PHL. Another is the Centers for Disease Control and Prevention National Laboratory System (NLS) initiative, the goal of which is to promote public-private collaboration to assure quality laboratory services and public health surveillance. To enhance the realization of the NLS, the Association of Public Health Laboratories (APHL) launched in 2004 a State Public Health Laboratory System Improvement Program. In the same year, APHL developed a Comprehensive Laboratory Services Survey, a tool to measure improvement through the decade to assure that essential PHL services are provided.

  4. How China's new health reform influences village doctors' income structure: evidence from a qualitative study in six counties in China.

    Science.gov (United States)

    Zhang, Shengfa; Zhang, Weijun; Zhou, Huixuan; Xu, Huiwen; Qu, Zhiyong; Guo, Mengqi; Wang, Fugang; Zhong, You; Gu, Linni; Liang, Xiaoyun; Sa, Zhihong; Wang, Xiaohua; Tian, Donghua

    2015-05-05

    In 2009, health-care reform was launched to achieve universal health coverage in China. A good understanding of how China's health reforms are influencing village doctors' income structure will assist authorities to adjust related polices and ensure that village doctors employment conditions enable them to remain motivated and productive. This study aimed to investigate the village doctors' income structure and analyse how these health policies influenced it. Based on a review of the previous literature and qualitative study, village doctors' income structure was depicted and analysed. A qualitative study was conducted in six counties of six provinces in China from August 2013 to January 2014. Forty-nine village doctors participated in in-depth interviews designed to document their income structure and its influencing factors. The themes and subthemes of key factors influencing village doctors' income structure were analysed and determined by a thematic analysis approach and group discussion. Several policies launched during China's 2009 health-care reform had major impact on village doctors. The National Essential Medicines System cancelled drug mark-ups, removing their primary source of income. The government implemented a series of measures to compensate, including paying them to implement public health activities and provide services covered by social health insurance, but these have also changed the village doctors' role. Moreover, integrated management of village doctors' activities by township-level staff has reduced their independence, and different counties' economic status and health reform processes have also led to inconsistencies in village doctors' payment. These changes have dramatically reduced village doctors' income and employment satisfaction. The health-care reform policies have had lasting impacts on village doctors' income structure since the policies' implementation in 2009. The village doctors have to rely on the salaries and subsidies from

  5. Influence of Cancer Worry on Four Cancer Related Health Protective Behaviors among a Nationally Representative Sample: Implications for Health Promotion Efforts.

    Science.gov (United States)

    Amuta, Ann O; Mkuu, Rahma S; Jacobs, Wura; Ejembi, Agbenu Z

    2017-03-01

    The aims of this study were to assess what sociodemographic characteristics are associated with cancer worry and what the influence of cancer worry is on four cancer-related protective health behaviors. Data from the Health Information National Trends Survey (HINTS) (4th cycle of the 4th iteration) were used. Multiple regression models were used for all analyses. Behaviors analyzed were as follows: physical activity, diets, smoking, and routine medical screening. Demographics controls included participant age, income, body mass index (BMI), race/ethnicity, and education. N = 2630, Older participants (OR = .99, p health behavior and may be short-lived, the influence of worry on health-related decision making is likely to be lasting even when the emotions are no longer present.

  6. The Role of Quality Service Systems in Involving Families in Mental Health Treatment for Children with Severe Emotional Disturbances

    Science.gov (United States)

    Mayberry, Lindsay Satterwhite; Heflinger, Craig Anne

    2012-01-01

    Family involvement in the planning and execution of mental health treatment has been shown to positively influence child outcomes; however, there is wide variability in the levels of involvement by families. The current study investigated the influence of child, family caregiver, service system, and community factors on the level of family…

  7. Gaming science innovations to integrate health systems science into medical education and practice.

    Science.gov (United States)

    White, Earla J; Lewis, Joy H; McCoy, Lise

    2018-01-01

    Health systems science (HSS) is an emerging discipline addressing multiple, complex, interdependent variables that affect providers' abilities to deliver patient care and influence population health. New perspectives and innovations are required as physician leaders and medical educators strive to accelerate changes in medical education and practice to meet the needs of evolving populations and systems. The purpose of this paper is to introduce gaming science as a lens to magnify HSS integration opportunities in the scope of medical education and practice. Evidence supports gaming science innovations as effective teaching and learning tools to promote learner engagement in scientific and systems thinking for decision making in complex scenarios. Valuable insights and lessons gained through the history of war games have resulted in strategic thinking to minimize risk and save lives. In health care, where decisions can affect patient and population outcomes, gaming science innovations have the potential to provide safe learning environments to practice crucial decision-making skills. Research of gaming science limitations, gaps, and strategies to maximize innovations to further advance HSS in medical education and practice is required. Gaming science holds promise to equip health care teams with HSS knowledge and skills required for transformative practice. The ultimate goals are to empower providers to work in complex systems to improve patient and population health outcomes and experiences, and to reduce costs and improve care team well-being.

  8. Nutrition warnings as front-of-pack labels: influence of design features on healthfulness perception and attentional capture.

    Science.gov (United States)

    Cabrera, Manuel; Machín, Leandro; Arrúa, Alejandra; Antúnez, Lucía; Curutchet, María Rosa; Giménez, Ana; Ares, Gastón

    2017-12-01

    Warnings are a new directive front-of-pack (FOP) nutrition labelling scheme that highlights products with high content of key nutrients. The design of warnings influences their ability to catch consumers' attention and to clearly communicate their intended meaning, which are key determinants of their effectiveness. The aim of the present work was to evaluate the influence of design features of warnings as a FOP nutrition labelling scheme on perceived healthfulness and attentional capture. Five studies with a total of 496 people were carried out. In the first study, the association of colour and perceived healthfulness was evaluated in an online survey in which participants had to rate their perceived healthfulness of eight colours. In the second study, the influence of colour, shape and textual information on perceived healthfulness was evaluated using choice-conjoint analysis. The third study focused on implicit associations between two design features (shape and colour) on perceived healthfulness. The fourth and fifth studies used visual search to evaluate the influence of colour, size and position of the warnings on attentional capture. Perceived healthfulness was significantly influenced by shape, colour and textual information. Colour was the variable with the largest contribution to perceived healthfulness. Colour, size and position of the warnings on the labels affected attentional capture. Results from the experiments provide recommendations for the design of warnings to identify products with unfavourable nutrient profile.

  9. Enabling and sustaining the activities of lay health influencers: lessons from a community-based tobacco cessation intervention study.

    Science.gov (United States)

    Castañeda, Heide; Nichter, Mark; Nichter, Mimi; Muramoto, Myra

    2010-07-01

    The authors present findings from a community-based tobacco cessation project that trained lay health influencers to conduct brief interventions. They outline four major lessons regarding sustainability. First, participants were concerned about the impact that promoting cessation might have on social relationships. "Social risk" must be addressed during training to ensure long-term sustainability. Second, formal training provided participants with an increased sense of self-efficacy, allowed them to embrace a health influencer identity, and aided in further reducing social risk. Third, material resources functioned to mediate social tensions during health intervention conversations. A variety of resources should be made available to health influencers to accommodate type of relationship, timing, and location of the interaction. Finally, project design must be attentive to the creation of a "community of practice" among health influencers as an integral part of project sustainability. These lessons have broad implications for successful health promotion beyond tobacco cessation.

  10. Private sector in public health care systems

    OpenAIRE

    Matějusová, Lenka

    2008-01-01

    This master thesis is trying to describe the situation of private sector in public health care systems. As a private sector we understand patients, private health insurance companies and private health care providers. The focus is placed on private health care providers, especially in ambulatory treatment. At first there is a definition of health as a main determinant of a health care systems, definition of public and private sectors in health care systems and the difficulties at the market o...

  11. Sustaining the edge: factors influencing strategy selection in academic health centers.

    Science.gov (United States)

    Walsh, Anne M; Szabat, Kathryn

    2002-01-01

    Competition within the acute care sector as well as increased penetration by managed care organizations has influenced the structure and role of academic health centers during the past decade. The market factors confronting academic health centers are not dissimilar from conditions that confront other organizations competing in mature industries characterized by declining profitability and intense rivalry for market share. When confronted with intense competition or adverse external events, organizations in other industries have responded to potential threats by forming alliances, developing joint ventures, or merging with another firm to maintain their competitive advantage. Although mergers and acquisitions dominated the strategic landscape in the healthcare industry during the past decade, recent evidence suggests that other types of strategic ventures may offer similar economic and contracting benefits to member organizations. Academic health centers have traditionally been involved in network relationships with multiple partners via their shared technology, collaborative research, and joint educational endeavors. These quasi-organizational relationships appear to have provided a framework for strategic decisions and allowed executives of academic health centers to select strategies that were competitive yet closely aligned with their organizational mission. The analysis of factors that influenced strategy selection by executives of academic health centers suggests a deliberate and methodical approach to achieving market share objectives, expanding managed care contracts, and developing physician networks.

  12. Factors influencing workplace violence risk among correctional health workers: insights from an Australian survey.

    Science.gov (United States)

    Cashmore, Aaron W; Indig, Devon; Hampton, Stephen E; Hegney, Desley G; Jalaludin, Bin B

    2016-11-01

    Little is known about the environmental and organisational determinants of workplace violence in correctional health settings. This paper describes the views of health professionals working in these settings on the factors influencing workplace violence risk. All employees of a large correctional health service in New South Wales, Australia, were invited to complete an online survey. The survey included an open-ended question seeking the views of participants about the factors influencing workplace violence in correctional health settings. Responses to this question were analysed using qualitative thematic analysis. Participants identified several factors that they felt reduced the risk of violence in their workplace, including: appropriate workplace health and safety policies and procedures; professionalism among health staff; the presence of prison guards and the quality of security provided; and physical barriers within clinics. Conversely, participants perceived workplace violence risk to be increased by: low health staff-to-patient and correctional officer-to-patient ratios; high workloads; insufficient or underperforming security staff; and poor management of violence, especially horizontal violence. The views of these participants should inform efforts to prevent workplace violence among correctional health professionals.

  13. Civil society participation in the health system: the case of Brazil's Health Councils.

    Science.gov (United States)

    Martinez, Martha Gabriela; Kohler, Jillian Clare

    2016-10-26

    Brazil created Health Councils to bring together civil society groups, heath professionals, and government officials in the discussion of health policies and health system resource allocation. However, several studies have concluded that Health Councils are not very influential on healthcare policy. This study probes this issue further by providing a descriptive account of some of the challenges civil society face within Brazil's Health Councils. Forty semi-structured interviews with Health Council Members at the municipal, state and national levels were conducted in June and July of 2013 and May of 2014. The geographical location of the interviewees covered all five regions of Brazil (North, Northeast, Midwest, Southeast, South) for a total of 5 different municipal Health Councils, 8 different state Health Councils, and the national Health Council in Brasilia. Interview data was analyzed using a thematic approach. Health Councils are limited by a lack of legal authority, which limits their ability to hold the government accountable for its health service performance, and thus hinders their ability to fulfill their mandate. Equally important, their membership guidelines create a limited level of inclusivity that seems to benefit only well-organized civil society groups. There is a reported lack of support and recognition from the relevant government that negatively affects the degree to which Health Council deliberations are implemented. Other deficiencies include an insufficient amount of resources for Health Council operations, and a lack of training for Health Council members. Lastly, strong individual interests among Health Council members tend to influence how members participate in Health Council discussions. Brazil's Health Councils fall short in providing an effective forum through which civil society can actively participate in health policy and resource allocation decision-making processes. Restrictive membership guidelines, a lack of autonomy from the

  14. Influence of Melatonin on the Immune System of Fish: A Review

    Science.gov (United States)

    Esteban, M. Ángeles; Cuesta, Alberto; Chaves-Pozo, Elena; Meseguer, José

    2013-01-01

    Endocrine-immune system interactions have been widely demonstrated in mammals, whereas in fish, these relationships remain unclear. Of the organs that constitute the endocrine system, the pineal gland and its secretory product melatonin act in the synchronization of daily and seasonal rhythms in most vertebrates, including fish. Seasonal differences in immunocompetence and disease prevalence have been well documented in humans. Seasonality also strongly influences the life history of fish by controlling the timing of physiological events, such as reproduction, food intake, locomotor activity, and growth performance. Apart from its synchronizing capabilities, the role of melatonin in physiological processes in fish is not thoroughly understood. The purpose of this review is to summarize current studies on the effects of melatonin on the fish immune system. These studies suggest that melatonin represents an important component of fish endocrine-immune system interactions. The elucidation of the defense mechanisms of fish will facilitate the development of health management tools to support the growing finfish aquaculture industry as well as address questions concerning the origins and evolution of the immune system in vertebrates. PMID:23579958

  15. Schisms in the church: National Health Service systems and institutional divergence in England and Wales.

    Science.gov (United States)

    Hughes, David; Vincent-Jones, Peter

    2008-12-01

    Since devolution, the four countries of the United Kingdom have pursued strikingly different National Health Service (NHS) reforms. While England created a supply-side market more radical than the previous internal market system, Wales moved to a softer version of the purchaser/provider split emphasizing localism. This article deploys institutional theory to analyze the forces shaping change, and describes the hybrid forms of economic organization emerging, including the economic regulation model implemented in England. The schism that has resulted in separate NHS subsystems warrants a different analysis from the more familiar phenomenon of infield divergence. We argue that schism was triggered by political-regulatory influences rather than economic or other social institutional forces, and predict that other decentralized public health care systems may follow a similar path. While political-regulatory, normative, and cognitive institutional influences push in the same direction in Wales, the misalignment of political-regulatory and normative elements in England looks set to result in a period of organizational turbulence.

  16. Influence of flexibility and variability of working hours on health and well-being.

    Science.gov (United States)

    Costa, Giovanni; Sartori, Samantha; Akerstedt, Torbjorn

    2006-01-01

    Flexible working hours can have several meanings and can be arranged in a number of ways to suit the worker and/or employer. Two aspects of "flexible" arrangement of working hours were considered: one more subjected to company control and decision (variability) and one more connected to individual discretion and autonomy (flexibility). The aim of the study was to analyze these two dimensions in relation to health and well-being, taking into consideration the interaction with some relevant background variables related to demographics plus working and social conditions. The dataset of the Third European Survey on working conditions, conducted in 2000 and involving 21,505 workers, was used. Nineteen health disorders and four psycho-social conditions were tested by means of multiple logistic regression analysis, in which mutually adjusted odds ratios were calculated for age, gender, marital status, number of children, occupation, mode of employment, shift work, night work, time pressure, mental and physical workload, job satisfaction, and participation in work organization. The flexibility and variability of working hours appeared inversely related to health and psycho-social well-being: the most favorable effects were associated with higher flexibility and lower variability. The analysis of the interactions with the twelve intervening variables showed that physical work, age, and flexibility are the three most important factors affecting health and well-being. Flexibility resulted as the most important factor to influence work satisfaction; the second to affect family and social commitment and the ability to do the same job when 60 years old, as well as trauma, overall fatigue, irritability, and headache; and the third to influence heart disease, stomachache, anxiety, injury, and the feeling that health being at risk because of work. Variability was the third most important factor influencing family and social commitments. Moreover, shift and night work confirmed to

  17. Promoting Health Through Policy and Systems Change: Public Health Students and Mentors on the Value of Policy Advocacy Experience in Academic Internships.

    Science.gov (United States)

    Marquez, Daniela; Pell, Dylan; Forster-Cox, Sue; Garcia, Evelyn; Ornelas, Sophia; Bandstra, Brenna; Mata, Holly

    2017-05-01

    Emerging professionals and new Certified Health Education Specialists often lack academic training in and actual experience in National Commission for Health Education Credentialing Area of Responsibility VII: Communicate, Promote, and Advocate for Health, Health Education/Promotion, and the Profession. For undergraduate and graduate students who have an opportunity to complete an internship or practicum experience, gaining experience in Competencies 7.2: Engage in advocacy for health and health education/promotion and 7.3: Influence policy and/or systems change to promote health and health education can have a profound impact on their career development and their ability to advocate for policies that promote health and health equity. Compelling evidence suggests that interventions that address social determinants of health such as poverty and education and those that change the context through improved policy or healthier environments have the greatest impact on public health, making it vital for emerging public health professionals to gain experience in policy advocacy and systems change. In this commentary, students and faculty from two large universities in the U.S.-Mexico border region reflect on the value of policy advocacy in academic internship/fieldwork experiences. Based on their experiences, they highly recommend that students seek out internship opportunities where they can participate in policy advocacy, and they encourage university faculty and practicum preceptors to provide more opportunities for policy advocacy in both classroom and fieldwork settings.

  18. Health for All - Italia, an informative health system

    Directory of Open Access Journals (Sweden)

    Marzia Loghi

    2008-06-01

    Full Text Available

    Background: On ISTAT website the informative system Health for All – Italia is available. It collects indicators on health coming from various sources to make up a basis for constructing an organic and joint framework on the country’s health reality. The system includes more than 4000 indicators about: demographic and socioeconomic context; causes of death; life styles; disease prevention; chronic and infectious diseases; disability; health status and life expectancy; health facilities; hospital discharges by diagnosis; health care resources. The database-related software was developed by the World Health Organization to make it easier for any user to access the information available either as tables, graphs and territorial maps.

    Methods: The system has been built considering data coming from different sources and using, if possible, the same definitions, classifications and desegregations. Time series goes from 1980 to the last year available (which can differ among the different sources. Indicators are calculated by provinces (if possible, regions, big areas and Italy. In order to compare indicators over time and space, standardised rates are calculated, using the same population reference. For each indicator metadata are available to give users additional notes necessary to correctly read and use the data, and publications or internet websites to examine more in-depth the argument.

    Results: Different kind of users find Health for All – Italia very useful for their aims: students, researchers, doctors, socio-sanitary operators, policy makers. Some examples of official reports from public institutions are briefly described in the paper.

    Conclusions: The increasing number of users of Health for All – Italia make necessary the online version and an English version for international comparisons.

  19. 42 CFR 438.242 - Health information systems.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Health information systems. 438.242 Section 438.242... Measurement and Improvement Standards § 438.242 Health information systems. (a) General rule. The State must ensure, through its contracts, that each MCO and PIHP maintains a health information system that collects...

  20. The influence of context and process when implementing e-health

    Directory of Open Access Journals (Sweden)

    Heaney David

    2009-01-01

    Full Text Available Abstract Background Investing in computer-based information systems is notoriously risky, since many systems fail to become routinely used as part of everyday working practices, yet there is clear evidence about the management practices which improve the acceptance and integration of such systems. Our aim in this study was to identify to what extent these generic management practices are evident in e-health projects, and to use that knowledge to develop a theoretical model of e-health implementation. This will support the implementation of appropriate e-health systems. Methods This study consisted of qualitative semi-structured interviews with managers and health professionals in Scotland, UK. We contacted the Scottish Ethics Committee, who advised that formal application to that body was not necessary for this study. The interview guide aimed to identify the issues which respondents believed had affected the successful implementation of e-health projects. We drew on our research into information systems in other sectors to identify likely themes and questions, which we piloted and revised. Eighteen respondents with experience of e-health projects agreed to be interviewed. These were recorded, transcribed, coded, and then analysed with 'Nvivo' data analysis software. Results Respondents identified factors in the context of e-health projects which had affected implementation, including clarity of the strategy; supportive structures and cultures; effects on working processes; and how staff perceived the change. The results also identified useful implementation practices such as balancing planning with adaptability; managing participation; and using power effectively. Conclusion The interviews confirmed that the contextual factors that affect implementation of information systems in general also affect implementation of e-health projects. As expected, these take place in an evolving context of strategies, structures, cultures, working processes and

  1. How Religious Beliefs and Practices Influence the Psychological Health of Catholic Priests.

    Science.gov (United States)

    Isacco, Anthony; Sahker, Ethan; Krinock, Elizabeth; Sim, Wonjin; Hamilton, Deanna

    2016-07-01

    Roman Catholic diocesan priests are a subgroup of men with unique religious and spiritual roles, beliefs, and practices. This qualitative study of 15 priests from the mid-Atlantic area of the United States focused on how priests' relationship with God and promises of celibacy and obedience influenced their psychological health. Using a consensual qualitative research (CQR) design, the analysis revealed that participants described their relationship with God as central to their health and contributing to positive outcomes (e.g., sense of connection and support). The influence of their promises of celibacy and obedience were linked to both positive outcomes (e.g., decreased stress, improved relationships) and negative outcomes (e.g., internal conflict, depression/loneliness). This study highlighted the central role that priests' relationship with God has on positive psychological health. Future research is necessary to understand how to maximize the positive effects and minimize the negative effects of priests' promises of celibacy and obedience, which would benefit programs aimed at supporting priests' psychological health. © The Author(s) 2015.

  2. A Case for Open Network Health Systems: Systems as Networks in Public Mental Health.

    Science.gov (United States)

    Rhodes, Michael Grant; de Vries, Marten W

    2017-01-08

    Increases in incidents involving so-called confused persons have brought attention to the potential costs of recent changes to public mental health (PMH) services in the Netherlands. Decentralized under the (Community) Participation Act (2014), local governments must find resources to compensate for reduced central funding to such services or "innovate." But innovation, even when pressure for change is intense, is difficult. This perspective paper describes experience during and after an investigation into a particularly violent incident and murder. The aim was to provide recommendations to improve the functioning of local PMH services. The investigation concluded that no specific failure by an individual professional or service provider facility led to the murder. Instead, also as a result of the Participation Act that severed communication lines between individuals and organizations, information sharing failures were likely to have reduced system level capacity to identify risks. The methods and analytical frameworks employed to reach this conclusion, also lead to discussion as to the plausibility of an unconventional solution. If improving communication is the primary problem, non-hierarchical information, and organizational networks arise as possible and innovative system solutions. The proposal for debate is that traditional "health system" definitions, literature and narratives, and operating assumptions in public (mental) health are 'locked in' constraining technical and organization innovations. If we view a "health system" as an adaptive system of economic and social "networks," it becomes clear that the current orthodox solution, the so-called integrated health system, typically results in a "centralized hierarchical" or "tree" network. An overlooked alternative that breaks out of the established policy narratives is the view of a 'health systems' as a non-hierarchical organizational structure or 'Open Network.' In turn, this opens new technological and

  3. Influence of health, lifestyle, working conditions, and sociodemography on early retirement among nurses

    DEFF Research Database (Denmark)

    Friis, Karina; Ekholm, Ola; Hundrup, Yrsa A

    2007-01-01

    by Statistics Denmark. The follow-up period was from 1993 to 2002. RESULTS: Nurses who had poor self-rated health were more likely to join PEW compared with nurses who considered their health as good (HR 1.28, 95% CI 1.16-1.41). Low job influence, high workload, and physical job demands only marginally...... increased the probability of retiring. Nurses who have relatively low gross incomes had an increased probability of entering PEW compared with nurses with relatively high gross incomes (HR 1.60, CI 1.43-1.79). Having a spouse increased the probability of joining PEW, especially having a spouse who had...... retired or was unemployed. CONCLUSIONS: The retirement age among nurses is influenced by a number of sociodemographic, work-related, and health-related factors. Poor health, low income, living outside the Copenhagen area, being married, having a spouse who is outside the labor force, and working...

  4. Influence of Information Systems on Business Performance

    Directory of Open Access Journals (Sweden)

    Dmitrij Lipaj

    2013-04-01

    Full Text Available Considering increased competition nowadays, businesses strive to gain competitive advantage, increase their economic indicators, work productivity and efficiency, reduce costs and get other benefits through implementation of integrated information systems. By improving internal processes and financial performance of the company, the general business performance could be influenced by the deployment of such information system (IS. In order to identify tangible and intangible benefits of IS implementation, influence on business performance, business processes and areas that are being affected, analysis of scientific literature, research synthesis and generalizations have been made.

  5. Mobile health information system: a mobile app. to aid health ...

    African Journals Online (AJOL)

    Mobile health information system: a mobile app. to aid health workers relate health information. ... Global Journal of Mathematical Sciences ... phones in delivering vital health information and effective fieldwork reporting is of significance.

  6. Factors Influencing Rural End-Users' Acceptance of e-Health in Developing Countries: A study on Portable Health Clinic in Bangladesh.

    Science.gov (United States)

    Hossain, Nazmul; Yokota, Fumihiko; Sultana, Nazneen; Ahmed, Ashir

    2018-04-17

    Existing studies regarding e-health are mostly focused on information technology design and implementation, system architecture and infrastructure, and its importance in public health with ancillaries and barriers to mass adoption. However, not enough studies have been conducted to assess the end-users' reaction and acceptance behavior toward e-health, especially from the perspective of rural communities in developing countries. The objective of this study is to explore the factors that influence rural end users' acceptance of e-health in Bangladesh. Data were collected between June and July 2016 through a field survey with structured questionnaire form 292 randomly selected rural respondents from Bheramara subdistrict, Bangladesh. Technology Acceptance Model was adopted as the research framework. Logistic regression analysis was performed to test the theoretical model. The study found social reference as the most significantly influential variable (Coef. = 2.28, odds ratio [OR] = 9.73, p acceptance behavior. The model explains 54.70% deviance (R 2  = 0.5470) in the response variable with its constructs. The "Hosmer-Lemeshow" goodness-of-fit score (0.539) is also above the standard threshold (0.05), which indicates that the data fit well with the model. The study provides guidelines for the successful adoption of e-health among rural communities in developing countries. This also creates an opportunity for e-health technology developers and service providers to have a better understanding of their end users.

  7. [Health-care utilization in elderly (Spain 2006-2012): Influence of health status and social class].

    Science.gov (United States)

    Aguilar-Palacio, Isabel; Carrera-Lasfuentes, Patricia; Solsona, Sofía; Sartolo, M Teresa; Rabanaque, M José

    2016-04-01

    to explore health-care utilization (primary and specialized health-care, hospitalizations, day hospital and emergency services) and overuse in elderly in Spain, considering the influence of health status, sex, social class and its temporal trend. cross sectional study in two phases. Spain. people surveyed in the National Health Surveys 2006 and 2011-12. Health status was measured using self-rated and diagnosed health (number and diagnoses). Social class was obtained from the last occupation of the main supporter (manual and non-manual workers). Logistic regression analyses were conducted adjusting by sex, age, health status, social class and year, obtaining its predictive capacity. the percentage of elderly population with health-care utilization decreased during the period analyzed. Women who belonged to the manual workers category presented the highest prevalence of low health (low self-rated health in 2006: 70.6%). Low health status was associated with a higher utilization of health-care services. Self-rated health was a better predictor of health-care utilization and overuse than diagnosed health, getting the highest predictive capacity for specialized health-care (C = 0.676). Old people from low social class used with higher frequency primary health-care and emergency services. On the other hand, specialized health-care and day hospital were more used by high social classes. inequalities in health and health-care utilization have been observed in elderly according social class. It is necessary to consider self-rated health as a health-care utilization predictor and to review our health-care services accessibility and equity. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  8. Factors influencing the work efficiency of district health managers in low-resource settings: a qualitative study in Ghana.

    Science.gov (United States)

    Bonenberger, Marc; Aikins, Moses; Akweongo, Patricia; Wyss, Kaspar

    2016-01-14

    There is increasing evidence that good district management practices can improve health system performance and conversely, that poor and inefficient management practices have detrimental effects. The aim of the present study was to identify factors contributing to inefficient management practices of district health managers and ways to improve their overall efficiency. Nineteen semi-structured interviews were conducted with district health managers in three districts of the Eastern Region in Ghana. The 19 interviews conducted comprised 90% of the managerial workforce in these districts in 2013. A thematic analysis was carried out using the WHO's leadership and management strengthening framework to structure the results. Key factors for inefficient district health management practices were identified to be: human resource shortages, inadequate planning and communication skills, financial constraints, and a narrow decision space that constrains the authority of district health managers and their ability to influence decision-making. Strategies that may improve managerial efficiency at both an individual and organizational level included improvements to planning, communication, and time management skills, and ensuring the timely release of district funds. Filling District Health Management Team vacancies, developing leadership and management skills of district health managers, ensuring a better flow of district funds, and delegating more authority to the districts seems to be a promising intervention package, which may result in better and more efficient management practices and stronger health system performance.

  9. Intelligent Integrated System Health Management

    Science.gov (United States)

    Figueroa, Fernando

    2012-01-01

    Intelligent Integrated System Health Management (ISHM) is the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system (Management: storage, distribution, sharing, maintenance, processing, reasoning, and presentation). Presentation discusses: (1) ISHM Capability Development. (1a) ISHM Knowledge Model. (1b) Standards for ISHM Implementation. (1c) ISHM Domain Models (ISHM-DM's). (1d) Intelligent Sensors and Components. (2) ISHM in Systems Design, Engineering, and Integration. (3) Intelligent Control for ISHM-Enabled Systems

  10. Exploring physicians' extended use of electronic health records (EHRs): A social influence perspective.

    Science.gov (United States)

    Wang, Wen; Zhao, Xiping; Sun, Jinglei; Zhou, Guangquan

    2016-12-01

    Once electronic health records (EHRs) have been fully implemented and integrated into the daily work of a healthcare organisation/hospital, there is considerable pressure on management to demonstrate the benefits that these systems can deliver to the organisation. One practical way to maximise the value and highlight the benefits of EHRs is to encourage physicians to increase and extend their use of EHR functions. This study used a social influence theory context to examine the impact of mechanisms of social influence on the intentions of physicians to extend their use of EHRs. A survey of physicians (n = 205) in a first-class comprehensive hospital in southern China was conducted approximately 2 years after the hospital's introduction of EHRs. A 16-item questionnaire was developed to measure the impact of four social influence factors (reward, punishment, social image and group norm) on physicians' intentions to extend their use of EHRs. The research model included two additional control variables (perceived usefulness and perceived ease of use) to account for potential covariance among social influence measures. The study's research model showed significant relationships between physicians' responses on two of the social influence measures (rewards and group norm) and their intentions to extend their use of EHRs. Punishment and social image measures did not influence physicians' intentions to increase their use of EHRs. These findings have suggested that for healthcare organisations to maximise the benefits of EHRs, the efforts of hospital management should be directed towards rewarding those physicians who increase their use of EHRs; and to promoting and reinforcing the increased usage of EHRs among physicians as a group norm. © The Author(s) 2016.

  11. The child welfare system: through the eyes of public health nurses.

    Science.gov (United States)

    Schneiderman, Janet U

    2005-01-01

    This qualitative descriptive study investigates how public health nurses working within the child welfare system view the organization and the organization's effect on their case management practice. Semistructured interviews were conducted utilizing the Bolman-Deal Organizational Model. This model identifies four frames of an organization: symbolic, human resources, political, and structural. A purposive sample of nine nurses and one social worker was selected to participate in comprehensive interviews. Data analysis identified two main themes. The first theme was the presence of organizational structural barriers to providing case management. The second theme was the lack of political influence by the nurses to change the structure of the organization; hence, their skills could be more completely utilized. Public health nurses who work in child welfare will need to systematically analyze their role within the organization and understand how to work in "host settings." Nursing educators need to prepare public health nurses to work in non-health care settings by teaching organizational analysis.

  12. Veneto Region, Italy. Health system review.

    Science.gov (United States)

    Toniolo, Franco; Mantoan, Domenico; Maresso, Anna

    2012-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. This HiT is one of the first to be written on a subnational level of government and focuses on the Veneto Region of northern Italy. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The Veneto Region is one of Italy's richest regions and the health of its resident population compares favourably with other regions in Italy. Life expectancy for both men and women, now at 79.1 and 85.2 years, respectively, is slightly higher than the national average, while mortality rates are comparable to national ones. The major causes of death are tumours and cardiovascular diseases. Under Italy's National Health Service, the organization and provision of health care is a regional responsibility and regions must provide a nationally defined (with regional input) basic health benefit package to all of their citizens; extra services may be provided if budgets allow. Health care is mainly financed by earmarked central and regional taxes, with regions receiving their allocated share of resources from the National Health Fund. Historically, health budget deficits have been a major problem in most Italian regions, but since the early 2000s the introduction of efficiency measures and tighter procedures on financial management have contributed to a significant decrease in the Veneto Regions health budget deficit.The health system is governed by the Veneto Region government (Giunta) via the Departments of Health and Social Services, which receive technical support from a single General Management Secretariat. Health care is

  13. Factors Influencing Support for National Health Insurance among Patients Attending Specialist Clinics in Malaysia

    Science.gov (United States)

    Almualm, Yasmin; Alkaff, Sharifa Ezat; Aljunid, Syed; Alsagoff, Syed Sagoff

    2013-01-01

    This study was carried out to determine the level of support towards the proposed National Health Insurance scheme among Malaysian patients attending specialist clinics at the National University of Malaysia Medical centre and its influencing factors. The cross sectional study was carried out from July-October 2012. 260 patients were selected using multistage sampling method. 71.2% of respondents supported the proposed National Health insurance scheme. 61.4% of respondents are willing to pay up to RM240 per year to join the National Health Insurance and 76.6% of respondents are of the view that enrolment in NHI should be made compulsory. Knowledge had a positive influence on respondent's support towards National Health Insurance. National Health Insurance when implemented in Malaysia can be used to raise funds for health care financing, increase access to health services and achieve the desired health status. More efforts should be taken to promote the scheme and educate the public in order to achieve higher support towards the proposed National Health Insurance. The cost to enroll in NHI as well as services to be included under the scheme should be duly considered. PMID:23985101

  14. The impact of human immunodeficiency virus (HIV) service scale-up on mechanisms of accountability in Zambian primary health centres: a case-based health systems analysis.

    Science.gov (United States)

    Topp, Stephanie M; Black, Jim; Morrow, Martha; Chipukuma, Julien M; Van Damme, Wim

    2015-02-18

    Questions about the impact of large donor-funded HIV interventions on low- and middle-income countries' health systems have been the subject of a number of expert commentaries, but comparatively few empirical research studies. Aimed at addressing a particular evidence gap vis-à-vis the influence of HIV service scale-up on micro-level health systems, this article examines the impact of HIV scale-up on mechanisms of accountability in Zambian primary health facilities. Guided by the Mechanisms of Effect framework and Brinkerhoff's work on accountability, we conducted an in-depth multi-case study to examine how HIV services influenced mechanisms of administrative and social accountability in four Zambian primary health centres. Sites were selected for established (over 3 yrs) antiretroviral therapy (ART) services and urban, peri-urban and rural characteristics. Case data included provider interviews (60); patient interviews (180); direct observation of facility operations (2 wks/centre) and key informant interviews (14). Resource-intensive investment in HIV services contributed to some early gains in administrative answerability within the four ART departments, helping to establish the material capabilities necessary to deliver and monitor service delivery. Simultaneous investment in external supervision and professional development helped to promote transparency around individual and team performance and also strengthened positive work norms in the ART departments. In the wider health centres, however, mechanisms of administrative accountability remained weak, hindered by poor data collection and under capacitated leadership. Substantive gains in social accountability were also elusive as HIV scale-up did little to address deeply rooted information and power asymmetries in the wider facilities. Short terms gains in primary-level service accountability may arise from investment in health system hardware. However, sustained improvements in service quality and

  15. Mapping Health Needs to Support Health System Management in Poland

    Science.gov (United States)

    Holecki, Tomasz; Romaniuk, Piotr; Woźniak-Holecka, Joanna; Szromek, Adam R.; Syrkiewicz-Świtała, Magdalena

    2018-01-01

    In Poland, following the example of other EU countries, the first maps of health needs prepared by the Ministry of Health were presented in 2016. The maps constitute a foundation for rational decision-making in the management of health care resources, being potentially useful for all actors in health system. This refers in particular to the institutions responsible for distribution of funds and contracting health service, but also for decision-makers, who determine the scope of funds to be utilized in the health system, or the structure of benefits provided to patients. Service providers are also addressees of the maps, to give them a basis for planning future activities. The article presents a structured assessment of the current state of affairs, based on recent experience and sets out likely directions for the development of health needs in mapping in Poland in the future. We discuss the criticism addressed toward maps by representatives of various groups acting in health care. It includes the lack of recognition of some of the key health needs, or wrong emphases, where much more attention is paid to the recognition of current resources in the health system, instead of making prognoses regarding the future developments of health needs. Nonetheless, we find that this instrument is potentially of high usability, in case of elimination of the existing weaknesses. PMID:29662876

  16. Strengthening Governance in Health Systems for Reproductive ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Home · What we do ... As a result, Pakistan's health system has suffered and health service delivery has worsened. ... This four-year project aims to strengthen health systems governance for reproductive health and rights in Pakistan.

  17. Health-system strengthening and tuberculosis control.

    Science.gov (United States)

    Atun, Rifat; Weil, Diana E C; Eang, Mao Tan; Mwakyusa, David

    2010-06-19

    Weak health systems are hindering global efforts for tuberculosis care and control, but little evidence is available on effective interventions to address system bottlenecks. This report examines published evidence, programme reviews, and case studies to identify innovations in system design and tuberculosis control to resolve these bottlenecks. We outline system bottlenecks in relation to governance, financing, supply chain management, human resources, health-information systems, and service delivery; and adverse effects from rapid introduction of suboptimum system designs. This report also documents innovative solutions for disease control and system design. Solutions pursued in individual countries are specific to the nature of the tuberculosis epidemic, the underlying national health system, and the contributors engaged: no one size fits all. Findings from countries, including Bangladesh, Cambodia, India, Tanzania, Thailand, and Vietnam, suggest that advances in disease control and system strengthening are complementary. Tuberculosis care and control are essential elements of health systems, and simultaneous efforts to innovate systems and disease response are mutually reinforcing. Highly varied and context-specific responses to tuberculosis show that solutions need to be documented and compared to develop evidence-based policies and practice. Copyright 2010 Elsevier Ltd. All rights reserved.

  18. Hygiene and other early childhood influences on the subsequent function of the immune system.

    Science.gov (United States)

    Rook, Graham A W; Lowry, Christopher A; Raison, Charles L

    2015-08-18

    The immune system influences brain development and function. Hygiene and other early childhood influences impact the subsequent function of the immune system during adulthood, with consequences for vulnerability to neurodevelopmental and psychiatric disorders. Inflammatory events during pregnancy can act directly to cause developmental problems in the central nervous system (CNS) that have been implicated in schizophrenia and autism. The immune system also acts indirectly by "farming" the intestinal microbiota, which then influences brain development and function via the multiple pathways that constitute the gut-brain axis. The gut microbiota also regulates the immune system. Regulation of the immune system is crucial because inflammatory states in pregnancy need to be limited, and throughout life inflammation needs to be terminated completely when not required; for example, persistently raised levels of background inflammation during adulthood (in the presence or absence of a clinically apparent inflammatory stimulus) correlate with an increased risk of depression. A number of factors in the perinatal period, notably immigration from rural low-income to rich developed settings, caesarean delivery, breastfeeding and antibiotic abuse have profound effects on the microbiota and on immunoregulation during early life that persist into adulthood. Many aspects of the modern western environment deprive the infant of the immunoregulatory organisms with which humans co-evolved, while encouraging exposure to non-immunoregulatory organisms, associated with more recently evolved "crowd" infections. Finally, there are complex interactions between perinatal psychosocial stressors, the microbiota, and the immune system that have significant additional effects on both physical and psychiatric wellbeing in subsequent adulthood. This article is part of a Special Issue entitled Neuroimmunology in Health And Disease. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights

  19. The 'Practice Entrepreneur' - An Australian case study of a systems thinking inspired health promotion initiative.

    Science.gov (United States)

    Joyce, A; Green, C; Carey, G; Malbon, E

    2017-01-23

    The potential of systems science concepts to inform approaches for addressing complex public health problems, such as obesity prevention, has been attracting significant attention over the last decade. Despite its recent popularity, there are very few studies examining the application of systems science concepts, termed systems thinking, in practice and whether (if at all) it influences the implementation of health promotion in real world settings and in what ways. Healthy Together Victoria (HTV) was based on a systems thinking approach to address obesity prevention alongside other chronic health problems and was implemented across 14 local government areas. This paper examines the experience of practitioners from one of those intervention sites. In-depth interviews with eight practitioners revealed that there was a rigidity with which they had experienced previous health promotion jobs relative to the flexibility and fluidity of HTV. While the health promotion literature does not indicate that health promotion should be overly prescriptive, the experience of these practitioners suggests it is being applied as such in real world settings. Within HTV, asking people to work with 'systems thinking', without giving a prescription about what systems thinking is, enabled practitioners to be 'practice entrepreneurs' by choosing from a variety of systems thinking methods (mapping, reflection) to engage actively in their positions. This highlights the importance of understanding how key concepts, both traditional planning approaches and systems science concepts, are interpreted and then implemented in real world settings. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. Does financial system influence tax revenue? The case of Nigeria ...

    African Journals Online (AJOL)

    We examined the influence of financial system activities on tax revenue ... our analysis showed that financial system activities influence tax revenue ... causality test and variance decomposition results corroborate our regression results.

  1. Why Does Disaster Recovery Work Influence Mental Health?: Pathways through Physical Health and Household Income.

    Science.gov (United States)

    Lowe, Sarah R; Kwok, Richard K; Payne, Julianne; Engel, Lawrence S; Galea, Sandro; Sandler, Dale P

    2016-12-01

    Disaster recovery work increases risk for mental health problems, yet the mechanisms underlying this association are unclear. We explored links from recovery work to post-traumatic stress (PTS), major depression (MD), and generalized anxiety disorder (GAD) symptoms through physical health symptoms and household income in the aftermath of the Deepwater Horizon oil spill. As part of the NIEHS GuLF STUDY, participants (N = 10,141) reported on cleanup work activities, spill-related physical health symptoms, and household income at baseline, and mental health symptoms an average of 14.69 weeks (SD = 16.79) thereafter. Cleanup work participation was associated with higher physical health symptoms, which in turn were associated with higher PTS, MD, and GAD symptoms. Similar pattern of results were found in models including workers only and investigating the influence of longer work duration and higher work-related oil exposure on mental health symptoms. In addition, longer worker duration and higher work-related oil exposure were associated with higher household income, which in turn was associated with lower MD and GAD symptoms. These findings suggest that physical health symptoms contribute to workers' risk for mental health symptoms, while higher household income, potentially from more extensive work, might mitigate risk. © Society for Community Research and Action 2016.

  2. The public health system in England

    National Research Council Canada - National Science Library

    Hunter, David J; Marks, Linda; Smith, Katherine E

    2010-01-01

    .... The Public Health System in England offers a wide-ranging, provocative and accessible assessment of challenges confronting a public health system, exploring how its parameters have shifted over time...

  3. Resources, attitudes and culture: an understanding of the factors that influence the functioning of accountability mechanisms in primary health care settings.

    Science.gov (United States)

    Cleary, Susan M; Molyneux, Sassy; Gilson, Lucy

    2013-08-16

    District level health system governance is recognised as an important but challenging element of health system development in low and middle-income countries. Accountability is a more recent focus in health system debates. Accountability mechanisms are governance tools that seek to regulate answerability between the health system and the community (external accountability) and/or between different levels of the health system (bureaucratic accountability). External accountability has attracted significant attention in recent years, but bureaucratic accountability mechanisms, and the interactions between the two forms of accountability, have been relatively neglected. This is an important gap given that webs of accountability relationships exist within every health system. There is a need to strike a balance between achieving accountability upwards within the health system (for example through information reporting arrangements) while at the same time allowing for the local level innovation that could improve quality of care and patient responsiveness. Using a descriptive literature review, this paper examines the factors that influence the functioning of accountability mechanisms and relationships within the district health system, and draws out the implications for responsiveness to patients and communities. We also seek to understand the practices that might strengthen accountability in ways that improve responsiveness--of the health system to citizens' needs and rights, and of providers to patients. The review highlights the ways in which bureaucratic accountability mechanisms often constrain the functioning of external accountability mechanisms. For example, meeting the expectations of relatively powerful managers further up the system may crowd out efforts to respond to citizens and patients. Organisational cultures characterized by supervision and management systems focused on compliance to centrally defined outputs and targets can constrain front line

  4. Local health systems in 21st century: who cares?-An exploratory study on health system governance in Amsterdam.

    Science.gov (United States)

    Plochg, T; Delnoij, D M J; Hogervorst, W V G; van Dijk, P; Belleman, S; Klazinga, N S

    2006-10-01

    There is a growing awareness that there should be a public health perspective to health system governance. Its intrinsic population health orientation provides the ultimate ground for determining the health needs and governing collaborative care arrangements within which these needs can be met. Notwithstanding differences across countries, population health concerns are not central to European health reforms. Governments currently withdraw leaving governance roles to care providers and/or financiers. Thereby, incentives that trigger the uptake of a public health perspective are often ignored. In this study we addressed this issue in the city of Amsterdam. Using a qualitative study design, we explored whether there is a public health perspective to the governance practices of the municipality and the major sickness fund in Amsterdam. And if so, what the scope of this perspective is. And if not, why not. Findings indicate that the municipality has a public health perspective to local health system governance, but its scope is limited. The municipality facilitates rather than governs health care provision in Amsterdam. Furthermore, the sickness fund runs major financial risks when adapting a public health perspective. It covers an insured population that partly overlaps the Amsterdam population. Returns on investments in population health are therefore uncertain, as competitors would also profit from the sickness fund's investments. The local health system in Amsterdam is not consistently aligned to the health needs of the Amsterdam population. The Amsterdam case is not unique and general consequences for local health system governance are discussed.

  5. Social influences and reproductive health of adolescents

    OpenAIRE

    Stanković Biljana

    2007-01-01

    Reproductive health represents a state of complete physical, mental and social prosperity, and not just the absence of illness or weakness, and it refers to reproductive processes, functions and systems. Adolescents, young people from the age of ten to nineteen, are yet to achieve their reproductive function, thus their reproductive health and behavior are very significant both from the individual and social standpoint. Risky behavior, which represents the main cause of diseases that young pe...

  6. The Influence of the Devotion Movement on the Health Care in North Korea

    Directory of Open Access Journals (Sweden)

    KIM Soo-Youn

    2006-06-01

    Full Text Available Since the early 1960s, North Korea has conducted 'devotion movement' under the directorship of Kim Il Sung across the nation. As a matter of fact, the movement was not a novel invention at all. When North Korean Temporary People's Polity was established in 1946, North Korea emphasized the importance of the devoted care of health personnel. It meant to reform the people's thought and mind along with complementing the lack of human and material resources. Thought reform was not a peculiar phenomenon observed in North Korea only. It was particularly stressed out among communist countries, including the Soviet Union. However any other communist country stresses the importance of thought reform. Devotion movement should be viewed as part of this process. As shown in many cases, the extent and degree of devotion movement and care are beyond our imagination, which does not intend to mean that North Korean health personnel's attitude towards patients is superior to the counterparts in South Korea. Indeed human being's behavior cannot be understood without taking account of society in general. The question can be raised as to whether or not North Korean health personnel's devoted care is really voluntary. To put aside the testimony that the most powerless group in a society can fall prey to victims, if social environment, whether directly or indirectly, is action on the people's thought and mind even in a subtle way and thus influence one's decision power, it is hard to highly evaluate the devoted care in North Korea. Moreover it seems like that the internal conflict exists surrounding devotion. In conclusion, I think that North Korean devotion movement has enforced health personnel to reform their thought and mind to adapt to North Korean regime and has played an important role to accomplish the purpose of North Korean Labor Party to realize essential constituents of its health system, in such a situation in which essential medical supplies are severely

  7. Mobile health monitoring system for community health workers

    CSIR Research Space (South Africa)

    Sibiya, G

    2014-09-01

    Full Text Available of hypertension as it provides real time information and eliminates the need to visit a healthcare facility to take blood pressure readings. Our proposed mobile health monitoring system enables faster computerization of data that has been recorded... pressure, heart rate and glucose readings. These reading closely related to most common NCDs. D. Feedback to health worker and the subject of care Community health workers are often not professionally trained on health. As a result they are not expected...

  8. Integrated System Health Management Development Toolkit

    Science.gov (United States)

    Figueroa, Jorge; Smith, Harvey; Morris, Jon

    2009-01-01

    This software toolkit is designed to model complex systems for the implementation of embedded Integrated System Health Management (ISHM) capability, which focuses on determining the condition (health) of every element in a complex system (detect anomalies, diagnose causes, and predict future anomalies), and to provide data, information, and knowledge (DIaK) to control systems for safe and effective operation.

  9. [Images of Ageing in Health Care Magazines of the Public Health System].

    Science.gov (United States)

    Hartmann-Tews, Ilse; Hoppe, Theresa

    2018-03-01

    Collective images of ageing influence attitudes towards ageing and health- related activities. The aim of this study was to explore images of ageing and old age in magazines published by public health institutions, namely health insurance companies and pharmacies. A standardized content analysis was conducted covering age-related articles (n=146) and accompanying photographs (n=218) of public health institutions. The stock of material comprises age-related articles of all magazines published 2012-2013 of 2 public health insurance companies (Allgemeine Ortskrankenkasse: "Bleib gesund", Barmer Ersatzkasse: "Gesundheit konkret"), 2 private health insurance companies (Gothaer Versicherung: "Gothaer magazin", Deutsche Krankenversicherung: "DKV impulse") and 2 consumer magazines of pharmacies ("Apothekenumschau","Senioren Ratgeber"). Illness turns out to be the most often focused main theme and key issue of age-related articles. With reference to the central dimensions of somatic culture - health, body-centered performance and appearance - most of the articles focus on deficits of old age, in particular illness and decrease of performance, and thus communicate a negative image of ageing. The visual presentation of elderly people is much more positive. There are various differences in the communication of images of ageing between the 2 types of magazines, with the consumer magazines of the pharmacy covering a broader spectrum of topics, referring more often to a healthy lifestyle and prevention and communicating a more multifaceted image of old age and ageing in comparison to the membership magazines of health insurance companies. Institutions of public health have many duties and responsibilities. One of these is to strengthen health competencies and locus of control of the population - in our case - elderly people. As images of ageing influence attitudes towards ageing and health-related activities, it seems to be sensible and of good economic sense to communicate a

  10. [What potential do geographic information systems have for population-wide health monitoring in Germany? : Perspectives and challenges for the health monitoring of the Robert Koch Institute].

    Science.gov (United States)

    Thißen, Martin; Niemann, Hildegard; Varnaccia, Gianni; Rommel, Alexander; Teti, Andrea; Butschalowsky, Hans; Manz, Kristin; Finger, Jonas David; Kroll, Lars Eric; Ziese, Thomas

    2017-12-01

    Geographic information systems (GISs) are computer-based systems with which geographical data can be recorded, stored, managed, analyzed, visualized and provided. In recent years, they have become an integral part of public health research. They offer a broad range of analysis tools, which enable innovative solutions for health-related research questions. An analysis of nationwide studies that applied geographic information systems underlines the potential this instrument bears for health monitoring in Germany. Geographic information systems provide up-to-date mapping and visualization options to be used for national health monitoring at the Robert Koch Institute (RKI). Furthermore, objective information on the residential environment as an influencing factor on population health and on health behavior can be gathered and linked to RKI survey data at different geographic scales. Besides using physical information, such as climate, vegetation or land use, as well as information on the built environment, the instrument can link socioeconomic and sociodemographic data as well as information on health care and environmental stress to the survey data and integrate them into concepts for analyses. Therefore, geographic information systems expand the potential of the RKI to present nationwide, representative and meaningful health-monitoring results. In doing so, data protection regulations must always be followed. To conclude, the development of a national spatial data infrastructure and the identification of important data sources can prospectively improve access to high quality data sets that are relevant for the health monitoring.

  11. Testing Theoretical Relationships: Factors Influencing Positive Health Practices (PHP) in Filipino College Students

    Science.gov (United States)

    Ayres, Cynthia; Mahat, Ganga; Atkins, Robert

    2013-01-01

    Objective: To examine variables influencing the positive health practices (PHP) of Filipino college students to gain a better understanding of health practices in this ethnic/racial group. Cross-sectional study tested theoretical relationships postulated among (a) PHP, (b) social support (SS), (c) optimism, and (d) acculturation. Participants: A…

  12. Advancing Health Literacy Measurement: A Pathway to Better Health and Health System Performance

    Science.gov (United States)

    Pleasant, Andrew

    2014-01-01

    The concept of health literacy initially emerged and continues to gain strength as an approach to improving health status and the performance of health systems. Numerous studies clearly link low levels of education, literacy, and health literacy with poor health, poor health care utilization, increased barriers to care, and early death. However, theoretical understandings and methods of measuring the complex social construct of health literacy have experienced a continual evolution that remains incomplete. As a result, the seemingly most-cited definition of health literacy proposed in the now-decade-old Institute of Medicine report on health literacy is long overdue for updating. Such an effort should engage a broad and diverse set of health literacy researchers, practitioners, and members of the public in creating a definition that can earn broad consensus through validation testing in a rigorous scientific approach. That effort also could produce the basis for a new universally applicable measure of health literacy. Funders, health systems, and policymakers should reconsider their timid approach to health literacy. Although the field and corresponding evidence base are not perfect, health literacy—especially when combined with a focus on prevention and integrative health—is one of the most promising approaches to advancing public health. PMID:25491583

  13. Software for Intelligent System Health Management

    Science.gov (United States)

    Trevino, Luis C.

    2004-01-01

    This viewgraph presentation describes the characteristics and advantages of autonomy and artificial intelligence in systems health monitoring. The presentation lists technologies relevant to Intelligent System Health Management (ISHM), and some potential applications.

  14. Dual-Use Aspects of System Health Management

    Science.gov (United States)

    Owens, P. R.; Jambor, B. J.; Eger, G. W.; Clark, W. A.

    1994-01-01

    System Health Management functionality is an essential part of any space launch system. Health management functionality is an integral part of mission reliability, since it is needed to verify the reliability before the mission starts. Health Management is also a key factor in life cycle cost reduction and in increasing system availability. The degree of coverage needed by the system and the degree of coverage made available at a reasonable cost are critical parameters of a successful design. These problems are not unique to the launch vehicle world. In particular, the Intelligent Vehicle Highway System, commercial aircraft systems, train systems, and many types of industrial production facilities require various degrees of system health management. In all of these applications, too, the designers must balance the benefits and costs of health management in order to optimize costs. The importance of an integrated system is emphasized. That is, we present the case for considering health management as an integral part of system design, rather than functionality to be added on at the end of the design process. The importance of maintaining the system viewpoint is discussed in making hardware and software tradeoffs and in arriving at design decisions. We describe an approach to determine the parameters to be monitored in any system health management application. This approach is based on Design of Experiments (DOE), prototyping, failure modes and effects analyses, cost modeling and discrete event simulation. The various computer-based tools that facilitate the approach are discussed. The approach described originally was used to develop a fault tolerant avionics architecture for launch vehicles that incorporated health management as an integral part of the system. Finally, we discuss generalizing the technique to apply it to other domains. Several illustrations are presented.

  15. [Uses and influence of health evaluation in two studies on the Brazilian National Dengue Fever Control Program].

    Science.gov (United States)

    Figueiró, Ana Cláudia; Hartz, Zulmira; Samico, Isabella; Cesse, Eduarda Angela Pessoa

    2012-11-01

    Evaluation aims to provide information, promote improvement in programs, and determine the merit and value of the object of evaluation. However, the challenge for evaluators is not only to promote, but also to document the usefulness of studies. Given this challenge, the article aimed to systematize the uses and influence of the process and findings in two evaluations on Brazilian National Dengue Fever Control Program, for decision-making by the respective public health administrators and professionals. Based on a theoretical analytical model, an exploratory study was performed with documental analysis for identification of events and registrations in the evaluations and their circulation in terms of possible uses and influence, from 2007 to 2010. Favorable factors for the use of evaluations were the mode of production of contextual knowledge and definition of evaluations with a focus on utility. The results, indicating greater instrumental use and immediate process and collective use may indicate the studies' pertinence to stakeholders and their usefulness to program management at different levels in the health system.

  16. Health and health-care systems in southeast Asia: diversity and transitions.

    Science.gov (United States)

    Chongsuvivatwong, Virasakdi; Phua, Kai Hong; Yap, Mui Teng; Pocock, Nicola S; Hashim, Jamal H; Chhem, Rethy; Wilopo, Siswanto Agus; Lopez, Alan D

    2011-01-29

    Southeast Asia is a region of enormous social, economic, and political diversity, both across and within countries, shaped by its history, geography, and position as a major crossroad of trade and the movement of goods and services. These factors have not only contributed to the disparate health status of the region's diverse populations, but also to the diverse nature of its health systems, which are at varying stages of evolution. Rapid but inequitable socioeconomic development, coupled with differing rates of demographic and epidemiological transitions, have accentuated health disparities and posed great public health challenges for national health systems, particularly the control of emerging infectious diseases and the rise of non-communicable diseases within ageing populations. While novel forms of health care are evolving in the region, such as corporatised public health-care systems (government owned, but operating according to corporate principles and with private-sector participation) and financing mechanisms to achieve universal coverage, there are key lessons for health reforms and decentralisation. New challenges have emerged with rising trade in health services, migration of the health workforce, and medical tourism. Juxtaposed between the emerging giant economies of China and India, countries of the region are attempting to forge a common regional identity, despite their diversity, to seek mutually acceptable and effective solutions to key regional health challenges. In this first paper in the Lancet Series on health in southeast Asia, we present an overview of key demographic and epidemiological changes in the region, explore challenges facing health systems, and draw attention to the potential for regional collaboration in health. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. Management Matters: A Leverage Point for Health Systems Strengthening in Global Health

    Directory of Open Access Journals (Sweden)

    Elizabeth H. Bradley

    2015-07-01

    Full Text Available Despite a renewed focus in the field of global health on strengthening health systems, inadequate attention has been directed to a key ingredient of high-performing health systems: management. We aimed to develop the argument that management – defined here as the process of achieving predetermined objectives through human, financial, and technical resources – is a cross-cutting function necessary for success in all World Health Organization (WHO building blocks of health systems strengthening. Management within health systems is particularly critical in low-income settings where the efficient use of scarce resources is paramount to attaining health goals. More generally, investments in management capacity may be viewed as a key leverage point in grand strategy, as strong management enables the achievement of large ends with limited means. We also sought to delineate a set of core competencies and identify key roles to be targeted for management capacity building efforts. Several effective examples of management interventions have been described in the research literature. Together, the existing evidence underscores the importance of country ownership of management capacity building efforts, which often challenge the status quo and thus need country leadership to sustain despite inevitable friction. The literature also recognizes that management capacity efforts, as a key ingredient of effective systems change, take time to embed, as new protocols and ways of working become habitual and integrated as standard operating procedures. Despite these challenges, the field of health management as part of global health system strengthening efforts holds promise as a fundamental leverage point for achieving health system performance goals with existing human, technical, and financial resources. The evidence base consistently supports the role of management in performance improvement but would benefit from additional research with improved

  18. Powerlessness, destiny, and control: the influence on health behaviors of African Americans.

    Science.gov (United States)

    Green, B Lee; Lewis, Rhonda K; Wang, Min Qi; Person, Sharina; Rivers, Brian

    2004-02-01

    This study assessed the extent to which a belief in fate or destiny might explain certain health behaviors among African Americans. A survey of 1,253 African Americans in Alabama churches was conducted. Fifty-nine percent of the total sample indicated that they believe in fate or destiny. The findings of this study suggest that fate/destiny may influence health decisions. The study found a statistically significant difference between men and women regarding their belief in fate or destiny. Women reported believing in fate and destiny more than men. Surprisingly people with more education (i.e., college or postgraduate) believed in fate and destiny significantly more than high school dropouts and high school graduates. A belief in fate or destiny also varied by income level. Respondents who made more in annual income were more likely to believe in fate and destiny than people who made less. One behavior, breast exam had a statistically significant association with a belief in fate and destiny. Women who reported never having a breast exam were more likely to believe in fate and destiny than women who did not have a belief in fate or destiny. These findings highlight the need for practitioners to examine more closely the definition of fate and destiny and determine how this belief influences or does not influence health behaviors as once believed. The research suggests a closer examination of the role culture plays in health decision making which may be independent of a belief in fate and destiny.

  19. Designing, Modeling and Evaluating Influence Strategiesfor Behavior Change Support Systems

    NARCIS (Netherlands)

    Öörni, Anssi; Kelders, Saskia Marion; van Gemert-Pijnen, Julia E.W.C.; Oinas-Kukkonen, Harri

    2014-01-01

    Behavior change support systems (BCSS) research is an evolving area. While the systems have been demonstrated to work to the effect, there is still a lot of work to be done to better understand the influence mechanisms of behavior change, and work out their influence on the systems architecture. The

  20. An assessment of interactions between global health initiatives and country health systems.

    Science.gov (United States)

    Samb, Badara; Evans, Tim; Dybul, Mark; Atun, Rifat; Moatti, Jean-Paul; Nishtar, Sania; Wright, Anna; Celletti, Francesca; Hsu, Justine; Kim, Jim Yong; Brugha, Ruairi; Russell, Asia; Etienne, Carissa

    2009-06-20

    Since 2000, the emergence of several large disease-specific global health initiatives (GHIs) has changed the way in which international donors provide assistance for public health. Some critics have claimed that these initiatives burden health systems that are already fragile in countries with few resources, whereas others have asserted that weak health systems prevent progress in meeting disease-specific targets. So far, most of the evidence for this debate has been provided by speculation and anecdotes. We use a review and analysis of existing data, and 15 new studies that were submitted to WHO for the purpose of writing this Report to describe the complex nature of the interplay between country health systems and GHIs. We suggest that this Report provides the most detailed compilation of published and emerging evidence so far, and provides a basis for identification of the ways in which GHIs and health systems can interact to mutually reinforce their effects. On the basis of the findings, we make some general recommendations and identify a series of action points for international partners, governments, and other stakeholders that will help ensure that investments in GHIs and country health systems can fulfil their potential to produce comprehensive and lasting results in disease-specific work, and advance the general public health agenda. The target date for achievement of the health-related Millennium Development Goals is drawing close, and the economic downturn threatens to undermine the improvements in health outcomes that have been achieved in the past few years. If adjustments to the interactions between GHIs and country health systems will improve efficiency, equity, value for money, and outcomes in global public health, then these opportunities should not be missed.

  1. Influence of Race, Ethnicity and Social Determinants of Health on Diabetes Outcomes.

    Science.gov (United States)

    Walker, Rebekah J; Strom Williams, Joni; Egede, Leonard E

    2016-04-01

    There is strong evidence that race, ethnicity and social determinants of health significantly influence outcomes for patients with diabetes. A better understanding of the mechanisms of these relationships or associations would improve development of cost-effective, culturally tailored programs for patients with diabetes. This article reviews the current state of the literature on the influence of race and ethnicity and social determinants of health on process of care, quality of care and outcomes for diabetes, with particular emphasis on the rural South to give an overview of the state of the literature. The literature review shows that racial or ethnic differences in the clinical outcomes for diabetes, including glycemic, blood pressure (BP) and lipid control, continue to persist. In addition, the literature review shows that the role of social determinants of health on outcomes, and the possible role these determinants play in disparities have largely been ignored. Psychosocial factors, such as self-efficacy, depression, social support and perceived stress, show consistent associations with self-care, quality of life and glycemic control. Neighborhood factors, such as food insecurity, social cohesion and neighborhood esthetics have been associated with glycemic control. Perceived discrimination has also been associated with self-care and the psychological component of quality of life. Healthcare professionals need to be skilled in assessing social determinants of health and taking them into consideration in clinical care. In addition, more research is needed to identify the separate and combined influence of race and ethnicity and social determinants of health on process of care, quality of care and outcomes in diabetes, especially in the South, where the burden of disease is particularly high. Copyright © 2016 Southern Society for Clinical Investigation. All rights reserved.

  2. Health record systems that meet clinical needs

    Directory of Open Access Journals (Sweden)

    Gabriella Negrini

    2012-10-01

    Full Text Available Introduction Increased attention has recently been focused on health record systems as a result of accreditation programs, a growing emphasis on patient safety, and the increase in lawsuits involving allegations of malpractice. Health-care professionals frequently express dissatisfaction with the health record systems and complain that the data included are neither informative nor useful for clinical decision making. This article reviews the main objectives of a hospital health record system, with emphasis on its roles in communication and exchange among clinicians, patient safety, and continuity of care, and asks whether current systems have responded to the recent changes in the Italian health-care system.Discussion If health records are to meet the expectations of all health professionals, the overall information need must be carefully analyzed, a common data set must be created, and essential specialist contributions must be defined. Working with health-care professionals, the hospital management should define how clinical information is to be displayed and organized, identify a functionally optimal layout, define the characteristics of ongoing patient assessment in terms of who will be responsible for these activities and how often they will be performed. Internet technology can facilitate data retrieval and meet the general requirements of a paper-based health record system, but it must also ensure focus on clinical information, business continuity, integrity, security, and privacy.Conclusions The current health records system needs to be thoroughly revised to increase its accessibility, streamline the work of health-care professionals who consult it, and render it more useful for clinical decision making—a challenging task that will require the active involvement of the many professional classes involved.

  3. Death in hospital and at home: population and health policy influences in Londrina, State of Paraná, Brazil (1996-2010

    Directory of Open Access Journals (Sweden)

    Fernando Cesar Iwamoto Marcucci

    2015-03-01

    Full Text Available An aging population and epidemiological transition involves prolonged terminal illnesses and an increased demand for end-stage support in health services, mainly in hospitals. Changes in health care and government health policies may influence the death locations, making it possible to remain at home or in an institution. The scope of this article is to analyze death locations in the city of Londrina, State of Paraná, from 1996 to 2010, and to verify the influence of population and health policy changes on these statistics. An analysis was conducted into death locations in Londrina in Mortality Information System (SIM considering the main causes and locations of death. There was an increase of 28% in deaths among the population in general, though 48% for the population over 60 years of age. There was an increase of deaths in hospitals, which were responsible for 70% of the occurrences, though death frequencies in others locations did not increase, and deaths in the home remained at about 18%. The locations of death did not change during this period, even with health policies that broadened care in other locations, such as the patient´s home. The predominance of hospital deaths was similar to other Brazilian cities, albeit higher than in other countries.

  4. Advancing the application of systems thinking in health: why cure crowds out prevention.

    Science.gov (United States)

    Bishai, David; Paina, Ligia; Li, Qingfeng; Peters, David H; Hyder, Adnan A

    2014-06-16

    This paper presents a system dynamics computer simulation model to illustrate unintended consequences of apparently rational allocations to curative and preventive services. A modeled population is subject to only two diseases. Disease A is a curable disease that can be shortened by curative care. Disease B is an instantly fatal but preventable disease. Curative care workers are financed by public spending and private fees to cure disease A. Non-personal, preventive services are delivered by public health workers supported solely by public spending to prevent disease B. Each type of worker tries to tilt the balance of government spending towards their interests. Their influence on the government is proportional to their accumulated revenue. The model demonstrates effects on lost disability-adjusted life years and costs over the course of several epidemics of each disease. Policy interventions are tested including: i) an outside donor rationally donates extra money to each type of disease precisely in proportion to the size of epidemics of each disease; ii) lobbying is eliminated; iii) fees for personal health services are eliminated; iv) the government continually rebalances the funding for prevention by ring-fencing it to protect it from lobbying.The model exhibits a "spend more get less" equilibrium in which higher revenue by the curative sector is used to influence government allocations away from prevention towards cure. Spending more on curing disease A leads paradoxically to a higher overall disease burden of unprevented cases of disease B. This paradoxical behavior of the model can be stopped by eliminating lobbying, eliminating fees for curative services, and ring-fencing public health funding. We have created an artificial system as a laboratory to gain insights about the trade-offs between curative and preventive health allocations, and the effect of indicative policy interventions. The underlying dynamics of this artificial system resemble features of

  5. Enabling health systems transformation: what progress has been made in re-orienting health services?

    Science.gov (United States)

    Wise, Marilyn; Nutbeam, Don

    2007-01-01

    The Ottawa Charter has been remarkably influential in guiding the development of the goals and concepts of health promotion, and in shaping global public health practice in the past 20 years. However, of the five action areas identified in the Ottawa Charter, it appears that there has been little systematic attention to the challenge of re-orienting health services, and less than optimal progress in practice. The purposes of re-orienting health services as proposed in the Ottawa Charter were to achieve a better balance in investment between prevention and treatment, and to include a focus on population health outcomes alongside the focus on individual health outcomes. However, there is little evidence that a re-orientation of health services in these terms has occurred systematically anywhere in the world. This is in spite of the fact that direct evidence of the need to re-orient health services and of the potential benefits of doing so has grown substantially since 1986. Patient education, preventive care (screening, immunisation), and organisational and environmental changes by health organisations have all been found to have positive health and environmental outcomes. However, evidence of effectiveness has not been sufficient, on its own, to sway community preferences and political decisions. The lack of progress points to the need for significant re-thinking of the approaches we have adopted to date. The paper proposes a number of ways forward. These include working effectively in partnership with the communities we want to serve to mobilise support for change, and to reinforce this by working more effectively at influencing broader public opinion through the media. The active engagement of clinical health professionals is also identified as crucial to achieving sustainable change. Finally we recognize that by working in partnership with like-minded advocacy organizations, the IUHPE could put its significant knowledge and experience to work in leading action to

  6. Two types of health care systems and their influence on the introduction of perinatal care: an epidemiological twin model in Berlin from 1950 to 1990.

    Science.gov (United States)

    Arabin, B; Raum, E; Mohnhaupt, A; Schwartz, F W

    1999-06-01

    When perinatal medicine emerged as a new medical discipline in the 1960s, Berlin was as one of the world's leading centers. During that time, the city was separated into two parts, each fostering its own health care system. After the destruction of the Berlin Wall, it was possible to speak with the citizens of East Berlin and to access their database systems. This created the singular opportunity to objectively compare the development of perinatal care in both parts of Berlin. Rates of maternal, perinatal, and infant mortality as well as the rate of preterm deliveries were evaluated over time and between East and West Berlin. The timing of introduction of 20 specific perinatal interventions was evaluated across 18 hospitals with more than 500 deliveries (11 in West Berlin and 7 in East Berlin). Interviews were conducted with 100 gynecologists, 100 midwives, and 100 women who had recently delivered their first child from each side of the city regarding their opinions of the importance of these interventions for the quality of perinatal medicine and how they would distribute a budget to improve maternity care. Maternal, perinatal, and infant mortality decreased in both parts of Berlin until 1990 (p Berlin, though the preterm delivery rate was slightly lower in East Berlin compared with West Berlin (p Berlin. In contrast, certain public health measures--such as maternal transport, screening programs for diabetes, and support of breastfeeding--were introduced much earlier in East Berlin. There were significant differences between the beliefs of gynecologists, midwives, and mothers in East and West Berlin. In general, citizens of East Berlin were more enthusiastic about technological medical advances, whereas citizens of West Berlin were more supportive of public health and alternative methods. In addition, there were significant differences between female and male physicians in their beliefs about how to improve health care, regardless of whether they resided in East

  7. Health visitors and breastfeeding support: influence of knowledge and self-efficacy

    DEFF Research Database (Denmark)

    Kronborg, Hanne; Væth, Michael; Olsen, Jørn

    2008-01-01

    BACKGROUND: Little is known about what influences health visitors' breastfeeding support. The objective was to describe health visitors' breastfeeding experiences, beliefs, knowledge and self-efficacy in breastfeeding guidance and determine the impact of a training course on these factors, and how...... to learn the mechanisms of breastfeeding. Data were collected through self-administered questionnaires before the intervention and after the follow-up period. One hundred and six (97%) health visitors and 1302 (82%) mothers responded. RESULTS: At baseline no substantial differences were seen between...... the two groups on years since education, own breastfeeding experiences, beliefs or self-efficacy in breastfeeding guidance except that health visitors in the intervention group, who had completed the course, demonstrated significantly higher scores on knowledge questions (P

  8. United Kingdom (England): Health system review.

    Science.gov (United States)

    Boyle, Seán

    2011-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. Various indicators show that the health of the population has improved over the last few decades. However, inequalities in health across socioeconomic groups have been increasing since the 1970s. The main diseases affecting the population are circulatory diseases, cancer, diseases of the respiratory system and diseases of the digestive system. Risk factors such as the steadily rising levels of alcohol consumption, the sharp increases in adult and child obesity and prevailing smoking levels are among the most pressing public health concerns, particularly as they reflect the growing health inequalities among different socioeconomic groups. Health services in England are largely free at the point of use. The NHS provides preventive medicine, primary care and hospital services to all those ordinarily resident. Over 12% of the population is covered by voluntary health insurance schemes, known in the United Kingdom as private medical insurance (PMI), which mainly provides access to acute elective care in the private sector. Responsibility for publicly funded health care rests with the Secretary of State for Health, supported by the Department of Health. The Department operates at a regional level through 10 strategic health authorities (SHAs), which are responsible for ensuring the quality and performance of local health services within their geographic area. Responsibility for commissioning health services at the local level lies with 151 primary care

  9. [Self-rated health in adults: influence of poverty and income inequality in the area of residence].

    Science.gov (United States)

    Caicedo, Beatriz; Berbesi Fernández, Dedsy

    2015-01-01

    To evaluate the influence of income inequality and poverty in the towns of Bogotá, Colombia, on poor self-rated health among their residents. The study was based on a multipurpose survey applied in Bogotá-Colombia. A hierarchical data structure (individuals=level1, locations=level 2) was used to define a logit-type multilevel logistic model. The dependent variable was self-perceived poor health, and local variables were income inequality and poverty. All analyses were controlled for socio-demographic variables and stratified by sex. The prevalence of self-reported fair or poor health in the study population was 23.2%. Women showed a greater risk of ill health, as well as men and women with a low educational level, older persons, those without work in the last week and persons affiliated to the subsidized health system. The highest levels of poverty in the city increased the risk of poor health. Cross-level interactions showed that young women and men with a low education level were the most affected by income inequality in the locality. In Bogotá, there are geographical differences in the perception of health. Higher rates of poverty and income inequality were associated with an increased risk of self-perceived poor health. Notable findings were the large health inequalities at the individual and local levels. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  10. Evaluation of Hematocrit Influence on Self-Monitoring of Blood Glucose Based on ISO 15197:2013: Comparison of a Novel System With Five Systems With Different Hematocrit Ranges.

    Science.gov (United States)

    Hattemer, Andrew; Wardat, Sami

    2018-03-01

    ISO 15197:2013 recommends testing procedures and acceptance criteria for the evaluation of influence quantities such as hematocrit on measurement results with systems for self-monitoring of blood glucose (SMBG). In this study, hematocrit influence was evaluated for a novel SMBG system (system A) and five other systems with different hematocrit ranges based on ISO 15197:2013. Test procedures were performed with one test strip lot for each system. Each system was tested within the hematocrit range indicated in the manufacturer's labeling (system A: 10-65%, B: 15-65%, C: 20-60%, D: 35-60%, E: 30-60%, F: 30-55%). According to ISO 15197:2013, clause 6.4.2, venous blood samples were used for the evaluation of hematocrit influence. The evaluation was performed for three glucose concentration categories (30-50 mg/dL, 96-144 mg/dL, and 280-420 mg/dL). For each glucose concentration category, at least five different hematocrit levels were investigated. The novel system A and systems B, E, and F complied with the tested lot with the defined criteria and showed ≤10 mg/dL and ≤10% difference between the test sample and the respective control sample with a hematocrit value of 42% ± 2% for BG concentrations 10% difference at glucose concentrations ≥100 mg/dL. Remarkable hematocrit influence within the labeled hematocrit range was obtained in two systems with the tested reagent system lot. Adequate SMBG systems should be carefully chosen by patients and their health care professionals, particularly for patients with increased and decreased hematocrit values.

  11. Physical factors that influence patients’ privacy perception toward a psychiatric behavioral monitoring system: a qualitative study

    Directory of Open Access Journals (Sweden)

    Zakaria N

    2017-12-01

    Full Text Available Nasriah Zakaria,1,2 Rusyaizila Ramli3 1Research Chair of Health Informatics and Promotion, 2Medical Informatics and E-learning Unit, Medical Education Department, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia; 3Advanced Military Maintenance Repair and Overhaul Center (AMMROC, Abu Dhabi, UAE Background: Psychiatric patients have privacy concerns when it comes to technology intervention in the hospital setting. In this paper, we present scenarios for psychiatric behavioral monitoring systems to be placed in psychiatric wards to understand patients’ perception regarding privacy. Psychiatric behavioral monitoring refers to systems that are deemed useful in measuring clinical outcomes, but little research has been done on how these systems will impact patients’ privacy. Methods: We conducted a case study in one teaching hospital in Malaysia. We investigated the physical factors that influence patients’ perceived privacy with respect to a psychiatric monitoring system. The eight physical factors identified from the information system development privacy model, a comprehensive model for designing a privacy-sensitive information system, were adapted in this research. Scenario-based interviews were conducted with 25 patients in a psychiatric ward for 3 months. Results: Psychiatric patients were able to share how physical factors influence their perception of privacy. Results show how patients responded to each of these dimensions in the context of a psychiatric behavioral monitoring system. Conclusion: Some subfactors under physical privacy are modified to reflect the data obtained in the interviews. We were able to capture the different physical factors that influence patient privacy. Keywords: information system development (ISD, physical factor, privacy, psychiatric monitoring system

  12. X-33/RLV System Health Management/Vehicle Health Management

    Science.gov (United States)

    Mouyos, William; Wangu, Srimal

    1998-01-01

    To reduce operations costs, Reusable Launch Vehicles (RLVS) must include highly reliable robust subsystems which are designed for simple repair access with a simplified servicing infrastructure, and which incorporate expedited decision-making about faults and anomalies. A key component for the Single Stage To Orbit (SSTO) RLV system used to meet these objectives is System Health Management (SHM). SHM incorporates Vehicle Health Management (VHM), ground processing associated with the vehicle fleet (GVHM), and Ground Infrastructure Health Management (GIHM). The primary objective of SHM is to provide an automated and paperless health decision, maintenance, and logistics system. Sanders, a Lockheed Martin Company, is leading the design, development, and integration of the SHM system for RLV and for X-33 (a sub-scale, sub-orbit Advanced Technology Demonstrator). Many critical technologies are necessary to make SHM (and more specifically VHM) practical, reliable, and cost effective. This paper will present the X-33 SHM design which forms the baseline for the RLV SHM, and it will discuss applications of advanced technologies to future RLVs. In addition, this paper will describe a Virtual Design Environment (VDE) which is being developed for RLV. This VDE will allow for system design engineering, as well as program management teams, to accurately and efficiently evaluate system designs, analyze the behavior of current systems, and predict the feasibility of making smooth and cost-efficient transitions from older technologies to newer ones. The RLV SHM design methodology will reduce program costs, decrease total program life-cycle time, and ultimately increase mission success.

  13. Media and politics: Empirical data on their cross-influence in health policy.

    Science.gov (United States)

    2011-01-01

    OBJECTIVES: Despite the central influence of public policies on health and welfare, relatively little is known about actual health care policy-making processes. This presentation will offer preliminary results from a federally funded project aimed at gaining insights into the interrelations among interest-group strategies, media discourses and political debates in health care. The policy debate on health care privatization in Quebec is used as a case study. APPROACH: Two sources of data were used: media sources and political debates. Media sources were the six main provincial newspapers in Quebec, two national newspapers and The Canadian Press, as well as transcripts from specific news-related programs of three national television stations and two national radio stations. Political debates were obtained through transcripts of all question periods in the Parliament and debates in the standing committee on health. Sources were systematically searched to identify all relevant data. Multiple search syntaxes were developed and tested to maximize sensitivity and specificity. All data was entered and coded into qualitative analysis software. RESULTS: Data was analyzed longitudinally from June 2005 to January 1, 2010. Four levels of results will be presented: 1) Descriptive analysis of the interest groups involved, their policy preferences and the rhetoric they employed to support their views. 2) Descriptive analysis of the main policy proposals that structured the debate as well as of the coalition of groups behind those proposals. 3) Graphic longitudinal analysis of the intensity of the debate and of the relative importance and evolution of various policy proposals. 4) Preliminary results on the nature, direction and level of inter-influence between the policy and media agendas. CONCLUSION: This presentation provides empirical evidence on current policy-making processes in health care. It shows, unsurprisingly, that policy-making is a circumvoluted process of inter-influence

  14. Health Information Systems

    International Development Research Centre (IDRC) Digital Library (Canada)

    the technology and expertise to process and share ... services. GEHS supports efforts that reach beyond healthcare institutions to capture evidence ... Health information systems are a foundation for quality care, and can increase accountability ...

  15. African Health Systems Initiative (AHSI) | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The African Health Systems Initiative (AHSI) is a 10-year Canadian International ... for strengthening African-led health systems and human resources for health. ... IDRC congratulates first cohort of Women in Climate Change Science Fellows.

  16. Croatia: health system review.

    Science.gov (United States)

    Džakula, Aleksandar; Sagan, Anna; Pavić, Nika; Lonćčarek, Karmen; Sekelj-Kauzlarić, Katarina

    2014-01-01

    Croatia is a small central European country on the Balkan peninsula, with a population of approximately 4.3 million and a gross domestic product (GDP) of 62% of the European Union (EU) average (expressed in purchasing power parity; PPP) in 2012. On 1 July 2013, Croatia became the 28th Member State of the EU. Life expectancy at birth has been increasing steadily in Croatia (with a small decline in the years following the 1991 to 1995 War of Independence) but is still lower than the EU average. Prevalence of overweight and obesity in the population has increased during recent years and trends in physical inactivity are alarming. The Croatian Health Insurance Fund (CHIF), established in 1993, is the sole insurer in the mandatory health insurance (MHI) system that provides universal health coverage to the whole population. The ownership of secondary health care facilities is distributed between the State and the counties. The financial position of public hospitals is weak and recent reforms were aimed at improving this. The introduction of concessions in 2009 (public private partnerships whereby county governments organize tenders for the provision of specific primary health care services) allowed the counties to play a more active role in the organization, coordination and management of primary health care; most primary care practices have been privatized. The proportion of GDP spent on health by the Croatian government remains relatively low compared to western Europe, as does the per capita health expenditure. Although the share of public expenditure as a proportion of total health expenditure (THE) has been decreasing, at around 82% it is still relatively high, even by European standards. The main source of the CHIFs revenue is compulsory health insurance contributions, accounting for 76% of the total revenues of the CHIF, although only about a third of the population (active workers) is liable to pay full health care contributions. Although the breadth and scope

  17. The influence of mastery on mother's health in middle years: Moderating role of stressful life context.

    Science.gov (United States)

    King, Victoria; Wickrama, K A S; Klopack, Erick; Lorenz, Frederick O

    2018-06-07

    Using data from 416 middle-aged mothers gathered over the course of a decade, this study examined the influence of mastery trajectories (the initial level and change), on change in physical health. Mastery is defined as one's ability to control and influence his/her life and environment to reach a desired outcome or goal. Both the initial level and change in mastery from 1991 to 1994 were associated with decreased physical health problems over the middle years (1991-2001). Contextual moderation of this association by stressful life contexts including negative life events and work-family conflict was investigated. Moderation analysis showed that under conditions of low contextual life stressors, the level and increase in mastery significantly contributed to decreases in physical health problems in middle-aged mothers. Alternatively, conditions of high contextual life stressors inhibited the ability of mastery to influence physical health of mothers, suggesting that the positive health impact of mastery on physical health is mitigated by stressful life experiences. Implications for the need to maintain important personal resources, such as mastery, during times of stress are discussed. Copyright © 2018 John Wiley & Sons, Ltd.

  18. Efficiency performance of China's health care delivery system.

    Science.gov (United States)

    Zhang, Luyu; Cheng, Gang; Song, Suhang; Yuan, Beibei; Zhu, Weiming; He, Li; Ma, Xiaochen; Meng, Qingyue

    2017-07-01

    Improving efficiency performance of the health care delivery system has been on the agenda for the health system reform that China initiated in 2009. This study examines the changes in efficiency performance and determinants of efficiency after the reform to provide evidence to assess the progress of the reform from the perspective of efficiency. Descriptive analysis, Data Envelopment Analysis, the Malmquist Index, and multilevel regressions are used with data from multiple sources, including the World Bank, the China Health Statistical Yearbook, and routine reports. The results indicate that over the last decade, health outcomes compared with health investment were relatively higher in China than in most other countries worldwide, and the trend was stable. The overall efficiency and total factor productivity increased after the reform, indicating that the reform was likely to have had a positive impact on the efficiency performance of the health care delivery system. However, the health care delivery structure showed low system efficiency, mainly attributed to the weakened primary health care system. Strengthening the primary health care system is central to enhancing the future performance of China's health care delivery system. Copyright © 2017 John Wiley & Sons, Ltd.

  19. Reliability model for helicopter main gearbox lubrication system using influence diagrams

    International Nuclear Information System (INIS)

    Rashid, H.S.J.; Place, C.S.; Mba, D.; Keong, R.L.C.; Healey, A.; Kleine-Beek, W.; Romano, M.

    2015-01-01

    The loss of oil from a helicopter main gearbox (MGB) leads to increased friction between components, a rise in component surface temperatures, and subsequent mechanical failure of gearbox components. A number of significant helicopter accidents have been caused due to such loss of lubrication. This paper presents a model to assess the reliability of helicopter MGB lubricating systems. Safety risk modeling was conducted for MGB oil system related accidents in order to analyse key failure mechanisms and the contributory factors. Thus, the dominant failure modes for lubrication systems and key contributing components were identified. The Influence Diagram (ID) approach was then employed to investigate reliability issues of the MGB lubrication systems at the level of primary causal factors, thus systematically investigating a complex context of events, conditions, and influences that are direct triggers of the helicopter MGB lubrication system failures. The interrelationships between MGB lubrication system failure types were thus identified, and the influence of each of these factors on the overall MGB lubrication system reliability was assessed. This paper highlights parts of the HELMGOP project, sponsored by the European Aviation Safety Agency to improve helicopter main gearbox reliability. - Highlights: • We investigated methods to optimize helicopter MGB oil system run-dry capability. • Used Influence Diagram to assess design and maintenance factors of MGB oil system. • Factors influencing overall MGB lubrication system reliability were identified. • This globally influences current and future helicopter MGB designs

  20. Social organization of self-management support of persons with diabetes: a health systems comparison.

    Science.gov (United States)

    Schiøtz, Michaela; Frølich, Anne; Krasnik, Allan; Taylor, Warren; Hsu, John

    2012-09-01

    Identify important organizational elements for providing self-management support (SMS). Semi-structured qualitative interviews conducted in two healthcare systems. Kaiser Permanente Northern California and the Danish Health Care System. 36 managers and healthcare professionals in the two healthcare systems. Elements important to providing self-management support to persons with diabetes. Healthcare professionals' provision of SMS was influenced by healthcare system organization and their perceptions of SMS, the capability and responsibility of healthcare systems, and their roles in the healthcare organization. Enabling factors for providing SMS included: strong leadership; aligned incentives; use of an integrated health information technology (HIT) system; multidisciplinary healthcare provider teams; ongoing training for healthcare professionals; outreach; and quality goals. Barriers to providing SMS included lack of collaboration between providers and skeptical attitudes towards prevention and outreach. Implementation of SMS can be improved by an understanding of the elements that enhance its provision: (1) initiatives seeking to improve collaboration and integration between providers; (2) implementation of an integrated HIT system; and (3) ongoing training of healthcare professionals.

  1. Understanding and valuing the broader health system benefits of Uganda's national Human Resources for Health Information System investment.

    Science.gov (United States)

    Driessen, Julia; Settle, Dykki; Potenziani, David; Tulenko, Kate; Kabocho, Twaha; Wadembere, Ismail

    2015-08-31

    To address the need for timely and comprehensive human resources for health (HRH) information, governments and organizations have been actively investing in electronic health information interventions, including in low-resource settings. The economics of human resources information systems (HRISs) in low-resource settings are not well understood, however, and warrant investigation and validation. This case study describes Uganda's Human Resources for Health Information System (HRHIS), implemented with support from the US Agency for International Development, and documents perceptions of its impact on the health labour market against the backdrop of the costs of implementation. Through interviews with end users and implementers in six different settings, we document pre-implementation data challenges and consider how the HRHIS has been perceived to affect human resources decision-making and the healthcare employment environment. This multisite case study documented a range of perceived benefits of Uganda's HRHIS through interviews with end users that sought to capture the baseline (or pre-implementation) state of affairs, the perceived impact of the HRHIS and the monetary value associated with each benefit. In general, the system appears to be strengthening both demand for health workers (through improved awareness of staffing patterns) and supply (by improving licensing, recruitment and competency of the health workforce). This heightened ability to identify high-value employees makes the health sector more competitive for high-quality workers, and this elevation of the health workforce also has broader implications for health system performance and population health. Overall, it is clear that HRHIS end users in Uganda perceived the system to have significantly improved day-to-day operations as well as longer term institutional mandates. A more efficient and responsive approach to HRH allows the health sector to recruit the best candidates, train employees in

  2. Influence of Child Factors on Health-Care Professionals' Recognition of Common Childhood Mental-Health Problems.

    Science.gov (United States)

    Burke, Delia A; Koot, Hans M; de Wilde, Amber; Begeer, Sander

    Early recognition of childhood mental-health problems can help minimise long-term negative outcomes. Recognition of mental-health problems, needed for referral and diagnostic evaluation, is largely dependent on health-care professionals' (HCPs) judgement of symptoms presented by the child. This study aimed to establish whether HCPs recognition of mental-health problems varies as a function of three child-related factors (type of problem, number of symptoms, and demographic characteristics). In an online survey, HCPs ( n  = 431) evaluated a series of vignettes describing children with symptoms of mental-health problems. Vignettes varied by problem type (Attention-Deficit/Hyperactivity Disorder (ADHD), Generalised Anxiety Disorder (GAD), Autism Spectrum Disorder (ASD), Conduct Disorder (CD) and Major Depressive Disorder), number of symptoms presented (few and many), and child demographic characteristics (ethnicity, gender, age and socio-economic status (SES)). Results show that recognition of mental-health problems varies by problem type, with ADHD best recognised and GAD worst. Furthermore, recognition varies by the number of symptoms presented. Unexpectedly, a child's gender, ethnicity and family SES did not influence likelihood of problem recognition. These results are the first to reveal differences in HCPs' recognition of various common childhood mental-health problems. HCPs in practice should be advised about poor recognition of GAD, and superior recognition of ADHD, if recognition of all childhood mental-health problems is to be equal.

  3. Influence of preschool-teacher-efficacy, social skills and work satisfaction on mental health

    OpenAIRE

    前田, 直樹; 金丸, 靖代; 畑田, 惣一郎; マエダ, ナオキ; カネマル, ヤスヨ; ハタダ, ソウイチロウ; Naoki, MAEDA; Yasuyo, KANEMARU; Soichiro, HATADA

    2009-01-01

    The purpose of the present study was to investigate preschool teacher's mental health and to examine the influence of preschool-teacher-efficacy, social skills and work satisfaction on their mental health. One hundred preschool teachers (8 males, 92 females) were administered a questionnaire including preschool teacher-efficacy scale, Kiss-18, work satisfaction scale and BDI-II. With regard to the situation of mental health, preschool teachers scored slightly lower than the general level. Pas...

  4. HealthStyles: a new psychographic segmentation system for health care marketers.

    Science.gov (United States)

    Endresen, K W; Wintz, J C

    1988-01-01

    HealthStyles is a new psychographic segmentation system specifically designed for the health care industry. This segmentation system goes beyond traditional geographic and demographic analysis and examines health-related consumer attitudes and behaviors. Four statistically distinct "styles" of consumer health care preferences have been identified. The profiles of the four groups have substantial marketing implications in terms of design and promotion of products and services. Each segment of consumers also has differing expectations of physician behavior.

  5. Fellowship Program in Health System Improvement: A novel approach integrating leadership development and patient-centred health system transformation.

    Science.gov (United States)

    Philippon, Donald J; Montesanti, Stephanie; Stafinski, Tania

    2018-03-01

    This article highlights a novel approach to professional development, integrating leadership, development and patient-centred health system transformation in the new Fellowship Program in Health System Improvement offered by the School of Public Health at the University of Alberta. Early assessment of the program is also provided.

  6. Influence green sand system by core sand additions

    Directory of Open Access Journals (Sweden)

    N. Špirutová

    2012-01-01

    Full Text Available Today, about two thirds of iron alloys casting (especially for graphitizing alloys of iron are produced into green sand systems with usually organically bonded cores. Separation of core sands from the green sand mixture is very difficult, after pouring. The core sand concentration increase due to circulation of green sand mixture in a closed circulation system. Furthermore in some foundries, core sands have been adding to green sand systems as a replacement for new sands. The goal of this contribution is: “How the green sand systems are influenced by core sands?”This effect is considered by determination of selected technological properties and degree of green sand system re-bonding. From the studies, which have been published yet, there is not consistent opinion on influence of core sand dilution on green sand system properties. In order to simulation of the effect of core sands on the technological properties of green sands, there were applied the most common used technologies of cores production, which are based on bonding with phenolic resin. Core sand concentration added to green sand system, was up to 50 %. Influence of core sand dilution on basic properties of green sand systems was determined by evaluation of basic industrial properties: moisture, green compression strength and splitting strength, wet tensile strength, mixture stability against staling and physical-chemistry properties (pH, conductivity, and loss of ignition. Ratio of active betonite by Methylene blue test was also determined.

  7. New Reforms to the Health System

    OpenAIRE

    Tran Dai, Candice; Duchâtel, Mathieu

    2012-01-01

    Based on:– Li Ling, “Successful reform of the health system hangs on two key elements,” Zhongguo jingyingbao (China Management News), 18 April 2009.– Li Hongmei, Li Xiaohong, Wang Junping, “Ten experts comment on the new reform of the health system: Providing better and cheaper access to medical care,” Renmin ribao (People’s Daily), 15 April 2009.– Yao Qi, “The new reform of the health system must first and foremost compensate for the shortcomings in the local hospitals,” Yangcheng wanbao (Ya...

  8. How to change environmental conditions for health.

    Science.gov (United States)

    Commers, Matthew J; Gottlieb, Nell; Kok, Gerjo

    2007-03-01

    Since the Lalonde report, contemporary public-health theory has given steadily more attention to the role of environments in influencing health status. Environments, both social and physical, influence health directly or through complex interactions with behavior, genetics and health-care systems. They are also important for public-health because environments are the complex systems through which people are both empowered and exercise their empowerment. If public-health professionals are to play a significant role in influencing environments for health, they need analytical instruments that enable them to link specific environmental conditions with the actions necessary to improve them. These instruments must also enable public-health professionals to identify points of leverage for stimulating key actors to take the actions necessary to make environments more promoting of health. This article first presents one such analytical instrument. Then, building on examples relating to socio-economic health inequities, the analytical instrument is applied to reveal how it can add value to health professionals' effectiveness in planning interventions for more health-promoting environments.

  9. United States of America: health system review.

    Science.gov (United States)

    Rice, Thomas; Rosenau, Pauline; Unruh, Lynn Y; Barnes, Andrew J; Saltman, Richard B; van Ginneken, Ewout

    2013-01-01

    This analysis of the United States health system reviews the developments in organization and governance, health financing, health-care provision, health reforms and health system performance. The US health system has both considerable strengths and notable weaknesses. It has a large and well-trained health workforce, a wide range of high-quality medical specialists as well as secondary and tertiary institutions, a robust health sector research program and, for selected services, among the best medical outcomes in the world. But it also suffers from incomplete coverage of its citizenry, health expenditure levels per person far exceeding all other countries, poor measures on many objective and subjective measures of quality and outcomes, an unequal distribution of resources and outcomes across the country and among different population groups, and lagging efforts to introduce health information technology. It is difficult to determine the extent to which deficiencies are health-system related, though it seems that at least some of the problems are a result of poor access to care. Because of the adoption of the Affordable Care Act in 2010, the United States is facing a period of enormous potential change. Improving coverage is a central aim, envisaged through subsidies for the uninsured to purchase private insurance, expanded eligibility for Medicaid (in some states) and greater protection for insured persons. Furthermore, primary care and public health receive increased funding, and quality and expenditures are addressed through a range of measures. Whether the ACA will indeed be effective in addressing the challenges identified above can only be determined over time. World Health Organization 2013 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  10. The health and health system of South Africa: historical roots of current public health challenges.

    Science.gov (United States)

    Coovadia, Hoosen; Jewkes, Rachel; Barron, Peter; Sanders, David; McIntyre, Diane

    2009-09-05

    The roots of a dysfunctional health system and the collision of the epidemics of communicable and non-communicable diseases in South Africa can be found in policies from periods of the country's history, from colonial subjugation, apartheid dispossession, to the post-apartheid period. Racial and gender discrimination, the migrant labour system, the destruction of family life, vast income inequalities, and extreme violence have all formed part of South Africa's troubled past, and all have inexorably affected health and health services. In 1994, when apartheid ended, the health system faced massive challenges, many of which still persist. Macroeconomic policies, fostering growth rather than redistribution, contributed to the persistence of economic disparities between races despite a large expansion in social grants. The public health system has been transformed into an integrated, comprehensive national service, but failures in leadership and stewardship and weak management have led to inadequate implementation of what are often good policies. Pivotal facets of primary health care are not in place and there is a substantial human resources crisis facing the health sector. The HIV epidemic has contributed to and accelerated these challenges. All of these factors need to be addressed by the new government if health is to be improved and the Millennium Development Goals achieved in South Africa.

  11. Embedding health literacy into health systems: a case study of a regional health service.

    Science.gov (United States)

    Vellar, Lucia; Mastroianni, Fiorina; Lambert, Kelly

    2017-12-01

    Objective The aim of the present study was to describe how one regional health service the Illawarra Shoalhaven Local Health District embedded health literacy principles into health systems over a 3-year period. Methods Using a case study approach, this article describes the development of key programs and the manner in which clinical incidents were used to create a health environment that allows consumers the right to equitably access quality health services and to participate in their own health care. Results The key outcomes demonstrating successful embedding of health literacy into health systems in this regional health service include the creation of a governance structure and web-based platform for developing and testing plain English consumer health information, a clearly defined process to engage with consumers, development of the health literacy ambassador training program and integrating health literacy into clinical quality improvement processes via a formal program with consumers to guide processes such as improvements to access and navigation around hospital sites. Conclusions The Illawarra Shoalhaven Local Health District has developed an evidence-based health literacy framework, guided by the core principles of universal precaution and organisational responsibility. Health literacy was also viewed as both an outcome and a process. The approach taken by the Illawarra Shoalhaven Local Health District to address poor health literacy in a coordinated way has been recognised by the Australian Commission on Safety and Quality in Health Care as an exemplar of a coordinated approach to embed health literacy into health systems. What is known about the topic? Poor health literacy is a significant national concern in Australia. The leadership, governance and consumer partnership culture of a health organisation can have considerable effects on an individual's ability to access, understand and apply the health-related information and services available to them

  12. The influence of physical and mental health on life satisfaction is mediated by self-rated health: A study with Brazilian elderly.

    Science.gov (United States)

    Pinto, Juliana Martins; Fontaine, Anne Marie; Neri, Anita Liberalesso

    2016-01-01

    Chronic diseases, signals and symptoms of health problems and objective losses in functionality are seen as strongly related to low levels of life satisfaction in old age. Among seniors, self-rated health is associated with both quality of health and life satisfaction, but its relationships with objective health measures are controversial. This study aimed at identifying the influence of self-rated health as a mediator of the relationships between objectives indicators of physical and mental health and the elderly's life satisfaction. Self-reporting and physical performance measures were derived from the data basis of the FIBRA Study, which investigated frailty and associated variables in a cross-sectional sample of 2164 subjects aged 65 and above, randomly selected in seven Brazilian cities. A model considering satisfaction as a dependent variable, the number of diseases, frailty, cognitive status and depressive symptoms as predictors and self-rated health as a mediating variable was tested through path analysis. The model fit the data well and explained 19% of life satisfaction's variance. According to the bootstrapping method, indirect effects were significant for all trajectories, suggesting that self-rated health is a mediator variable between physical and mental health and elderlýs life satisfaction. In conclusion, adverse conditions of physical and mental health can influence the elderlýs life satisfaction, mostly when they determine a decrease in their levels of self-rated health. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Analysis of factors influencing the outpatient workload at Chinese health centres

    Directory of Open Access Journals (Sweden)

    Yin Ping

    2010-06-01

    Full Text Available Abstract Background Although the community health service system is now established in China, the utilisation of the community health service institutions is low due to the lack of a gate-keeping role of the primary health service providers and referrals among the three-tiered health service institutions. In addition to this, patients who can afford to pay, often seek best services in big hospitals to guarantee the quality of care. Thus, the need of guiding the patients to the community health services and increasing the utilisation of the community health service institutions is becoming an urgent problem, which hinders the future development of community health services. This study focuses on the question of how to increase the utilisation of Chinese community health centres (HCs. Methods A cross-sectional Base-line Survey of Chinese City Community Health Service System Building using the multi-staged cluster sampling was conducted to collect data from all HCs in 28 key contact cities. Relevant indicators of totally 1790 HCs were analysed. The statistical methods included ANONVA and logistic regression. Results and Conclusions The analysis suggested several key factors for increasing the outpatient workload (OW at the HCs: establishing an adequate referral system among the different levels of the health system; enhancing the qualification of health personnel and increasing the compensation by the health insurance for services provided at HCs. Other key factors with a positive effect on the OW included: the government ownership of the HCs, the scale of the institutions, the medical equipment used, the mix of health services provided, and the women in childbearing age in the residence.

  14. The impact of mHealth interventions on health systems: a systematic review protocol.

    Science.gov (United States)

    Fortuin, Jill; Salie, Faatiema; Abdullahi, Leila H; Douglas, Tania S

    2016-11-25

    Mobile health (mHealth) has been described as a health enabling tool that impacts positively on the health system in terms of improved access, quality and cost of health care. The proposed systematic review will examine the impact of mHealth on health systems by assessing access, quality and cost of health care as indicators. The systematic review will include literature from various sources including published and unpublished/grey literature. The databases to be searched include: PubMed, Cochrane Library, Google Scholar, NHS Health Technology Assessment Database and Web of Science. The reference lists of studies will be screened and conference proceedings searched for additional eligible reports. Literature to be included will have mHealth as the primary intervention. Two authors will independently screen the search output, select studies and extract data; discrepancies will be resolved by consensus and discussion with the assistance of the third author. The systematic review will inform policy makers, investors, health professionals, technologists and engineers about the impact of mHealth in strengthening the health system. In particular, it will focus on three metrics to determine whether mHealth strengthens the health system, namely quality of, access to and cost of health care services. Systematic review registration: PROSPERO CRD42015026070.

  15. Budget-makers and health care systems.

    Science.gov (United States)

    White, Joseph

    2013-10-01

    Health programs are shaped by the decisions made in budget processes, so how budget-makers view health programs is an important part of making health policy. Budgeting in any country involves its own policy community, with key players including budgeting professionals and political authorities. This article reviews the typical pressures on and attitudes of these actors when they address health policy choices. The worldview of budget professionals includes attitudes that are congenial to particular policy perspectives, such as the desire to select packages of programs that maximize population health. The pressures on political authorities, however, are very different: most importantly, public demand for health care services is stronger than for virtually any other government activity. The norms and procedures of budgeting also tend to discourage adoption of some of the more enthusiastically promoted health policy reforms. Therefore talk about rationalizing systems is not matched by action; and action is better explained by the need to minimize blame. The budget-maker's perspective provides insight about key controversies in healthcare policy such as decentralization, competition, health service systems as opposed to health insurance systems, and dedicated vs. general revenue finance. It also explains the frequency of various "gaming" behaviors. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  16. [The Health Plan for Catalonia: an instrument to transform the health system].

    Science.gov (United States)

    Constante i Beitia, Carles

    2015-11-01

    The Department of Health of the Generalitat in Catalonia periodically draws up the Health Plan, which is the strategic document that brings together the reference framework for initiatives concerning public health in terms of the Catalan health administration. The 2011-2015 version of the Health Plan incorporates key care and system governance-related elements, which, in conjunction with health goals, make up the complete picture of what the health system in Catalonia should look like until 2015. The Plan was drawn up at a time when the environmental conditions were extremely particular, given the major economic crisis that began in 2007. This has meant that the system has been forced to address public health problems using a significant reduction in the economic resources available, while aiming to maintain the level of care provided, both quantitatively and qualitatively, and preserve the sustainability of the system whose defining traits are its universality, equity and the wide range of services on offer. The Health Plan focuses on three areas of action, 9 major courses of action and 32 strategic projects designed to respond to new social needs: addressing the most common health issues, comprehensive care for chronic patients and organizational modernization. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  17. Gender as an Influencer of Online Health Information-Seeking and Evaluation Behavior

    OpenAIRE

    Rowley, J.; Johnson, F.; Sbaffi, L.

    2016-01-01

    This article contributes to the growing body of research that explores the significance of context in health information behavior. Specifically, through the lens of trust judgments, it demonstrates that gender is a determinant of the information evaluation process. A questionnaire-based survey collected data from adults regarding the factors that influence their judgment of the trustworthiness of online health information. Both men and women identified credibility, recommendation, ease of use...

  18. THE E-HEALTH SYSTEMS IN POLAND

    Directory of Open Access Journals (Sweden)

    Zdzisław PÓLKOWSKI

    2013-11-01

    Full Text Available Information Technologies are disruptive technologies that have caused major changes in health system in Poland. Current digital economy is driven by modern information and new IT tools, which offer hospitals, doctors and patient access to any type of information, regardless of its form of existence, storage type or geographical location. These tools encourage the development of new activities, health services. The purpose of this article is to analyze the the current state of development of e-services in Poland in the context of nowadays health system. In the first part of the paper, the authors present various programmes, which enable the access to the medical services and patients’ data online. The next part of the paper is devoted to examining the technical aspects of the said programmes and presenting their advantages as well as the areas which might be improved.The last part of the work will be focused on the websites of the selected health institutions. According to the authors, WWW services provide much information on how the process of computer systems are being implemented, what data the services include and the capacity of the equipment as well as the software, human resources and the knowledge in this sphere. Moreover this section highlights the latest trends in e-health with particular emphasis on aspects such as the use of private and public cloud computer and t heir integration with web sites of health institutions. This study brings its contribution to the understanding of the change of health system in Poland behavior by using a new perspective e-health systems and IT tools above by doctors, officers and patients.

  19. Influences on adolescent smoking

    Directory of Open Access Journals (Sweden)

    Helena Koprivnikar

    2011-06-01

    Full Text Available Abstract There are numerous and intertwining factors that influence adolescent smoking and have to be considered when we develop and implement programmes and measures for the prevention and reduction of adolescent smoking. In different environments (schools, health system, local communities we have to reduce risk factors and strenghten protective factors through programmes incorporated in the system. The protective factors are low prevalence of smoking, healthy lifestyle, physical activity and good mental health, indicating the importance of links to programmes outside of the tobacco control.

  20. Factors influencing Chinese college students' preferences for mental health professionals.

    Science.gov (United States)

    Ip, Vitti; Chan, Fong; Chan, Jacob Yui-Chung; Lee, June Ka Yan; Sung, Connie; H Wilson, Emma

    2016-01-01

    Transition from high school to college can be particularly difficult and stressful for Chinese college students because of parent expectations. The purpose of this study was to examine therapist variables influencing Chinese college students' preferences for mental health professionals using conjoint analysis. Two hundred fifty-eight community college students in Hong Kong were asked to rate the profile of 55 mental health professionals representing a combination of therapist characteristics (i.e., gender, age, race/ethnicity, professional background, and training institutions) from the most to least preferred therapist from whom to seek psychological counselling. Results indicated that students' preference formation was based largely on professional background and training institution of the mental health professionals. Clinical psychologists and clinical social workers were preferred over educational psychologists (school psychologists), counsellors, and psychiatrists. Mental health professionals who received training from more prestigious schools were preferred over those trained at less prestigious schools. Understanding clients' preference formation for choosing mental health professionals could be the first step to gain insights for developing effective educational and outreach strategies to promote help seeking behavior and mental health service utilization among Chinese college students.

  1. MOTIVATION AND COMPENSATION IN HEALTH SYSTEM

    Directory of Open Access Journals (Sweden)

    K. N. Borisov

    2015-01-01

    Full Text Available By the definition accepted by WHO, «health» it is not simple absence of an illness, but a condition of full physical, moral, mental and social wellbeing. By this definition forms of behavior and a way of life of the people, allowing prolonging the period of active, creative and happy life are meant. Health of each person – the main value for modern society. A crisis state of population as open social system, it is shown by its indignation in reply to stressful influences of negative socio-economic factors. It is accompanied by change of a condition of the public health which level refl ects depth of occurring changes. In the conditions of market managing also, the policy in the field of compensation, material encouragement and social support of medical workers essentially changes. A certain level of compensation regardless of should be guaranteed to the medical worker, whether mechanisms of economic incentives of its work are used or not. At the same time, the desire of the worker to hold a position with higher salary and desire to work on it is productive and is qualitative – far not same. Increase of material compensation not always leads to increase of labor motivation and aspiration it is better to work. Socially psychological bases of labor motivation of medical workers are those new approaches that will allow solving problems of increase of labor motivation more effectively. In article the assessment of labor motivation is analyzed by medical workers, measures for increase of labor motivation and according to improvement of quality of medical care are off ered. The majority of the western experts inefficiency of management recognize as the main problem of health care ofRussia. The conclusion that medical institutes, academies and institutes of a post degree obrazoyovaniye, professional development faculties, and, probably, and institutes an upravleyoniya, should adapt foreign experience (motivational, conceptual, technological and

  2. How community-dwelling seniors with multimorbidity conceive the concept of mental health and factors that may influence it: a phenomenographic study.

    Science.gov (United States)

    Grundberg, Ake; Ebbeskog, Britt; Dahlgren, Madeleine Abrandt; Religa, Dorota

    2012-12-13

    Multimorbidity, that is, the coexistence of chronic diseases, is associated with mental health issues among elderly people. In Sweden, seniors with multimorbidity often live at home and receive care from nursing aides and district nurses. The aim of this study was to describe the variation in how community-dwelling seniors with multimorbidity perceive the concept of mental health and what may influence it. Thirteen semi-structured interviews were analysed using a phenomenographic approach. Six qualitatively different ways of understanding the concept of mental health and factors that may influence it, reflecting key variations of meaning, were identified. The discerned categories were: mental health is dependent on desirable feelings and social contacts, mental health is dependent on undesirable feelings and social isolation, mental health is dependent on power of the mind and ability to control thoughts, mental health is dependent on powerlessness of the mind and inability to control thoughts, mental health is dependent on active behaviour and a healthy lifestyle, and mental health is dependent on passive behaviour and physical inactivity. According to the respondents' view, the concept of mental health can be defined as how an individual feels, thinks, and acts and also includes a positive as well as a negative aspect. Social contacts, physical activity, and optimism may improve mental health while social isolation, ageing, and chronic pain may worsen it. Findings highlight the importance of individually definitions of mental health and that community-dwelling seniors with multimorbidity may describe how multiple chronic conditions can affect their life situation. It is essential to organize the health care system to provide individual health promotion dialogues, and future research should address the prerequisites for conducting mental health promotion dialogues.

  3. A Case for Open Network Health Systems: Systems as Networks in Public Mental Health

    Directory of Open Access Journals (Sweden)

    Michael Grant Rhodes

    2017-03-01

    Full Text Available Increases in incidents involving so-called confused persons have brought attention to the potential costs of recent changes to public mental health (PMH services in the Netherlands. Decentralized under the (Community Participation Act (2014, local governments must find resources to compensate for reduced central funding to such services or “innovate.” But innovation, even when pressure for change is intense, is difficult. This perspective paper describes experience during and after an investigation into a particularly violent incident and murder. The aim was to provide recommendations to improve the functioning of local PMH services. The investigation concluded that no specific failure by an individual professional or service provider facility led to the murder. Instead, also as a result of the Participation Act that severed communication lines between individuals and organizations, information sharing failures were likely to have reduced system level capacity to identify risks. The methods and analytical frameworks employed to reach this conclusion, also lead to discussion as to the plausibility of an unconventional solution. If improving communication is the primary problem, non-hierarchical information, and organizational networks arise as possible and innovative system solutions. The proposal for debate is that traditional “health system” definitions, literature and narratives, and operating assumptions in public (mental health are ‘locked in’ constraining technical and organization innovations. If we view a “health system” as an adaptive system of economic and social “networks,” it becomes clear that the current orthodox solution, the so-called integrated health system, typically results in a “centralized hierarchical” or “tree” network. An overlooked alternative that breaks out of the established policy narratives is the view of a ‘health systems’ as a non-hierarchical organizational structure or

  4. How do external donors influence national health policy processes? Experiences of domestic policy actors in Cambodia and Pakistan.

    Science.gov (United States)

    Khan, Mishal S; Meghani, Ankita; Liverani, Marco; Roychowdhury, Imara; Parkhurst, Justin

    2018-03-01

    Although concerns have historically been raised about the influence of external donors on health policy process in recipient countries, remarkably few studies have investigated perspectives and experiences of domestic policymakers and advisers. This study examines donor influence at different stages of the health policy process (priority setting, policy formulation, policy implementation and monitoring and evaluation) in two aid-dependent LMICs, Cambodia and Pakistan. It identifies mechanisms through which asymmetries in influence between donors and domestic policy actors emerge. We conducted 24 key informant interviews-14 in Pakistan and 10 in Cambodia-with high-level decision-makers who inform or authorize health priority setting, allocate resources and/or are responsible for policy implementation, identifying three routes of influence: financial resources, technical expertise and indirect financial and political incentives. We used both inductive and deductive approaches to analyse the data. Our findings indicate that different routes of influence emerged depending on the stage of the policy process. Control of financial resources was the most commonly identified route by which donors influenced priority setting and policy implementation. Greater (perceived) technical expertise played an important role in donor influence at the policy formulation stage. Donors' power in influencing decisions, particularly during the final (monitoring and evaluation) stage of the policy process, was mediated by their ability to control indirect financial and political incentives as well as direct control of financial resources. This study thus helps unpack the nuances of donor influence over health policymaking in these settings, and can potentially indicate areas that require attention to increase the ownership of domestic actors of their countries' health policy processes. © The Author(s) 2017. Published by Oxford University Press in association with The London School of

  5. Distance to hospital and socioeconomic status influence secondary health care use

    DEFF Research Database (Denmark)

    Zielinski, Andrzej; Borgquist, Lars; Halling, Anders

    2013-01-01

    Objective. The aim of this study was to investigate how distance to hospital and socioeconomic status (SES) influence the use of secondary health care (SHC) when taking comorbidity into account. Design and setting. A register-based study in Östergötland County. Subjects. The adult population...

  6. Integrating ICTs within health systems | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-06-10

    Jun 10, 2016 ... But for too long, ICT and health system researchers have worked in isolation ... be used to enable the governance and functioning of health systems in ... most African countries adopted direct payment for health services as the ...

  7. Health at the center of health systems reform: how philosophy can inform policy.

    Science.gov (United States)

    Sturmberg, Joachim P; Martin, Carmel M; Moes, Mark M

    2010-01-01

    Contemporary views hold that health and disease can be defined as objective states and thus should determine the design and delivery of health services. Yet health concepts are elusive and contestable. Health is neither an individual construction, a reflection of societal expectations, nor only the absence of pathologies. Based on philosophical and sociological theory, empirical evidence, and clinical experience, we argue that health has simultaneously objective and subjective features that converge into a dynamic complex-adaptive health model. Health (or its dysfunction, illness) is a dynamic state representing complex patterns of adaptation to body, mind, social, and environmental challenges, resulting in bodily homeostasis and personal internal coherence. The "balance of health" model-emergent, self-organizing, dynamic, and adaptive-underpins the very essence of medicine. This model should be the foundation for health systems design and also should inform therapeutic approaches, policy decision-making, and the development of emerging health service models. A complex adaptive health system focused on achieving the best possible "personal" health outcomes must provide the broad policy frameworks and resources required to implement people-centered health care. People-centered health systems are emergent in nature, resulting in locally different but mutually compatible solutions across the whole health system.

  8. Bringing (domestic) politics back in: global and local influences on health equity.

    Science.gov (United States)

    Schrecker, Ted

    2015-07-01

    The Lancet-University of Oslo Commission on Global Governance for health correctly concluded that: 'with globalization, health inequity increasingly results from transnational activities that involve actors with different interests and degrees of power'. At the same time, taking up that Commission's focus on political determinants of health and 'power asymmetries' requires recognizing the interplay of globalization with domestic politics, and the limits of global influences as explanations for policies that affect health inequalities. I make this case using three examples - trade policy, climate change policy, and the domestic politics of poverty reduction and social policy - and a concluding observation about the 2015 UK election. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  9. The Influence of Organizational Systems on Information Exchange in Long-Term Care Facilities: An Institutional Ethnography.

    Science.gov (United States)

    Caspar, Sienna; Ratner, Pamela A; Phinney, Alison; MacKinnon, Karen

    2016-06-01

    Person-centered care is heavily dependent on effective information exchange among health care team members. We explored the organizational systems that influence resident care attendants' (RCAs) access to care information in long-term care (LTC) settings. We conducted an institutional ethnography in three LTC facilities. Investigative methods included naturalistic observations, in-depth interviews, and textual analysis. Practical access to texts containing individualized care-related information (e.g., care plans) was dependent on job classification. Regulated health care professionals accessed these texts daily. RCAs lacked practical access to these texts and primarily received and shared information orally. Microsystems of care, based on information exchange formats, emerged. Organizational systems mandated written exchange of information and did not formally support an oral exchange. Thus, oral information exchanges were largely dependent on the quality of workplace relationships. Formal systems are needed to support structured oral information exchange within and between the microsystems of care found in LTC. © The Author(s) 2016.

  10. Public and private sector in the health care system of the Federation bosnia and herzegovina: policy and strategy.

    Science.gov (United States)

    Slipicevic, Osman; Malicbegovic, Adisa

    2012-01-01

    In Bosnia and Herzegovina citizens receive health care from both public and private providers. The current situation calls for a clear government policy and strategy to ensure better position and services from both parts. This article examines how health care services are delivered, particularly with respect to relationship between public and private providers. The paper notes that the public sector is plagued by a number of weaknesses in terms of inefficiency of services provision, poorly motivated staff, prevalent dual practice of public employees, poor working conditions and geographical imbalances. Private sector is not developing in ways that address the weaknesses of the public sector. Poorly regulated, it operates as an isolated entity, strongly profit-driven. The increasing burdens on public health care system calls for government to abandon its passive role and take action to direct growth and use potential of private sector. The paper proposes a number of mechanisms that can be used to influence private as well as public sector, since actions directed toward one part of the system will inevitable influence the other.

  11. Environmental health risk assessment: Energy systems

    International Nuclear Information System (INIS)

    Krewski, D.; Somers, E.; Winthrop, S.O.

    1984-01-01

    Most industrialized nations have come to rely on a variety of systems for energy production, both of a conventional and non-conventional nature. In the paper, the spectrum of energy systems currently in use in Canada is outlined along with their potential health risks. Several examples of environmental health studies involving both outdoor and indoor air pollution related to energy production in Canada are reported. The limitations of current technologies for assessing health risks are discussed and possible approaches to managing energy related health risks are indicated. (author)

  12. The Nigerian health care system: Need for integrating adequate medical intelligence and surveillance systems

    Directory of Open Access Journals (Sweden)

    Menizibeya Osain Welcome

    2011-01-01

    Full Text Available Objectives : As an important element of national security, public health not only functions to provide adequate and timely medical care but also track, monitor, and control disease outbreak. The Nigerian health care had suffered several infectious disease outbreaks year after year. Hence, there is need to tackle the problem. This study aims to review the state of the Nigerian health care system and to provide possible recommendations to the worsening state of health care in the country. To give up-to-date recommendations for the Nigerian health care system, this study also aims at reviewing the dynamics of health care in the United States, Britain, and Europe with regards to methods of medical intelligence/surveillance. Materials and Methods : Databases were searched for relevant literatures using the following keywords: Nigerian health care, Nigerian health care system, and Nigerian primary health care system. Additional keywords used in the search were as follows: United States (OR Europe health care dynamics, Medical Intelligence, Medical Intelligence systems, Public health surveillance systems, Nigerian medical intelligence, Nigerian surveillance systems, and Nigerian health information system. Literatures were searched in scientific databases Pubmed and African Journals OnLine. Internet searches were based on Google and Search Nigeria. Results : Medical intelligence and surveillance represent a very useful component in the health care system and control diseases outbreak, bioattack, etc. There is increasing role of automated-based medical intelligence and surveillance systems, in addition to the traditional manual pattern of document retrieval in advanced medical setting such as those in western and European countries. Conclusion : The Nigerian health care system is poorly developed. No adequate and functional surveillance systems are developed. To achieve success in health care in this modern era, a system well grounded in routine

  13. [Corruption and health care system].

    Science.gov (United States)

    Marasović Šušnjara, Ivana

    2014-06-01

    Corruption is a global problem that takes special place in health care system. A large number of participants in the health care system and numerous interactions among them provide an opportunity for various forms of corruption, be it bribery, theft, bureaucratic corruption or incorrect information. Even though it is difficult to measure the amount of corruption in medicine, there are tools that allow forming of the frames for possible interventions.

  14. Factors That Influence Enrolment and Retention in Ghana’ National Health Insurance Scheme

    Science.gov (United States)

    Millicent Kotoh, Agnes; Aryeetey, Genevieve Cecilia; der Geest, Sjaak Van

    2018-01-01

    Background: The government of Ghana introduced the National Health Insurance Scheme (NHIS) in 2004 with the goal of achieving universal coverage within 5 years. Evidence, however, shows that expanding NHIS coverage and especially retaining members have remained a challenge. A multilevel perspective was employed as a conceptual framework and methodological tool to examine why enrolment and retention in the NHIS remains low. Methods: A household survey was conducted after 20 months educational and promotional activities aimed at improving enrolment and retention rates in 15 communities in the Central and Eastern Regions (ERs) of Ghana. Observation, indepth interviews and informal conversations were used to collect qualitative data. Forty key informants (community members, health providers and district health insurance schemes’ [DHISs] staff) purposely selected from two casestudy communities in the Central Region (CR) were interviewed. Several community members, health providers and DHISs’ staff were also engaged in informal conversations in the other five communities in the region. Also, four staff of the Ministry of Health (MoH), Ghana Health Service (GHS) and National Health Insurance Authority (NHIA) were engaged in in-depth interviews. Descriptive statistics was used to analyse quantitative data. Qualitative data was analysed using thematic content analysis. Results: The results show that factors that influence enrolment and retention in the NHIS are multi-dimensional and cut across all stakeholders. People enrolled and renewed their membership because of NHIS’ benefits and health providers’ positive behaviour. Barriers to enrolment and retention included: poverty, traditional risk-sharing arrangements influence people to enrol or renew their membership only when they need healthcare, dissatisfaction about health providers’ behaviour and service delivery challenges. Conclusion: Given the multi-dimensional nature of barriers to enrolment and retention

  15. Changing the health care system: a professional education program for Hispanic leaders in California.

    Science.gov (United States)

    Greenwald, H P; DeVries, R A; Dickstein, D A

    2001-01-01

    This article reports characteristics and evaluation findings on a program aimed at promoting change in California's health care system by training minority managers and policy specialists. Between 1990 and 1992, 30 Hispanic college graduates enrolled in the University of Southern California's Hispanic Leadership Program. Funded in part by the W. K. Kellogg Foundation, this program led to award of the Master of Health Administration degree and involved students in a series of community workshops. Evaluation took place via alumni surveys and focus groups. Although four individuals failed to complete the program, nearly all others entered careers potentially leading to positions of influence in health care delivery. Graduates indicated that they possessed most of the skills they considered necessary to help improve services to Hispanic people. All had taken concrete action toward this objective. Experience with the program has provided lessons valuable for conducting efforts of this kind, the principal one being that success requires substantial human and material resources. Long-term follow-up will be necessary to assess the program's ultimate impact on California's health care system.

  16. 'Your health our concern, our health whose concern?': perceptions of injustice in organizational relationships and processes and frontline health worker motivation in Ghana

    NARCIS (Netherlands)

    Aberese-Ako, M.; van Dijk, H.; Gerrits, T.; Arhinful, D.K.; Agyepong, I.A.

    2014-01-01

    Taking a perspective of frontline health workers as internal clients within health systems, this study explored how perceived injustice in policy and organizational matters influence frontline health worker motivation and the consequent effect on workers’ attitudes and performance in delivering

  17. Your health our concern, our health whose concern? : perceptions of injustice in organizational relationships and processes and frontline health worker motivation in Ghana

    NARCIS (Netherlands)

    Aberese-Ako, M.; Dijk, van H.; Gerrits, T.; Arhinful, D.K.; Agyepong, I.A.

    2014-01-01

    Taking a perspective of frontline health workers as internal clients within health systems, this study explored how perceived injustice in policy and organizational matters influence frontline health worker motivation and the consequent effect on workers’ attitudes and performance in delivering

  18. Nutra-ergonomics: influence of nutrition on physical employment standards and the health of workers.

    Science.gov (United States)

    Shearer, Jane; Graham, Terry E; Skinner, Tina L

    2016-06-01

    The importance of ergonomics across several scientific domains, including biomechanics, psychology, sociology, and physiology, have been extensively explored. However, the role of other factors that may influence the health and productivity of workers, such as nutrition, is generally overlooked. Nutra-ergonomics describes the interface between workers, their work environment, and performance in relation to their nutritional status. It considers nutrition to be an integral part of a safe and productive workplace that encompasses physical and mental health as well as the long-term wellbeing of workers. This review explores the knowledge, awareness, and common practices of nutrition, hydration, stimulants, and fortified product use employed prior to physical employment standards testing and within the workplace. The influence of these nutra-ergonomic strategies on physical employment standards, worker safety, and performance will be examined. Further, the roles, responsibilities, and implications for the applicant, worker, and the employer will be discussed within the context of nutra-ergonomics, with reference to the provision and sustainability of an environment conducive to optimize worker health and wellbeing. Beyond physical employment standards, workplace productivity, and performance, the influence of extended or chronic desynchronization (irregular or shift work) in the work schedule on metabolism and long-term health, including risk of developing chronic and complex diseases, is discussed. Finally, practical nutra-ergonomic strategies and recommendations for the applicant, worker, and employer alike will be provided to enhance the short- and long-term safety, performance, health, and wellbeing of workers.

  19. The structure of mental health research: networks of influence among psychiatry and clinical psychology journals.

    Science.gov (United States)

    Haslam, N; Lusher, D

    2011-12-01

    Psychiatry and clinical psychology are the two dominant disciplines in mental health research, but the structure of scientific influence and information flow within and between them has never been mapped. Citations among 96 of the highest impact psychiatry and clinical psychology journals were examined, based on 10 052 articles published in 2008. Network analysis explored patterns of influence between journal clusters. Psychiatry journals tended to have greater influence than clinical psychology journals, and their influence was asymmetrical: clinical psychology journals cited psychiatry journals at a much higher rate than the reverse. Eight journal clusters were found, most dominated by a single discipline. Their citation network revealed an influential central cluster of 'core psychiatry' journals that had close affinities with a 'psychopharmacology' cluster. A group of 'core clinical psychology' journals was linked to a 'behavior therapy' cluster but both were subordinate to psychiatry journals. Clinical psychology journals were less integrated than psychiatry journals, and 'health psychology/behavioral medicine' and 'neuropsychology' clusters were relatively peripheral to the network. Scientific publication in the mental health field is largely organized along disciplinary lines, and is to some degree hierarchical, with clinical psychology journals tending to be structurally subordinate to psychiatry journals.

  20. The potential influence of masculine identity on health-improving behavior in midlife and older African American men.

    Science.gov (United States)

    Hooker, Steven P; Wilcox, Sara; Burroughs, Ericka L; Rheaume, Carol E; Courtenay, Will

    2012-06-01

    To gain a greater understanding of masculinity and its potential influence on health-improving behavior in midlife and older African American (AA) men. Forty-nine AA men aged 45-88 years completed in-depth interviews to ascertain their perspectives on masculinity, how masculine identity in this population might be influenced by age and physical activity level, or how it might impact health. Taped interviews were transcribed and organized for analysis with common themes identified by multiple researchers. Most often cited attributes of someone considered "manly" included a leader of a family/household, provider, strong work ethic, and masculine physique. Terms such as responsible, principled, and man of character also described the typical man. Potential negative and positive influences of manhood on health included avoiding health care appointments and being a good example to children/others, respectively. Themes associated with age-related changes in manhood were acceptance and being more health conscious. Elements associated with how manhood was influenced by AA race included stress and perseverance. Midlife and older AA men in this study primarily expressed views of masculinity that fit the traditional perception of manhood. However, the attributes revealed, such as family provider, responsibility, self-reliance, and perseverance, were viewed as having potential for both negative and positive impacts on health and health-improving behaviors. It will be essential to integrate these prevalent attributes of masculine identity into health promotion interventions such that they facilitate positive behavior change while not competing with gender role norms among this vulnerable group of men.

  1. Influence of social support on health among gender and socio-economic groups of adolescents

    NARCIS (Netherlands)

    Geckova, A; van Dijk, JP; Stewart, R; Groothoff, JW; Post, D

    Background: The influence of social support on health was explored among gender and socio-economic groups with the aim of contributing to the explanation of socio-economic health differences among Slovak adolescents. Methods: The sample consisted of 2616 Slovak adolescents (52.4% male, 47.6% female,

  2. The Influence of Social Networking Photos on Social Norms and Sexual Health Behaviors

    Science.gov (United States)

    Jordan, Alexander H.

    2013-01-01

    Abstract Two studies tested whether online social networking technologies influence health behavioral social norms, and in turn, personal health behavioral intentions. In Study 1, experimental participants browsed peers' Facebook photos on a college network with a low prevalence of sexually suggestive content. Participants estimated the percentage of their peers who have sex without condoms, and rated their own future intentions to use condoms. Experimental participants, compared to controls who did not view photos, estimated that a larger percentage of their peers use condoms, and indicated a greater intention to use condoms themselves in the future. In Study 2, participants were randomly assigned to view sexually suggestive or nonsexually suggestive Facebook photos, and responded to sexual risk behavioral questions. Compared to participants viewing nonsuggestive photos, those who viewed sexually suggestive Facebook photos estimated that a larger percentage of their peers have unprotected sexual intercourse and sex with strangers and were more likely to report that they themselves would engage in these behaviors. Thus, online social networks can influence perceptions of the peer prevalence of sexual risk behaviors, and can influence users' own intentions with regard to such behaviors. These studies suggest the potential power of social networks to affect health behaviors by altering perceptions of peer norms. PMID:23438268

  3. Beyond form and functioning: Understanding how contextual factors influence village health committees in northern India.

    Directory of Open Access Journals (Sweden)

    Kerry Scott

    Full Text Available Health committees are a common strategy to foster community participation in health. Efforts to strengthen committees often focus on technical inputs to improve committee form (e.g. representative membership and functioning (e.g. meeting procedures. However, porous and interconnected contextual spheres also mediate committee effectiveness. Using a framework for contextual analysis, we explored the contextual features that facilitated or hindered Village Health, Sanitation and Nutrition Committee (VHSNC functionality in rural north India. We conducted interviews (n = 74, focus groups (n = 18 and observation over 1.5 years. Thematic content analysis enabled the identification and grouping of themes, and detailed exploration of sub-themes. While the intervention succeeded in strengthening committee form and functioning, participant accounts illuminated the different ways in which contextual influences impinged on VHSNC efficacy. Women and marginalized groups navigated social hierarchies that curtailed their ability to assert themselves in the presence of men and powerful local families. These dynamics were not static and unchanging, illustrated by pre-existing cross-caste problem solving, and the committee's creation of opportunities for the careful violation of social norms. Resource and capacity deficits in government services limited opportunities to build relationships between health system actors and committee members and engendered mistrust of government institutions. Fragmented administrative accountability left committee members bearing responsibility for improving local health without access to stakeholders who could support or respond to their efforts. The committee's narrow authority was at odds with widespread community needs, and committee members struggled to involve diverse government services across the health, sanitation, and nutrition sectors. Multiple parallel systems (political decentralization, media and other village groups

  4. Beyond form and functioning: Understanding how contextual factors influence village health committees in northern India.

    Science.gov (United States)

    Scott, Kerry; George, Asha S; Harvey, Steven A; Mondal, Shinjini; Patel, Gupteswar; Ved, Rajani; Garimella, Surekha; Sheikh, Kabir

    2017-01-01

    Health committees are a common strategy to foster community participation in health. Efforts to strengthen committees often focus on technical inputs to improve committee form (e.g. representative membership) and functioning (e.g. meeting procedures). However, porous and interconnected contextual spheres also mediate committee effectiveness. Using a framework for contextual analysis, we explored the contextual features that facilitated or hindered Village Health, Sanitation and Nutrition Committee (VHSNC) functionality in rural north India. We conducted interviews (n = 74), focus groups (n = 18) and observation over 1.5 years. Thematic content analysis enabled the identification and grouping of themes, and detailed exploration of sub-themes. While the intervention succeeded in strengthening committee form and functioning, participant accounts illuminated the different ways in which contextual influences impinged on VHSNC efficacy. Women and marginalized groups navigated social hierarchies that curtailed their ability to assert themselves in the presence of men and powerful local families. These dynamics were not static and unchanging, illustrated by pre-existing cross-caste problem solving, and the committee's creation of opportunities for the careful violation of social norms. Resource and capacity deficits in government services limited opportunities to build relationships between health system actors and committee members and engendered mistrust of government institutions. Fragmented administrative accountability left committee members bearing responsibility for improving local health without access to stakeholders who could support or respond to their efforts. The committee's narrow authority was at odds with widespread community needs, and committee members struggled to involve diverse government services across the health, sanitation, and nutrition sectors. Multiple parallel systems (political decentralization, media and other village groups) presented

  5. Influences on the choice of health professionals to practise in rural ...

    African Journals Online (AJOL)

    Background. Training health care professionals (HCPs) to work in rural areas is a challenge for educationalists. This study aimed to understand how HCPs choose to work in rural areas and how education influences this. Methods. Qualitative individual interviews were conducted with 15 HCPs working in rural areas in SA.

  6. Portable Health Algorithms Test System

    Science.gov (United States)

    Melcher, Kevin J.; Wong, Edmond; Fulton, Christopher E.; Sowers, Thomas S.; Maul, William A.

    2010-01-01

    A document discusses the Portable Health Algorithms Test (PHALT) System, which has been designed as a means for evolving the maturity and credibility of algorithms developed to assess the health of aerospace systems. Comprising an integrated hardware-software environment, the PHALT system allows systems health management algorithms to be developed in a graphical programming environment, to be tested and refined using system simulation or test data playback, and to be evaluated in a real-time hardware-in-the-loop mode with a live test article. The integrated hardware and software development environment provides a seamless transition from algorithm development to real-time implementation. The portability of the hardware makes it quick and easy to transport between test facilities. This hard ware/software architecture is flexible enough to support a variety of diagnostic applications and test hardware, and the GUI-based rapid prototyping capability is sufficient to support development execution, and testing of custom diagnostic algorithms. The PHALT operating system supports execution of diagnostic algorithms under real-time constraints. PHALT can perform real-time capture and playback of test rig data with the ability to augment/ modify the data stream (e.g. inject simulated faults). It performs algorithm testing using a variety of data input sources, including real-time data acquisition, test data playback, and system simulations, and also provides system feedback to evaluate closed-loop diagnostic response and mitigation control.

  7. Dealing with Health and Health Care System Challenges in China: assessing health determinants and health care reforms

    NARCIS (Netherlands)

    H. Zhang (Hao)

    2017-01-01

    markdownabstractThis dissertation investigates the challenges faced by China around 2010 in two domains – population health and the health care system. Specifically, chapters 2 and 3 are devoted to health challenges, explaining the female health disadvantage in later life and assessing the effect

  8. [The health system of Brazil].

    Science.gov (United States)

    Montekio, Víctor Becerril; Medina, Guadalupe; Aquino, Rosana

    2011-01-01

    This paper describes the Brazilian health system, which includes a public sector covering almost 75% of the population and an expanding private sector offering health services to the rest of the population. The public sector is organized around the Sistema Único de Saúde (SUS) and it is financed with general taxes and social contributions collected by the three levels of government (federal, state and municipal). SUS provides health care through a decentralized network of clinics, hospitals and other establishments, as well as through contracts with private providers. SUS is also responsible for the coordination of the public sector. The private sector includes a system of insurance schemes known as Supplementary Health which is financed by employers and/or households: group medicine (companies and households), medical cooperatives, the so called Self-Administered Plans (companies) and individual insurance plans.The private sector also includes clinics, hospitals and laboratories offering services on out-of-pocket basis mostly used by the high-income population. This paper also describes the resources of the system, the stewardship activities developed by the Ministry of Health and other actors, and the most recent policy innovations implemented in Brazil, including the programs saúde da Familia and Mais Saúde.

  9. Rethinking health systems strengthening: key systems thinking tools and strategies for transformational change.

    Science.gov (United States)

    Swanson, R Chad; Cattaneo, Adriano; Bradley, Elizabeth; Chunharas, Somsak; Atun, Rifat; Abbas, Kaja M; Katsaliaki, Korina; Mustafee, Navonil; Mason Meier, Benjamin; Best, Allan

    2012-10-01

    While reaching consensus on future plans to address current global health challenges is far from easy, there is broad agreement that reductionist approaches that suggest a limited set of targeted interventions to improve health around the world are inadequate. We argue that a comprehensive systems perspective should guide health practice, education, research and policy. We propose key 'systems thinking' tools and strategies that have the potential for transformational change in health systems. Three overarching themes span these tools and strategies: collaboration across disciplines, sectors and organizations; ongoing, iterative learning; and transformational leadership. The proposed tools and strategies in this paper can be applied, in varying degrees, to every organization within health systems, from families and communities to national ministries of health. While our categorization is necessarily incomplete, this initial effort will provide a valuable contribution to the health systems strengthening debate, as the need for a more systemic, rigorous perspective in health has never been greater.

  10. Rating the Efficiency of Regional Health Systems and Compulsory Health Insurance

    Directory of Open Access Journals (Sweden)

    Tatyana Nikolayevna Russkikh

    2015-12-01

    Full Text Available In the face of increasing of the regional differentiation of the health systems and compulsory health insurance, the comparative analysis and efficiency assessment of their performance in the context of the subjects of the Russian Federation becomes particularly relevant. Therefore, the research is focused on the regional health systems and compulsory health insurance (CHI, and the subject matter of the study is the analysis of the system performance. In the article, the comparative analysis of the authors’ approaches to the formation of efficiency criteria of the performance of regional health systems and CHI, as well as to the development of a typology of the constituent entities of the Russian Federation based on these criteria is conducted. The authors propose a system of indicators to measure the economic, medical and social efficiency of the systems under consideration. Moreover, a set of indicators of economic efficiency forms two groups of indicators. The first group of indicators reflects the financial performance, and the second — the structural efficiency. A methodological approach to the formation of the rating for subjects of the Russian Federation according to the levels of efficiency, based on the procedures of cluster analysis and fuzzy mathematics are developed. A feature of the proposed approach to the construction of a typology of the subjects in terms of efficiency is the introduction of a reference subject with the national average performance indicators system that allows to qualitatively assess the effectiveness of regional health systems and CHI by comparing them with the «reference subject». The results of the empirical research have indicated a high differentiation of the subjects of the Russian Federation in terms of economic efficiency, have allowed to identify the subjects-outsiders. The theoretical and practical results can be used for the rational choice of priorities of the state policy in the field of the

  11. The Impact of Online Social Networks on Health and Health Systems: A Scoping Review and Case Studies.

    Science.gov (United States)

    Griffiths, Frances; Dobermann, Tim; Cave, Jonathan A K; Thorogood, Margaret; Johnson, Samantha; Salamatian, Kavé; Gomez Olive, Francis X; Goudge, Jane

    2015-12-01

    Interaction through online social networks potentially results in the contestation of prevailing ideas about health and health care, and to mass protest where health is put at risk or health care provision is wanting. Through a review of the academic literature and case studies of four social networking health sites (PatientsLikeMe, Mumsnet, Treatment Action Campaign, and My Pro Ana), we establish the extent to which this phenomenon is documented, seek evidence of the prevalence and character of health-related networks, and explore their structure, function, participants, and impact, seeking to understand how they came into being and how they sustain themselves. Results indicate mass protest is not arising from these established health-related networking platforms. There is evidence of changes in policy following campaigning activity prompted by experiences shared through social networking such as improved National Health Service care for miscarriage (a Mumsnet campaign). Platform owners and managers have considerable power to shape these campaigns. Social networking is also influencing health policy indirectly through increasing awareness and so demand for health care. Transient social networking about health on platforms such as Twitter were not included as case studies but may be where the most radical or destabilizing influence on health care policy might arise.

  12. Factors influencing the job satisfaction of health system employees in tabriz, iran.

    Science.gov (United States)

    Bagheri, Shokoufe; Kousha, Ahmad; Janati, Ali; Asghari-Jafarabadi, Mohammad

    2012-01-01

    Employees can be counseled on how they feel about their job. If any particular dimension of their job is causing them dissatisfaction, they can be assisted to appropriately change it. In this study, we investigated the factors affecting job satisfaction from the perspective of employees working in the health system and thereby a quantitative measure of job satisfaction. Using eight focus group discussions (n=70), factors affecting job satisfaction of the employees were discussed. The factors identified from literature review were categorized in four groups: structural and managerial, social, work in it-self, environmental and welfare factors. The findings confirmed the significance of structural and managerial, social, work in it-self, environmental and welfare factors in the level of job satisfaction. In addition, a new factor related to individual characteristics such as employee personal characteristics and development was identified. In order to improve the quality and productivity of work, besides, structural and managerial, social, work in it-self, environmental and welfare factors, policy makers should be taken into account individual characteristics of the employee as a factor affecting job satisfaction.

  13. Global Health Systems and Policy Development: Implications for Health Literacy Research, Theory and Practice.

    Science.gov (United States)

    Rowlands, Gillian; Dodson, Sarity; Leung, Angela; Levin-Zamir, Diane

    2017-01-01

    Accessible and responsive health systems are critical to population health and human development. While progress has been made toward global health and development targets, significant inequities remain within and between countries. Expanding health inequities suggest a widespread and systemic neglect of vulnerable citizens, and a failure to enshrine within policies a responsibility to tailor care to the variable capabilities of citizens. Implementation of health and social policies that drive the design of accessible health systems, services, products and infrastructure represents the next frontier for health reform. Within this chapter we argue the need to consider health and health literacy across policy domains, to operationalize the intent to address inequities in health in meaningful and pragmatic ways, and to actively monitor progress and impact within the context of the Sustainable Development Goals (SDGs). We contend that viewing and developing policies and systems within a health literacy framework will assist in placing citizens and equity considerations at the center of development efforts. In this chapter, we explore the relationship between health literacy and equitable access to health care, and the role of health system and policy reform. We first explore international policies, health literacy, and the SDGs. We then explore national policies and the role that national and local services and systems play in building health literacy, and responding to the health literacy challenges of citizens. We discuss the World Health Organization's (WHO) Framework for Integrated People-Centered Health Services and the way in which health services are being encouraged to understand and respond to citizen health literacy needs. Each section of the chapter ends with a summary and a review of health literacy research and practice. Throughout, we illustrate our points through 'vignettes' from around the world.

  14. Influence Business Process On The Quality Of Accounting Information System

    Directory of Open Access Journals (Sweden)

    Meiryani

    2015-01-01

    Full Text Available Abstract The purpose of this study was to determine the influence of business process to the quality of the accounting information system. This study aims to examine the influence of business process on the quality of the information system of accounting information system. The study was theoritical research which considered the roles of business process on quality of accounting information system which use secondary data collection. The results showed that the business process have a significant effect on the quality of accounting information systems.

  15. A cross-case comparative analysis of international security forces' impacts on health systems in conflict-affected and fragile states.

    Science.gov (United States)

    Bourdeaux, Margaret; Kerry, Vanessa; Haggenmiller, Christian; Nickel, Karlheinz

    2015-01-01

    Destruction of health systems in fragile and conflict-affected states increases civilian mortality. Despite the size, scope, scale and political influence of international security forces intervening in fragile states, little attention has been paid to array of ways they may impact health systems beyond their effects on short-term humanitarian health aid delivery. Using case studies we published on international security forces' impacts on health systems in Haiti, Kosovo, Afghanistan and Libya, we conducted a comparative analysis that examined three questions: What aspects, or building blocks, of health systems did security forces impact across the cases and what was the nature of these impacts? What forums or mechanisms did international security forces use to interact with health system actors? What policies facilitated or hindered security forces from supporting health systems? We found international security forces impacted health system governance, information systems and indigenous health delivery organizations. Positive impacts included bolstering the authority, transparency and capability of health system leadership. Negative impacts included undermining the impartial nature of indigenous health institutions by using health projects to achieve security objectives. Interactions between security and health actors were primarily ad hoc, often to the detriment of health system support efforts. When international security forces were engaged in health system support activities, the most helpful communication and consultative mechanisms to manage their involvement were ones that could address a wide array of problems, were nimble enough to accommodate rapidly changing circumstances, leveraged the power of personal relationships, and were able to address the tensions that arose between security and health system supporting strategies. Policy barriers to international security organizations participating in health system support included lack of mandate, conflicts

  16. Factors influencing the provision of public health services by village doctors in Hubei and Jiangxi provinces, China.

    Science.gov (United States)

    Ding, Yan; Smith, Helen J; Fei, Yang; Xu, Biao; Nie, Shaofa; Yan, Weirong; Diwan, Vinod K; Sauerborn, Rainer; Dong, Hengjin

    2013-01-01

    The Chinese central government launched the Health System Reform Plan in 2009 to strengthen disease control and health promotion and provide a package of basic public health services. Village doctors receive a modest subsidy for providing public health services associated with the package. Their beliefs about this subsidy and providing public health services could influence the quality and effectiveness of preventive health services and disease surveillance. To understand village doctors' perspectives on the subsidy and their experiences of delivering public health services, we performed 10 focus group discussions with village doctors, 12 in-depth interviews with directors of township health centres and 4 in-depth interviews with directors of county-level Centers for Disease Control and Prevention. The study was conducted in four counties in central China, two in Hubei province and two in Jiangxi province. Village doctors prioritize medical services but they do their best to manage their time to include public health services. The willingness of township health centre directors and village doctors to provide public health services has improved since the introduction of the package and a minimum subsidy, but village doctors do not find the subsidy to be sufficient remuneration for their efforts. Improving the delivery of public health services by village doctors is likely to require an increase in the subsidy, improvement in the supervisory relationship between village clinics and township health centres and the creation of a government pension for village doctors.

  17. [Influence of organizational climate on job satisfaction among health professionals].

    Science.gov (United States)

    Muñoz-Seco, E; Coll-Benejam, J M; Torrent-Quetglas, M; Linares-Pou, L

    2006-03-15

    To describe the quality of professional life (QPL) as perceived by primary care workers and to measure the organizational climate (OC). To identify the influence of OC on QPL and the variables that explain this relationship. Cross-sectional study. Primary care centres in the Menorca Health Area (Balearic Islands, Spain). One hundred and sixty six primary care, including health-workers and others. Two anonymous, self-administered, PC-validated questionnaires were filled in: QPL-35 (dimensions: perception of demands, support from managers, and motivation) and OC (dimensions: team-work, cohesion, and commitment). Age, seniority, professional group, job relationship, and the health centre were analysed. Positive answers: 67.4%. Average QPL was 5.78, lower for older workers and higher among those perceiving more cohesion. Average score for perceived demands was 5.53, higher among physicians and less if there is high commitment. Support from managers was 4.9, positively associated with cohesion and team-work and negatively associated with permanent workers and clerical staff. Intrinsic motivation was 7.43, greater if commitment was higher. Regardless of age, professional category and seniority, there was a significant association between OC and QPL (strongest in the motivation [r2=0.26] and managerial support [r2=0.476] dimensions). OC influences QPL, especially in motivation and managerial support. Commitment enhances motivation and perception of demands. Where there is better cohesion and team-work, the manager s support is also rated more highly.

  18. Influence Business Process On The Quality Of Accounting Information System

    OpenAIRE

    Meiryani; Muhammad Syaifullah

    2015-01-01

    Abstract The purpose of this study was to determine the influence of business process to the quality of the accounting information system. This study aims to examine the influence of business process on the quality of the information system of accounting information system. The study was theoritical research which considered the roles of business process on quality of accounting information system which use secondary data collection. The results showed that the business process have a signifi...

  19. Organizational Structure and Management in Romanian Health System

    OpenAIRE

    Boldureanu Daniel; Boldureanu Gabriela

    2010-01-01

    The health system in Romania in a continuous transformation from a centralized system (type Semashko) exists before 1989 year to one based on social health insurance (type Bismark). This paper examines the management and the organizational structure of the health system in Romania, and the relations between them in the context of the Health Reform Law.

  20. Big Data: Implications for Health System Pharmacy.

    Science.gov (United States)

    Stokes, Laura B; Rogers, Joseph W; Hertig, John B; Weber, Robert J

    2016-07-01

    Big Data refers to datasets that are so large and complex that traditional methods and hardware for collecting, sharing, and analyzing them are not possible. Big Data that is accurate leads to more confident decision making, improved operational efficiency, and reduced costs. The rapid growth of health care information results in Big Data around health services, treatments, and outcomes, and Big Data can be used to analyze the benefit of health system pharmacy services. The goal of this article is to provide a perspective on how Big Data can be applied to health system pharmacy. It will define Big Data, describe the impact of Big Data on population health, review specific implications of Big Data in health system pharmacy, and describe an approach for pharmacy leaders to effectively use Big Data. A few strategies involved in managing Big Data in health system pharmacy include identifying potential opportunities for Big Data, prioritizing those opportunities, protecting privacy concerns, promoting data transparency, and communicating outcomes. As health care information expands in its content and becomes more integrated, Big Data can enhance the development of patient-centered pharmacy services.

  1. Influence of socioeconomic status on trauma center performance evaluations in a Canadian trauma system.

    Science.gov (United States)

    Moore, Lynne; Turgeon, Alexis F; Sirois, Marie-Josée; Murat, Valérie; Lavoie, André

    2011-09-01

    Trauma center performance evaluations generally include adjustment for injury severity, age, and comorbidity. However, disparities across trauma centers may be due to other differences in source populations that are not accounted for, such as socioeconomic status (SES). We aimed to evaluate whether SES influences trauma center performance evaluations in an inclusive trauma system with universal access to health care. The study was based on data collected between 1999 and 2006 in a Canadian trauma system. Patient SES was quantified using an ecologic index of social and material deprivation. Performance evaluations were based on mortality adjusted using the Trauma Risk Adjustment Model. Agreement between performance results with and without additional adjustment for SES was evaluated with correlation coefficients. The study sample comprised a total of 71,784 patients from 48 trauma centers, including 3,828 deaths within 30 days (4.5%) and 5,549 deaths within 6 months (7.7%). The proportion of patients in the highest quintile of social and material deprivation varied from 3% to 43% and from 11% to 90% across hospitals, respectively. The correlation between performance results with or without adjustment for SES was almost perfect (r = 0.997; 95% CI 0.995-0.998) and the same hospital outliers were identified. We observed an important variation in SES across trauma centers but no change in risk-adjusted mortality estimates when SES was added to adjustment models. Results suggest that after adjustment for injury severity, age, comorbidity, and transfer status, disparities in SES across trauma center source populations do not influence trauma center performance evaluations in a system offering universal health coverage. Copyright © 2011 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Influence of qualitative research on women's health screening guidelines.

    Science.gov (United States)

    Abadir, Anna Maria; Lang, Ariella; Klein, Talia; Abenhaim, Haim Arie

    2014-01-01

    Considerable time and resources are allocated to carry out qualitative research. The purpose of our study was to evaluate the availability of qualitative research on women's health screening and assess its influence on screening practice guidelines in the United States, Canada, and the United Kingdom. Medline, CINHAL, and WEB of Science databases were used to identify the availability of qualitative research conducted in the past 15 years on 3 different women's health screening topics: cervical cancer screening, breast cancer screening, and prenatal first-trimester screening. Key national practice guidelines on women's health screening were selected using the National Guideline Clearinghouse web site. Bibliometric analysis was used to determine the frequency of qualitative references cited in the guidelines. A total of 272 qualitative research papers on women's health screening was identified: 109 on cervical cancer screening, 104 on breast cancer screening, and 59 on prenatal first-trimester screening. The qualitative studies focused on health care provider perspectives as well as ethical, ethnographic, psychological, and social issues surrounding screening. Fifteen national clinical practice guidelines on women's health screening were identified. A total of 943 references was cited, only 2 of which comprised of qualitative research cited by only 1 clinical practice guideline. Although there is considerable qualitative research that has been carried out on women's health screening, its incorporation into clinical practice guidelines is minimal. Further exploration of the disconnect between the two is important for enhancing knowledge translation of qualitative research within clinical practice. Copyright © 2014 Mosby, Inc. All rights reserved.

  3. Cognitive systems engineering in health care

    CERN Document Server

    Bisantz, Ann M; Fairbanks, Rollin J

    2014-01-01

    Cognitive Engineering for Better Health Care Systems, Ann M. Bisantz, Rollin J. Fairbanks, and Catherine M. BurnsThe Role of Cognitive Engineering in Improving Clinical Decision Support, Anne Miller and Laura MilitelloTeam Cognitive Work Analysis as an Approach for Understanding Teamwork in Health Care, Catherine M. BurnsCognitive Engineering Design of an Emergency Department Information System, Theresa K. Guarrera, Nicolette M. McGeorge, Lindsey N. Clark, David T. LaVergne, Zachary A. Hettinger, Rollin J. Fairbanks, and Ann M. BisantzDisplays for Health Care Teams: A Conceptual Framework and Design Methodology, Avi ParushInformation Modeling for Cognitive Work in a Health Care System, Priyadarshini R. PennathurSupport for ICU Clinician Cognitive Work through CSE, Christopher Nemeth, Shilo Anders, Jeffrey Brown, Anna Grome, Beth Crandall, and Jeremy PamplinMatching Cognitive Aids and the "Real Work" of Health Care in Support of Surgical Microsystem Teamwork, Sarah Henrickson Parker and Shawna J. PerryEngageme...

  4. Public Trust in Health Information Sharing: Implications for Biobanking and Electronic Health Record Systems

    Directory of Open Access Journals (Sweden)

    Jodyn Platt

    2015-02-01

    Full Text Available Biobanks are made all the more valuable when the biological samples they hold can be linked to health information collected in research, electronic health records, or public health practice. Public trust in such systems that share health information for research and health care practice is understudied. Our research examines characteristics of the general public that predict trust in a health system that includes researchers, health care providers, insurance companies and public health departments. We created a 119-item survey of predictors and attributes of system trust and fielded it using Amazon’s MTurk system (n = 447. We found that seeing one’s primary care provider, having a favorable view of data sharing and believing that data sharing will improve the quality of health care, as well as psychosocial factors (altruism and generalized trust were positively and significantly associated with system trust. As expected, privacy concern, but counterintuitively, knowledge about health information sharing were negatively associated with system trust. We conclude that, in order to assure the public’s trust, policy makers charged with setting best practices for governance of biobanks and access to electronic health records should leverage critical access points to engage a diverse public in joint decision making.

  5. [Barriers for introducing a health technology assessment organization to inform health care decision-making in the Spanish National Health System].

    Science.gov (United States)

    Artells, Juan José; Peiró, Salvador; Meneu, Ricard

    2014-01-01

    To identify difficulties, obstacles and limitations to establish an organizational structure devoted to the evaluation of healthcare technologies for incorporation, maintenance or removal from the services portfolio of the Spanish National Health System (sNHS). Panel of 14 experts, structured according to processes adapted from brainstorming, nominal group, and Rand consensus method techniques. The panel proposed 77 items as potential obstacles to the establishment of an official and independent "agency" able to inform on sNHS healthcare benefits funding or selective disinvestment. These items were focused on: 1) lack of political motivation to introduce the cost-effectiveness analysis from the state and regional governments and lack of independence and transparency of the evaluation processes, 2) the tension between a decentralized health system and evaluation activities with significant scale economies, 3) technical difficulties of the evaluation processes, including their ability to influence decision making and 4) social and professional refusal to the exclusion of healthcare benefits when it is perceived as indiscriminate. Although there is a different number and type of obstacles for developing the capacity of the sNHS to include or exclude healthcare benefits based on the evaluation of their effectiveness and efficiency, experts place in the political arena (political motivation, transparency, governance) the main difficulties to advance in this field.

  6. The Economics of Public Health: Missing Pieces to the Puzzle of Health System Reform.

    Science.gov (United States)

    Mays, Glen P; Atherly, Adam J; Zaslavsky, Alan M

    2017-12-01

    The United States continues to experiment with health care delivery and financing innovations, but relatively little attention is given to the public health system and its capacity for improving health status in the U.S. population at large. The public health system operates as a multisector enterprise in which government agencies work in conjunction with private and voluntary organizations to identify health risks in the population and to mobilize community-wide actions that prevent and contain these risks. The Affordable Care Act and related health reform initiatives are generating new interest in the question of how best to expand and integrate public health approaches into the larger U.S. health system. The research articles featured in this issue of Health Services Research cluster around two broad topics: how public health agencies can deliver services efficiently and how public health agencies can interact productively with other elements of the health system. The results suggest promising avenues for aligning medical care and public health practices. © Health Research and Educational Trust.

  7. Strengthening health systems through linking research evidence to ...

    African Journals Online (AJOL)

    informed policies. Accordingly, a critical way of addressing these challenges facing health systems in the region is through the linking of health research findings to policy. Keywords: Evidence; Sub-Saharan Africa; Health Policy; Health Systems ...

  8. Role of information systems in public health services.

    Science.gov (United States)

    Hartshorne, J E; Carstens, I L

    1990-07-01

    The purpose of this review is to establish a conceptual framework on the role of information systems in public health care. Information is indispensable for effective management and development of health services and therefore considered as an important operational asset or resource. A Health Information System is mainly required to support management and operations at four levels: namely transactional and functional; operational control; management planning and control; and strategic planning. To provide the necessary information needs of users at these levels of management in the health care system, a structured information system coupled with appropriate information technology is required. Adequate and relevant information is needed regarding population characteristics, resources available and expended, output and outcome of health care activities. Additionally information needs to be reliable, accurate, timely, easily accessible and presented in a compact and meaningful form. With a well-planned health information system health authorities would be in a position to provide a quality, cost-effective and efficient health service for as many people as need it, optimal utilisation of resources and to maintain and improve the community's health status.

  9. Influence of Nanotoxicity on Human Health and Environment: The Alternative Strategies.

    Science.gov (United States)

    Viswanath, Buddolla; Kim, Sanghyo

    Currently, nanotechnology revolutionizing both scientific and industrial community due to their applications in the fields of medicine, environmental protection, energy, and space exploration. Despite of the evident benefits of nanoparticles, there are still open questions about the influence of these nanoparticles on human health and environment. This is one of the critical issues that have to be addressed in the near future, before massive production of nanomaterials. Manufactured nanoparticles, which are finding ever-increasing applications in industry and consumer products fall into the category of emerging contaminants with ecological and toxicological effects on populations, communities and ecosystems. The existing experimental knowledge gave evidence that inhaled nanoparticles are less efficiently separated than larger particles by the macrophage clearance mechanisms and these nanoparticles are known to translocate through the lymphatic, circulatory and nervous systems to many tissues and organs, including the brain. In this review we highlight adverse impacts of nanoparticles on human and the environment with special emphasis on green nanoscience as a sustainable alternative.

  10. Facial redness, expression, and masculinity influence perceptions of anger and health.

    Science.gov (United States)

    Young, Steven G; Thorstenson, Christopher A; Pazda, Adam D

    2018-02-01

    Past research has found that skin colouration, particularly facial redness, influences the perceived health and emotional state of target individuals. In the current work, we explore several extensions of this past research. In Experiment 1, we manipulated facial redness incrementally on neutral and angry faces and had participants rate each face for anger and health. Different red effects emerged, as perceived anger increased in a linear manner as facial redness increased. Health ratings instead showed a curvilinear trend, as both extreme paleness and redness were rated as less healthy than moderate levels of red. Experiment 2 replicated and extended these findings by manipulating the masculinity of both angry and neutral faces that varied in redness. The results found the effect of red on perceived anger and health was moderated by masculine face structure. Collectively, these results show that facial redness has context dependent effects that vary based on facial expression, appearance, and differentially impact ratings of emotional states and health.

  11. Review: the role of vitamin D in nervous system health and disease.

    Science.gov (United States)

    DeLuca, G C; Kimball, S M; Kolasinski, J; Ramagopalan, S V; Ebers, G C

    2013-08-01

    Vitamin D and its metabolites have pleomorphic roles in both nervous system health and disease. Animal models have been paramount in contributing to our knowledge and understanding of the consequences of vitamin D deficiency on brain development and its implications for adult psychiatric and neurological diseases. The conflation of in vitro, ex vivo, and animal model data provide compelling evidence that vitamin D has a crucial role in proliferation, differentiation, neurotrophism, neuroprotection, neurotransmission, and neuroplasticity. Vitamin D exerts its biological function not only by influencing cellular processes directly, but also by influencing gene expression through vitamin D response elements. This review highlights the epidemiological, neuropathological, experimental and molecular genetic evidence implicating vitamin D as a candidate in influencing susceptibility to a number of psychiatric and neurological diseases. The strength of evidence varies for schizophrenia, autism, Parkinson's disease, amyotrophic lateral sclerosis, Alzheimer's disease, and is especially strong for multiple sclerosis. © 2013 British Neuropathological Society.

  12. The Social Group Influences of US Health Journalists and Their Impact on the Newsmaking Process

    Science.gov (United States)

    McCauley, M. P.; Blake, K. D.; Meissner, H. I.; Viswanath, K.

    2013-01-01

    The news media play a vital role in disseminating health information, yet little is known about the social characteristics of health journalists or the impact they have on the newsmaking process. This study examines how the social group influences of US health journalists impact two important aspects of news production--"media agenda-setting" and…

  13. What Factors Influence States' Capacity to Report Children's Health Care Quality Measures? A Multiple-Case Study.

    Science.gov (United States)

    Christensen, Anna L; Petersen, Dana M; Burton, Rachel A; Forsberg, Vanessa C; Devers, Kelly J

    2017-01-01

    Objectives The objective of this study was to describe factors that influence the ability of state Medicaid agencies to report the Centers for Medicare & Medicaid Services' (CMS) core set of children's health care quality measures (Child Core Set). Methods We conducted a multiple-case study of four high-performing states participating in the Children's Health Insurance Program Reauthorization Act (CHIPRA) Quality Demonstration Grant Program: Illinois, Maine, Pennsylvania, and Oregon. Cases were purposively selected for their diverse measurement approaches and used data from 2010 to 2015, including 154 interviews, semiannual grant progress reports, and annual public reports on Child Core Set measures. We followed Yin's multiple-case study methodology to describe how and why each state increased the number of measures reported to CMS. Results All four states increased the number of Child Core Set measures reported to CMS during the grant period. Each took a different approach to reporting, depending on the available technical, organizational, and behavioral inputs in the state. Reporting capacity was influenced by a state's Medicaid data availability, ability to link to other state data systems, past experience with quality measurement, staff time and technical expertise, and demand for the measures. These factors were enhanced by CHIPRA Quality Demonstration grant funding and other federal capacity building activities, as hypothesized in our conceptual framework. These and other states have made progress reporting the Child Core Set since 2010. Conclusion With financial support and investment in state data systems and organizational factors, states can overcome challenges to reporting most of the Child Core Set measures.

  14. Health system resilience: Lebanon and the Syrian refugee crisis

    Science.gov (United States)

    Ammar, Walid; Kdouh, Ola; Hammoud, Rawan; Hamadeh, Randa; Harb, Hilda; Ammar, Zeina; Atun, Rifat; Christiani, David; Zalloua, Pierre A

    2016-01-01

    Background Between 2011 and 2013, the Lebanese population increased by 30% due to the influx of Syrian refugees. While a sudden increase of such magnitude represents a shock to the health system, threatening the continuity of service delivery and destabilizing governance, it also offers a unique opportunity to study resilience of a health system amidst ongoing crisis. Methods We conceptualized resilience as the capacity of a health system to absorb internal or external shocks (for example prevent or contain disease outbreaks and maintain functional health institutions) while sustaining achievements. We explored factors contributing to the resilience of the Lebanese health system, including networking with stakeholders, diversification of the health system, adequate infrastructure and health human resources, a comprehensive communicable disease response and the integration of the refugees within the health system. Results In studying the case of Lebanon we used input–process–output–outcome approach to assess the resilience of the Lebanese health system. This approach provided us with a holistic view of the health system, as it captured not only the sustained and improved outcomes, but also the inputs and processes leading to them. Conclusion Our study indicates that the Lebanese health system was resilient as its institutions sustained their performance during the crisis and even improved. PMID:28154758

  15. Managing Health Information System | Campbell | Nigerian ...

    African Journals Online (AJOL)

    The effective planning, management monitoring and evaluation of health services, health resources and indeed the health system requires a wealth of health information, with its simultaneous effective and efficient management. It is an instrument used to help policy-making, decision making and day to day actions in the ...

  16. The social group influences of US health journalists and their impact on the newsmaking process.

    Science.gov (United States)

    McCauley, M P; Blake, K D; Meissner, H I; Viswanath, K

    2013-04-01

    The news media play a vital role in disseminating health information, yet little is known about the social characteristics of health journalists or the impact they have on the newsmaking process. This study examines how the social group influences of US health journalists impact two important aspects of news production--'media agenda-setting' and 'framing'. Using data from a national survey of health and medical science journalists, the authors conducted multivariable logistic regression analyses to study the links between the gender, age and race/ethnicity of respondents, and the ways in which they utilized news sources, other resources, news priorities and story angles. Female respondents were more likely than males to say that educating people to make informed decisions and disseminating new, accurate information are important priorities. Female and minority journalists were more likely than white males to use a variety of sources, and to say it is important to develop the health and scientific literacy of audiences and influence public health behaviors. The gender and race/ethnicity of journalists play an important role in the production of health news. Health educators can foster improved coverage by learning more about the life experiences of health journalists and developing better working relationships with them.

  17. The application of systems thinking in health: why use systems thinking?

    Science.gov (United States)

    Peters, David H

    2014-08-26

    This paper explores the question of what systems thinking adds to the field of global health. Observing that elements of systems thinking are already common in public health research, the article discusses which of the large body of theories, methods, and tools associated with systems thinking are more useful. The paper reviews the origins of systems thinking, describing a range of the theories, methods, and tools. A common thread is the idea that the behavior of systems is governed by common principles that can be discovered and expressed. They each address problems of complexity, which is a frequent challenge in global health. The different methods and tools are suited to different types of inquiry and involve both qualitative and quantitative techniques. The paper concludes by emphasizing that explicit models used in systems thinking provide new opportunities to understand and continuously test and revise our understanding of the nature of things, including how to intervene to improve people's health.

  18. Enhancing the Effectiveness of Consumer-Focused Health Information Technology Systems Through eHealth Literacy

    DEFF Research Database (Denmark)

    Kayser, Lars; Kushniruk, Andre; Osborne, Richard H

    2015-01-01

    BACKGROUND: eHealth systems and applications are increasingly focused on supporting consumers to directly engage with and use health care services. Involving end users in the design of these systems is critical to ensure a generation of usable and effective eHealth products and systems. Often...... the end users engaged for these participatory design processes are not actual representatives of the general population, and developers may have limited understanding about how well they might represent the full range of intended users of the eHealth products. As a consequence, resulting information...... model with the domains of a new concept of eHealth literacy. METHODS: This approach expands an existing method for supporting health IT system development, which advocates use of a three-dimensional user-task-context matrix to comprehensively identify the users of health IT systems, and what their needs...

  19. The importance of fixed costs in animal health systems.

    Science.gov (United States)

    Tisdell, C A; Adamson, D

    2017-04-01

    In this paper, the authors detail the structure and optimal management of health systems as influenced by the presence and level of fixed costs. Unlike variable costs, fixed costs cannot be altered, and are thus independent of the level of veterinary activity in the short run. Their importance is illustrated by using both single-period and multi-period models. It is shown that multi-stage veterinary decision-making can often be envisaged as a sequence of fixed-cost problems. In general, it becomes clear that, the higher the fixed costs, the greater the net benefit of veterinary activity must be, if such activity is to be economic. The authors also assess the extent to which it pays to reduce fixed costs and to try to compensate for this by increasing variable costs. Fixed costs have major implications for the industrial structure of the animal health products industry and for the structure of the private veterinary services industry. In the former, they favour market concentration and specialisation in the supply of products. In the latter, they foster increased specialisation. While cooperation by individual farmers may help to reduce their individual fixed costs, the organisational difficulties and costs involved in achieving this cooperation can be formidable. In such cases, the only solution is government provision of veterinary services. Moreover, international cooperation may be called for. Fixed costs also influence the nature of the provision of veterinary education.

  20. How community-dwelling seniors with multimorbidity conceive the concept of mental health and factors that may influence it: A phenomenographic study

    Directory of Open Access Journals (Sweden)

    Åke Grundberg

    2012-12-01

    Full Text Available Multimorbidity, that is, the coexistence of chronic diseases, is associated with mental health issues among elderly people. In Sweden, seniors with multimorbidity often live at home and receive care from nursing aides and district nurses. The aim of this study was to describe the variation in how community-dwelling seniors with multimorbidity perceive the concept of mental health and what may influence it. Thirteen semi-structured interviews were analysed using a phenomenographic approach. Six qualitatively different ways of understanding the concept of mental health and factors that may influence it, reflecting key variations of meaning, were identified. The discerned categories were: mental health is dependent on desirable feelings and social contacts, mental health is dependent on undesirable feelings and social isolation, mental health is dependent on power of the mind and ability to control thoughts, mental health is dependent on powerlessness of the mind and inability to control thoughts, mental health is dependent on active behaviour and a healthy lifestyle, and mental health is dependent on passive behaviour and physical inactivity. According to the respondents’ view, the concept of mental health can be defined as how an individual feels, thinks, and acts and also includes a positive as well as a negative aspect. Social contacts, physical activity, and optimism may improve mental health while social isolation, ageing, and chronic pain may worsen it. Findings highlight the importance of individually definitions of mental health and that community-dwelling seniors with multimorbidity may describe how multiple chronic conditions can affect their life situation. It is essential to organize the health care system to provide individual health promotion dialogues, and future research should address the prerequisites for conducting mental health promotion dialogues.

  1. Embedding health policy and systems research into decision-making processes in low- and middle-income countries.

    Science.gov (United States)

    Koon, Adam D; Rao, Krishna D; Tran, Nhan T; Ghaffar, Abdul

    2013-08-08

    Attention is increasingly directed to bridging the gap between the production of knowledge and its use for health decision-making in low- and middle-income countries (LMICs). An important and underdeveloped area of health policy and systems research (HPSR) is the organization of this process. Drawing from an interdisciplinary conception of embeddedness, a literature review was conducted to identify examples of embedded HPSR used to inform decision-making in LMICs. The results of the literature review were organized according to the World Health Organization's Building Blocks Framework. Next, a conceptual model was created to illustrate the arrangement of organizations that produce embedded HPSR and the characteristics that facilitate its uptake into the arena of decision-making. We found that multiple forces converge to create context-specific pathways through which evidence enters into decision-making. Depending on the decision under consideration, the literature indicates that decision-makers may call upon an intricate combination of actors for sourcing HPSR. While proximity to decision-making does have advantages, it is not the position of the organization within the network, but rather the qualities the organization possesses, that enable it to be embedded. Our findings suggest that four qualities influence embeddedness: reputation, capacity, quality of connections to decision-makers, and quantity of connections to decision-makers and others. In addition to this, the policy environment (e.g. the presence of legislation governing the use of HPSR, presence of strong civil society, etc.) strongly influences uptake. Through this conceptual model, we can understand which conditions are likely to enhance uptake of HPSR in LMIC health systems. This raises several important considerations for decision-makers and researchers about the arrangement and interaction of evidence-generating organizations in health systems.

  2. Health professionals' perceptions of cultural influences on stroke experiences and rehabilitation in Kuwait.

    Science.gov (United States)

    Omu, Onutobor; Reynolds, Frances

    2012-01-01

    The aim of this study was to investigate the perceptions of health professionals who treat stroke patients in Kuwait regarding cultural influences on the experience of stroke and rehabilitation in Kuwait. Health professionals interviewed were from a variety of cultural backgrounds thus providing an opportunity to investigate how they perceived the influence of culture on stroke recovery and rehabilitation in Kuwait. Semi-structured interviews were carried out with 12 health professionals with current/recent stroke rehabilitation experience in Kuwait, followed by thematic analysis of the verbatim transcripts. The health professionals identified several features of the Kuwaiti culture that they believed affected the experiences of stroke patients. These were religious beliefs, family involvement, limited education and public information about stroke, prevailing negative attitudes toward stroke, access to finances for private treatment, social stigma and the public invisibility of disabled people, difficulties identifying meaningful goals for rehabilitation, and an acceptance of dependency linked with the widespread presence of maids and other paid assistants in most Kuwaiti homes. To offer culturally sensitive care, these issues should be taken into account during the rehabilitation of Kuwaiti stroke patients in their home country and elsewhere.

  3. Improving the use of health data for health system strengthening

    Directory of Open Access Journals (Sweden)

    Tara Nutley

    2013-02-01

    Full Text Available Background: Good quality and timely data from health information systems are the foundation of all health systems. However, too often data sit in reports, on shelves or in databases and are not sufficiently utilised in policy and program development, improvement, strategic planning and advocacy. Without specific interventions aimed at improving the use of data produced by information systems, health systems will never fully be able to meet the needs of the populations they serve. Objective: To employ a logic model to describe a pathway of how specific activities and interventions can strengthen the use of health data in decision making to ultimately strengthen the health system. Design: A logic model was developed to provide a practical strategy for developing, monitoring and evaluating interventions to strengthen the use of data in decision making. The model draws on the collective strengths and similarities of previous work and adds to those previous works by making specific recommendations about interventions and activities that are most proximate to affect the use of data in decision making. The model provides an organizing framework for how interventions and activities work to strengthen the systematic demand, synthesis, review, and use of data. Results: The logic model and guidance are presented to facilitate its widespread use and to enable improved data-informed decision making in program review and planning, advocacy, policy development. Real world examples from the literature support the feasible application of the activities outlined in the model. Conclusions: The logic model provides specific and comprehensive guidance to improve data demand and use. It can be used to design, monitor and evaluate interventions, and to improve demand for, and use of, data in decision making. As more interventions are implemented to improve use of health data, those efforts need to be evaluated.

  4. Meta-Analytic Structural Equation Modeling of the Influences of Family-Centered Care on Parent and Child Psychological Health

    OpenAIRE

    Dunst, Carl J.; Trivette, Carol M.

    2009-01-01

    Background. Family-centered care is now practiced throughout the world by physicians, nurses, and allied health care professionals. The call for adoption of family-centered care is based on the contention that the physical and psychological health of a child is influenced by parents' psychological health where family-centered care enhances parent well-being which in turn influences child well-being. We empirically assessed whether these relationships are supported by available evidence. M...

  5. The quality of the outdoor environment influences childrens health -- a cross-sectional study of preschools.

    Science.gov (United States)

    Söderström, M; Boldemann, C; Sahlin, U; Mårtensson, F; Raustorp, A; Blennow, M

    2013-01-01

    To test how the quality of the outdoor environment of child day care centres (DCCs) influences children's health. The environment was assessed using the Outdoor Play Environmental Categories (OPEC) tool, time spent outdoors and physical activity as measured by pedometer. 172/253 (68%) of children aged 3.0-5.9 from nine DCCs participated in Southern Sweden. Health data collected were body mass index, waist circumference, saliva cortisol, length of night sleep during study, and symptoms and well-being which were scored (1-week diary - 121 parent responders). Also, parent-rated well-being and health of their child were scored (questionnaire, 132 parent responders). MANOVA, ANOVA and principal component analyses were performed to identify impacts of the outdoor environment on health. High-quality outdoor environment at DCCs is associated with several health aspects in children such as leaner body, longer night sleep, better well-being and higher mid-morning saliva cortisol levels. The quality of the outdoor environment at DCCs influenced the health and well-being of preschool children and should be given more attention among health care professionals and community planners. ©2012 The Author(s)/Acta Paediatrica ©2012 Foundation Acta Paediatrica.

  6. Innovation in health service delivery: integrating community health assistants into the health system at district level in Zambia.

    Science.gov (United States)

    Zulu, Joseph Mumba; Hurtig, Anna-Karin; Kinsman, John; Michelo, Charles

    2015-01-28

    To address the huge human resources for health gap in Zambia, the Ministry of Health launched the National Community Health Assistant Strategy in 2010. The strategy aims to integrate community-based health workers into the health system by creating a new group of workers, called community health assistants (CHAs). However, literature suggests that the integration process of national community-based health worker programmes into health systems has not been optimal. Conceptually informed by the diffusion of innovations theory, this paper qualitatively aimed to explore the factors that shaped the acceptability and adoption of CHAs into the health system at district level in Zambia during the pilot phase. Data gathered through review of documents, 6 focus group discussions with community leaders, and 12 key informant interviews with CHA trainers, supervisors and members of the District Health Management Team were analysed using thematic analysis. The perceived relative advantage of CHAs over existing community-based health workers in terms of their quality of training and scope of responsibilities, and the perceived compatibility of CHAs with existing groups of health workers and community healthcare expectations positively facilitated the integration process. However, limited integration of CHAs in the district health governance system hindered effective programme trialability, simplicity and observability at district level. Specific challenges at this level included a limited information flow and sense of programme ownership, and insufficient documentation of outcomes. The district also had difficulties in responding to emergent challenges such as delayed or non-payment of CHA incentives, as well as inadequate supervision and involvement of CHAs in the health posts where they are supposed to be working. Furthermore, failure of the health system to secure regular drug supplies affected health service delivery and acceptability of CHA services at community level. The

  7. Perceived Socioeconomic Status: A New Type of Identity which Influences Adolescents’ Self Rated Health

    Science.gov (United States)

    Goodman, Elizabeth; Huang, Bin; Schafer-Kalkhoff, Tara; Adler, Nancy E.

    2007-01-01

    Purpose The cognitive, social, and biological transitions of adolescence suggest that subjective perceptions of social position based on the socioeconomic hierarchy may undergo important changes during this period, yet how such perceptions develop is poorly understood and no studies assess if changes in such perceptions influence adolescents’ health. This study describes adolescents’ subjective perceptions of familial socioeconomic status (SSS), how SSS changes over time, and how age, race, and objective socioeconomic status (SES) indicators influence SSS. In addition, the study determines if SSS independently influences adolescents’ self-rated health, an important predictor of morbidity and health service utilization. Methods 1179 non-Hispanic black and white baseline 7–12th graders from a Midwestern public school district completed a validated, teen-specific measure of SSS annually for 4 consecutive years. A parent provided information on SES. Markov modeling assessed transitions in SSS over time. Results SSS declined with age (p=.001) and stabilized among older teens. In addition to age, SES and race, but not gender, were significant correlates of SSS, but the relationships between these factors were complex. In cross-sectional and longitudinal analyses, black teens from families with low parent education had higher SSS than white teens from similarly educated families, while white teens from highly educated families had higher SSS than black teens from highly educated families. Lower SSS and changes in SSS predicted poor self rated health even when adjusting for race and objective SES measures. Conclusion Subjective evaluations of socioeconomic status predict adolescents’ global health ratings even when adjusting for the sociodemographic factors which shape them. PMID:17950168

  8. Rationing in health systems: A critical review.

    Science.gov (United States)

    Keliddar, Iman; Mosadeghrad, Ali Mohammad; Jafari-Sirizi, Mehdi

    2017-01-01

    Background: It is difficult to provide health care services to all those in need of such services due to limited resources and unlimited demands. Thus, priority setting and rationing have to be applied. This study aimed at critically examining the concept of rationing in health sector and identifying its purposes, influencing factors, mechanisms, and outcomes. Methods: The critical interpretive synthesis methodology was used in this study. PubMed, Cochrane, and Proquest databases were searched using the related key words to find related documents published between 1970 and 2015. In total, 161 published reports were reviewed and included in the study. Thematic content analysis was applied for data analysis. Results: Health services rationing means restricting the access of some people to useful or potentially useful health services due to budgetary limitation. The inherent features of the health market and health services, limited resources, and unlimited needs necessitate health services rationing. Rationing can be applied in 4 levels: health care policy- makers, health care managers, health care providers, and patients. Health care rationing can be accomplished through fixed budget, benefit package, payment mechanisms, queuing, copayments, and deductibles. Conclusion: This paper enriched our understanding of health services rationing and its mechanisms at various levels and contributed to the literature by broadly conceptualizing health services rationing.

  9. Health Information System in a Cloud Computing Context.

    Science.gov (United States)

    Sadoughi, Farahnaz; Erfannia, Leila

    2017-01-01

    Healthcare as a worldwide industry is experiencing a period of growth based on health information technology. The capabilities of cloud systems make it as an option to develop eHealth goals. The main objectives of the present study was to evaluate the advantages and limitations of health information systems implementation in a cloud-computing context that was conducted as a systematic review in 2016. Science direct, Scopus, Web of science, IEEE, PubMed and Google scholar were searched according study criteria. Among 308 articles initially found, 21 articles were entered in the final analysis. All the studies had considered cloud computing as a positive tool to help advance health technology, but none had insisted too much on its limitations and threats. Electronic health record systems have been mostly studied in the fields of implementation, designing, and presentation of models and prototypes. According to this research, the main advantages of cloud-based health information systems could be categorized into the following groups: economic benefits and advantages of information management. The main limitations of the implementation of cloud-based health information systems could be categorized into the 4 groups of security, legal, technical, and human restrictions. Compared to earlier studies, the present research had the advantage of dealing with the issue of health information systems in a cloud platform. The high frequency of studies conducted on the implementation of cloud-based health information systems revealed health industry interest in the application of this technology. Security was a subject discussed in most studies due to health information sensitivity. In this investigation, some mechanisms and solutions were discussed concerning the mentioned systems, which would provide a suitable area for future scientific research on this issue. The limitations and solutions discussed in this systematic study would help healthcare managers and decision

  10. Seamless personal health information system in cloud computing.

    Science.gov (United States)

    Chung, Wan-Young; Fong, Ee May

    2014-01-01

    Noncontact ECG measurement has gained popularity these days due to its noninvasive and conveniences to be applied on daily life. This approach does not require any direct contact between patient's skin and sensor for physiological signal measurement. The noncontact ECG measurement is integrated with mobile healthcare system for health status monitoring. Mobile phone acts as the personal health information system displaying health status and body mass index (BMI) tracking. Besides that, it plays an important role being the medical guidance providing medical knowledge database including symptom checker and health fitness guidance. At the same time, the system also features some unique medical functions that cater to the living demand of the patients or users, including regular medication reminders, alert alarm, medical guidance, appointment scheduling. Lastly, we demonstrate mobile healthcare system with web application for extended uses, thus health data are clouded into web server system and web database storage. This allows remote health status monitoring easily and so forth it promotes a cost effective personal healthcare system.

  11. High-performance work systems in health care management, part 1: development of an evidence-informed model.

    Science.gov (United States)

    Garman, Andrew N; McAlearney, Ann Scheck; Harrison, Michael I; Song, Paula H; McHugh, Megan

    2011-01-01

    : Although management practices are recognized as important factors in improving health care quality and efficiency, most research thus far has focused on individual practices, ignoring or underspecifying the contexts within which these practices are operating. Research from other industries, which has increasingly focused on systems rather than individual practices, has yielded results that may benefit health services management. : Our goal was to develop a conceptual model on the basis of prior research from health care as well as other industries that could be used to inform important contextual considerations within health care. : Using theoretical frameworks from A. Donabedian (1966), P. M. Wright, T. M. Gardner, and L. M. Moynihan (2003), and B. Schneider, D. B. Smith, and H. W. Goldstein (2000) and review methods adapted from R. Pawson (2006b), we reviewed relevant research from peer-reviewed and other industry-relevant sources to inform our model. The model we developed was then reviewed with a panel of practitioners, including experts in quality and human resource management, to assess the applicability of the model to health care settings. : The resulting conceptual model identified four practice bundles, comprising 14 management practices as well as nine factors influencing adoption and perceived sustainability of these practices. The mechanisms by which these practices influence care outcomes are illustrated using the example of hospital-acquired infections. In addition, limitations of the current evidence base are discussed, and an agenda for future research in health care settings is outlined. : Results may help practitioners better conceptualize management practices as part of a broader system of work practices. This may, in turn, help practitioners to prioritize management improvement efforts more systematically.

  12. Occupational musculoskeletal and mental health: Significance of rationalization and opportunities to create sustainable production systems - A systematic review.

    Science.gov (United States)

    Westgaard, R H; Winkel, J

    2011-01-01

    influence on outcome. It is concluded that production system rationalization represents a pervasive work life intervention without a primary occupational health focus. It has considerable and mostly negative influence on worker health, but this can be reduced by attention to modifiers. The results create a basis for new priorities in ergonomic intervention research. Copyright © 2010 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  13. Differences between African-American and Caucasian students on enrollment influences and barriers in kinesiology-based allied health education programs.

    Science.gov (United States)

    Barfield, J P; Cobler, D C; Lam, Eddie T C; Zhang, James; Chitiyo, George

    2012-06-01

    Kinesiology departments have recently started to offer allied health education programs to attract additional students to teacher education units (9). Although allied health professions offer increased work opportunities, insufficient enrollment and training of minority students in these academic fields contribute to underrepresentation in the workforce (3). To improve workforce diversity, kinesiology departments must understand how enrollment influences and barriers differ by race among prospective students. Therefore, the purpose of this study was to identify differences in allied health education enrollment influences and enrollment barriers between minority and Caucasian students. Participants (n = 601) consisted of students enrolled in kinesiology-based allied health education programs. Multivariate ANOVA was used to compare group differences in enrollment decision making. "Personal influence," "career opportunity," and "physical self-efficacy" were all significantly stronger enrollment influences among African-American students than among Caucasian students, and "social influence," "experiential opportunity," "academic preparation," and "physical self-efficacy" were all perceived as significantly greater barriers compared with Caucasian students. Findings support the need to recruit African-American students through sport and physical education settings and to market program-based experiential opportunities.

  14. Impostor phenomenon and mental health: The influence of racial discrimination and gender.

    Science.gov (United States)

    Bernard, Donte L; Lige, Quiera M; Willis, Henry A; Sosoo, Effua E; Neblett, Enrique W

    2017-03-01

    The impostor phenomenon (IP), or feelings of intellectual incompetence, reflects a maladaptive set of cognitions, which pose a significant psychological risk for African American emerging adults. In light of recent evidence suggesting that personal and sociocultural factors may influence the association between IP and psychological adjustment, this study used 2 waves of data to examine the extent to which gender and racial discrimination moderated the association between IP and indices of mental health among 157 African American college students (69% women; mean age = 18.30) attending a predominantly White institution. Analyses revealed that young African American women reporting higher frequencies of racial discrimination and women reporting lower levels of distress resulting from racial discrimination were most vulnerable to negative mental health outcomes, particularly at higher levels of IP. These findings suggest that IP may interact with gender and racial discrimination experiences to influence mental health outcomes. We discuss how these findings can be utilized to inform treatment of African American emerging adults experiencing IP and the importance of considering how gender and discrimination may intersect to exacerbate feelings of intellectual incompetence. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  15. Security Attacks and Solutions in Electronic Health (E-health) Systems.

    Science.gov (United States)

    Zeadally, Sherali; Isaac, Jesús Téllez; Baig, Zubair

    2016-12-01

    For centuries, healthcare has been a basic service provided by many governments to their citizens. Over the past few decades, we have witnessed a significant transformation in the quality of healthcare services provided by healthcare organizations and professionals. Recent advances have led to the emergence of Electronic Health (E-health), largely made possible by the massive deployment and adoption of information and communication technologies (ICTs). However, cybercriminals and attackers are exploiting vulnerabilities associated primarily with ICTs, causing data breaches of patients' confidential digital health information records. Here, we review recent security attacks reported for E-healthcare and discuss the solutions proposed to mitigate them. We also identify security challenges that must be addressed by E-health system designers and implementers in the future, to respond to threats that could arise as E-health systems become integrated with technologies such as cloud computing, the Internet of Things, and smart cities.

  16. The Influence of School Health Education Programmes on the Knowledge and Behaviour of School Children towards Nutrition and Health

    Science.gov (United States)

    Keirle, Kathleen; Thomas, Malcolm

    2000-02-01

    A comparative investigation was conducted involving two school situations; one identified as being health promoting and having a comprehensive policy and a defined programme of health education, and the other not health promoting, having no policy and an unstructured programme of health education. A total of 367 students from two secondary and four primary schools participated in the study. The factors used to categorise schools are highlighted. A self-completion questionnaire was employed to assess students' knowledge and behaviour with regard to nutrition and health. Students' dietary intake was monitored by employing a frequency of consumption tick sheet. The results revealed that students from the more health promoting secondary school (School 1(H)) were more knowledgeable of what constitutes a healthy diet and the benefits and risks to health. The implications of these results are considered within the context of the many factors that could influence students' knowledge and behaviour.

  17. Health by Design: Interweaving Health Promotion into Environments and Settings

    Science.gov (United States)

    Springer, Andrew E.; Evans, Alexandra E.; Ortuño, Jaquelin; Salvo, Deborah; Varela Arévalo, Maria Teresa

    2017-01-01

    The important influence of the environmental context on health and health behavior—which includes place, settings, and the multiple environments within place and settings—has directed health promotion planners from a focus solely on changing individuals, toward a focus on harnessing and changing context for individual and community health promotion. Health promotion planning frameworks such as Intervention Mapping provide helpful guidance in addressing various facets of the environmental context in health intervention design, including the environmental factors that influence a given health condition or behavior, environmental agents that can influence a population’s health, and environmental change methods. In further exploring how to harness the environmental context for health promotion, we examine in this paper the concept of interweaving of health promotion into context, defined as weaving or blending together health promotion strategies, practices, programs, and policies to fit within, complement, and build from existing settings and environments. Health promotion interweaving stems from current perspectives in health intervention planning, improvement science and complex systems thinking by guiding practitioners from a conceptualization of context as a backdrop to intervention, to one that recognizes context as integral to the intervention design and to the potential to directly influence health outcomes. In exploring the general approach of health promotion interweaving, we examine selected theoretical and practice-based interweaving concepts in relation to four key environments (the policy environment, the information environment, the social/cultural/organizational environment, and the physical environment), followed by evidence-based and practice-based examples of health promotion interweaving from the literature. Interweaving of health promotion into context is a common practice for health planners in designing health promotion interventions, yet

  18. The Influence of Religiosity and Spirituality on Rural Parents' Health Decision Making and Human Papillomavirus Vaccine Choices.

    Science.gov (United States)

    Thomas, Tami; Blumling, Amy; Delaney, Augustina

    2015-01-01

    General health implications of religiosity and spirituality on health have been associated with health promotion, so the purpose of this study was to examine the influence of religiosity and spirituality on rural parents' decision making to vaccinate their children against human papillomavirus (HPV). The associations of religiosity and spirituality with parental HPV vaccine decisions were examined in a sample of parents residing in small rural communities (N = 37). Parents of children aged 9 to 13 years participated in focus groups held in rural community contexts. Religiosity (i.e., participation in religious social structures) was a recurring and important theme when discussing HPV vaccination. Spirituality (i.e., subjective commitment to spiritual or religious beliefs) was found to influence the ways in which parents perceived their control over and coping with health issues potentially related to HPV vaccination. Together, religiosity and spirituality were found to play integral roles in these parents' lives and influenced their attitudes toward HPV vaccination uptake for their children.

  19. Sports celebrities and public health: Diego Maradona's influence on drug use prevention.

    Science.gov (United States)

    Brown, William J; de Matviuk, Marcela Alejandra Chavan

    2010-06-01

    Exposure to a sports celebrity through media and sporting events can have important influences on a public health issue associated with that celebrity. The battle against drug use by Argentinean soccer icon Diego Maradona has provoked concerns about drug abuse and prevention in Argentina, particularly among young people. The present study analyzes how two forms of involvement with Maradona affected the public's concern and perceptions of drug use after Maradona's drug-related health crisis in 2004. Results indicate that those who had a greater degree of parasocial interaction with Maradona were more likely to have an increased awareness of drug abuse, a greater personal concern about drug abuse, abstained from drug use, and more strongly support drug abuse prevention programs. In contrast, identification with Maradona had a mitigating effect on drug use prevention. Implications of these findings regarding the influence of sports celebrities on substance abuse are discussed.

  20. Consultation on the Libyan health systems: towards patient-centred services

    Science.gov (United States)

    El Oakley, Reida M.; Ghrew, Murad H.; Aboutwerat, Ali A.; Alageli, Nabil A.; Neami, Khaldon A.; Kerwat, Rajab M.; Elfituri, Abdulbaset A.; Ziglam, Hisham M.; Saifenasser, Aymen M.; Bahron, Ali M.; Aburawi, Elhadi H.; Sagar, Samir A.; Tajoury, Adel E.; Benamer, Hani T.S.

    2013-01-01

    The extra demand imposed upon the Libyan health services during and after the Libyan revolution in 2011 led the ailing health systems to collapse. To start the planning process to re-engineer the health sector, the Libyan Ministry of Health in collaboration with the World Health Organisation (WHO) and other international experts in the field sponsored the National Health Systems Conference in Tripoli, Libya, between the 26th and the 30th of August 2012. The aim of this conference was to study how health systems function at the international arena and to facilitate a consultative process between 500 Libyan health experts in order to identify the problems within the Libyan health system and propose potential solutions. The scientific programme adopted the WHO health care system framework and used its six system building blocks: i) Health Governance; ii) Health Care Finance; iii) Health Service Delivery; iv) Human Resources for Health; v) Pharmaceuticals and Health Technology; and vi) Health Information System. The experts used a structured approach starting with clarifying the concepts, evaluating the current status of that health system block in Libya, thereby identifying the strengths, weaknesses, and major deficiencies. This article summarises the 500 health expert recommendations that seized the opportunity to map a modern health systems to take the Libyan health sector into the 21st century. PMID:23359277

  1. Global health initiative investments and health systems strengthening: a content analysis of global fund investments.

    Science.gov (United States)

    Warren, Ashley E; Wyss, Kaspar; Shakarishvili, George; Atun, Rifat; de Savigny, Don

    2013-07-26

    Millions of dollars are invested annually under the umbrella of national health systems strengthening. Global health initiatives provide funding for low- and middle-income countries through disease-oriented programmes while maintaining that the interventions simultaneously strengthen systems. However, it is as yet unclear which, and to what extent, system-level interventions are being funded by these initiatives, nor is it clear how much funding they allocate to disease-specific activities - through conventional 'vertical-programming' approach. Such funding can be channelled to one or more of the health system building blocks while targeting disease(s) or explicitly to system-wide activities. We operationalized the World Health Organization health system framework of the six building blocks to conduct a detailed assessment of Global Fund health system investments. Our application of this framework framework provides a comprehensive quantification of system-level interventions. We applied this systematically to a random subset of 52 of the 139 grants funded in Round 8 of the Global Fund to Fight AIDS, Tuberculosis and Malaria (totalling approximately US$1 billion). According to the analysis, 37% (US$ 362 million) of the Global Fund Round 8 funding was allocated to health systems strengthening. Of that, 38% (US$ 139 million) was for generic system-level interventions, rather than disease-specific system support. Around 82% of health systems strengthening funding (US$ 296 million) was allocated to service delivery, human resources, and medicines & technology, and within each of these to two to three interventions. Governance, financing, and information building blocks received relatively low funding. This study shows that a substantial portion of Global Fund's Round 8 funds was devoted to health systems strengthening. Dramatic skewing among the health system building blocks suggests opportunities for more balanced investments with regard to governance, financing, and

  2. Extrinsic and Intrinsic Factors Influencing Employee Motivation: Lessons from AMREF Health Africa in Kenya

    Directory of Open Access Journals (Sweden)

    Stephen Morangi Nyambegera

    2016-10-01

    Full Text Available The purpose of the study was to determine the factors that influence employee motivation in Kenyan Organizations. The study was guided by the following research questions: (i what are the extrinsic factors that influence employee motivation in AMREF Health Africa in Kenya? (ii what intrinsic factors influence employee motivation in AMREF Health Africa in Kenya? A descriptive research design was adopted. Stratified random sampling technique was used to draw a sample size of 96 respondents. The data collection instrument was a structured questionnaire developed by the researchers.  A set of descriptive and correlation statistics were adopted for analysis. The study identified several intrinsic factors that influence employee motivation. These included employee achievements, recognition, work itself, responsibility and advancement, salary structure, the level to which the employees feel appreciated, and the employee perception of their jobs among other factors. The study further, established that the intrinsic factors that influence employee motivation include empowerment and autonomy, employees’ view of their work, organization trust, skill variety requirements among others. The study recommends that the organization should acknowledge and make use of a proper mix of extrinsic and intrinsic factors in their human resource management practices to ensure that employees are well motivated to perform their tasks.

  3. Mobile health systems and emergence

    NARCIS (Netherlands)

    Jones, Valerie M.; Graziosi, Barbara

    2015-01-01

    Changes in the age distribution of the population and increased prevalence of chronic illnesses, together with a shortage of health professionals and other resources, will increasingly challenge the ability of national healthcare systems to meet rising demand for services. Large-scale use of eHealth

  4. Understanding the modifiable health systems barriers to hypertension management in Malaysia: a multi-method health systems appraisal approach.

    Science.gov (United States)

    Risso-Gill, Isabelle; Balabanova, Dina; Majid, Fadhlina; Ng, Kien Keat; Yusoff, Khalid; Mustapha, Feisul; Kuhlbrandt, Charlotte; Nieuwlaat, Robby; Schwalm, J-D; McCready, Tara; Teo, Koon K; Yusuf, Salim; McKee, Martin

    2015-07-03

    The growing burden of non-communicable diseases in middle-income countries demands models of care that are appropriate to local contexts and acceptable to patients in order to be effective. We describe a multi-method health system appraisal to inform the design of an intervention that will be used in a cluster randomized controlled trial to improve hypertension control in Malaysia. A health systems appraisal was undertaken in the capital, Kuala Lumpur, and poorer-resourced rural sites in Peninsular Malaysia and Sabah. Building on two systematic reviews of barriers to hypertension control, a conceptual framework was developed that guided analysis of survey data, documentary review and semi-structured interviews with key informants, health professionals and patients. The analysis followed the patients as they move through the health system, exploring the main modifiable system-level barriers to effective hypertension management, and seeking to explain obstacles to improved access and health outcomes. The study highlighted the need for the proposed intervention to take account of how Malaysian patients seek treatment in both the public and private sectors, and from western and various traditional practitioners, with many patients choosing to seek care across different services. Patients typically choose private care if they can afford to, while others attend heavily subsidised public clinics. Public hypertension clinics are often overwhelmed by numbers of patients attending, so health workers have little time to engage effectively with patients. Treatment adherence is poor, with a widespread belief, stemming from concepts of traditional medicine, that hypertension is a transient disturbance rather than a permanent asymptomatic condition. Drug supplies can be erratic in rural areas. Hypertension awareness and education material are limited, and what exist are poorly developed and ineffective. Despite having a relatively well funded health system offering good access to

  5. Factors That Influence Enrolment and Retention in Ghana' National Health Insurance Scheme.

    Science.gov (United States)

    Kotoh, Agnes Millicent; Aryeetey, Genevieve Cecilia; Van der Geest, Sjaak

    2017-10-17

    The government of Ghana introduced the National Health Insurance Scheme (NHIS) in 2004 with the goal of achieving universal coverage within 5 years. Evidence, however, shows that expanding NHIS coverage and especially retaining members have remained a challenge. A multilevel perspective was employed as a conceptual framework and methodological tool to examine why enrolment and retention in the NHIS remains low. A household survey was conducted after 20 months educational and promotional activities aimed at improving enrolment and retention rates in 15 communities in the Central and Eastern Regions (ERs) of Ghana. Observation, indepth interviews and informal conversations were used to collect qualitative data. Forty key informants (community members, health providers and district health insurance schemes' [DHISs] staff) purposely selected from two casestudy communities in the Central Region (CR) were interviewed. Several community members, health providers and DHISs' staff were also engaged in informal conversations in the other five communities in the region. Also, four staff of the Ministry of Health (MoH), Ghana Health Service (GHS) and National Health Insurance Authority (NHIA) were engaged in in-depth interviews. Descriptive statistics was used to analyse quantitative data. Qualitative data was analysed using thematic content analysis. The results show that factors that influence enrolment and retention in the NHIS are multi-dimensional and cut across all stakeholders. People enrolled and renewed their membership because of NHIS' benefits and health providers' positive behaviour. Barriers to enrolment and retention included: poverty, traditional risk-sharing arrangements influence people to enrol or renew their membership only when they need healthcare, dissatisfaction about health providers' behaviour and service delivery challenges. Given the multi-dimensional nature of barriers to enrolment and retention, we suggest that the NHIA should engage DHISs, health

  6. College Students' Perceived and Personal Mental Health Stigma: The Influence on Help-Seeking Attitudes and Intentions

    Science.gov (United States)

    Pompeo, Alyson

    2014-01-01

    Despite being vulnerable to mental health problems, college students are a population that is especially influenced by perceptions of peer mental health stigmatization (Quinn, Wilson, MacIntyre, & Tinklin, 2009), a known barrier to seeking mental health services (Corrigan, 2004a; Komiya, Good, & Sherrod, 2000; Vogel, Wade, & Haake,…

  7. Influence of package and health-related claims on perception and sensory acceptability of snack bars.

    Science.gov (United States)

    Pinto, Vinícius Rodrigues Arruda; Freitas, Tamara Beatriz de Oliveira; Dantas, Maria Inês de Souza; Della Lucia, Suzana Maria; Melo, Laura Fernandes; Minim, Valéria Paula Rodrigues; Bressan, Josefina

    2017-11-01

    Concerns for health can lead to healthier food choices, especially if the consumer is well informed. This study aimed to evaluate the importance of package and health-related claims on Brazilian consumers' acceptance of snack bars. In order to evaluate package attributes, in focus groups discussions, 19 consumers chose the most important factors that influence their purchase decisions. Next, 102 consumers evaluated six commercial brands of snack bars in a three-session acceptance test: the first with no information about the product, the second containing the product package and the third with information on health-related claims associated with consumption of the bar. In general, package attributes, price and flavor were the most important factors that influence the purchase of snack bars. Health claims positively influenced consumer acceptance, but information concerning the absence of gluten and lactose did not significantly alter sensory acceptance. The presence of omega-3s, sugars, preservatives, flavorings and colorings have the potential to improve acceptability, because they were able to raise the acceptance of the seed bar, removing it from the rejection region. Protein and nut bars are not well known to the general public and the lower mean acceptance of the seed and protein bars demonstrated the need for sensorial improvement. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Economic valuation of health care services in public health systems: a study about Willingness to Pay (WTP) for nursing consultations.

    Science.gov (United States)

    Martín-Fernández, Jesús; del Cura-González, Ma Isabel; Rodríguez-Martínez, Gemma; Ariza-Cardiel, Gloria; Zamora, Javier; Gómez-Gascón, Tomás; Polentinos-Castro, Elena; Pérez-Rivas, Francisco Javier; Domínguez-Bidagor, Julia; Beamud-Lagos, Milagros; Tello-Bernabé, Ma Eugenia; Conde-López, Juan Francisco; Aguado-Arroyo, Óscar; Sanz-Bayona, Ma Teresa; Gil-Lacruz, Ana Isabel

    2013-01-01

    Identifying the economic value assigned by users to a particular health service is of principal interest in planning the service. The aim of this study was to evaluate the perception of economic value of nursing consultation in primary care (PC) by its users. Economic study using contingent valuation methodology. A total of 662 users of nursing consultation from 23 health centers were included. Data on demographic and socioeconomic characteristics, health needs, pattern of usage, and satisfaction with provided service were compiled. The validity of the response was evaluated by an explanatory mixed-effects multilevel model in order to assess the factors associated with the response according to the welfare theory. Response reliability was also evaluated. Subjects included in the study indicated an average Willingness to Pay (WTP) of €14.4 (CI 95%: €13.2-15.5; median €10) and an average Willingness to Accept [Compensation] (WTA) of €20.9 (CI 95%: €19.6-22.2; median €20). Average area income, personal income, consultation duration, home visit, and education level correlated with greater WTP. Women and older subjects showed lower WTP. Fixed parameters explained 8.41% of the residual variability, and response clustering in different health centers explained 4-6% of the total variability. The influence of income on WTP was different in each center. The responses for WTP and WTA in a subgroup of subjects were consistent when reassessed after 2 weeks (intraclass correlation coefficients 0.952 and 0.893, respectively). The economic value of nursing services provided within PC in a public health system is clearly perceived by its user. The perception of this value is influenced by socioeconomic and demographic characteristics of the subjects and their environment, and by the unique characteristics of the evaluated service. The method of contingent valuation is useful for making explicit this perception of value of health services.

  9. Data liquidity in health information systems.

    Science.gov (United States)

    Courtney, Paul K

    2011-01-01

    In 2001, the Institute of Medicine report Crossing the Quality Chasm and the National Committee on Vital and Health Statistics report Information for Health were released, and they provided the context for the development of information systems used to support health-supporting processes. Both had as their goals, implicit or explicit, to ensure the right data are provided to the right person at the right time, which is one definition of "data liquidity." This concept has had some traction in recent years as a shorthand way to express a system property for health information technology, but there is not a well-defined characterization of what properties of a system or of its components give it better or worse data liquidity. This article looks at some recent work that help to identify those properties and perhaps can help to ground the concept with metrics that are assessable.

  10. Systems Health Care: daily measurement and lifestyle change

    Science.gov (United States)

    Nakajima, Hiroshi; Tsuchiya, Naoki; Shiga, Toshikazu; Hata, Yutaka

    2012-06-01

    Health is quite important to be realized in our daily life. However, its idea covers wide area and has individual dependency. Activities in health care have been widely developed by medical, drag, insurance, food, and other types of industries mainly centering diseases. In this article, systems approach named Systems Health Care is introduced and discussed to generate new and precious values based on measurements in daily life to change lifestyle habits for realizing each health. Firstly, issues related to health such as its definitions are introduced and discussed by centering health rather than disease. In response to the discussions on health, Home and Medical Care is continuously introduced to point out the important role causality between life style and vital signal such as exercise and blood pressure based on detailed sampling time. Systems approaches of Systems Health Care are discussed from various points of views. Real applications of devices and services are used to make the studies and discussions deeper on the subjects of the article.

  11. Parental influences on weight-related health behaviors in western and eastern cultures.

    Science.gov (United States)

    Niemeier, B S; Duan, Y P; Shang, B R; Yang, J

    2017-03-01

    Excessive bodyweight contributes to a myriad of risk factors for chronic diseases, and multiple reports have demonstrated that parents influence the development of their children's behaviors that contribute to bodyweight. However, studies that include considerations for cultural influences are limited, and methodology that considers direct reports from young adults and their parents across cultures does not exist. A sample of young adults (N = 327) and their parents in the U.S. and in China were recruited and completed a series of questionnaires in two cycles (2010 and 2014). With correlation and multiple regression analyses, parents' characteristics, behaviors, and parental authority styles were examined and compared to weight-related health behaviors and bodyweight of their young-adult children. Additionally, similarities and differences of parental influences between the two cultures were explored. Parents' body mass indexes (BMIs) and dietary behaviors were positively associated with those of their young adult children in the mixed-culture sample (P permissive parental authority, the relationships between young adults' and their parents' BMIs were negative for U.S. participants and positive for Chinese participants (P parenting, the relationship between young adults' and their parents' dietary consumption behaviors was negative for U.S. participants and positive for Chinese participants (P development of life-long health behaviors that contribute to BMI are significantly influenced by parents' behaviors and parenting styles. Moreover, an interaction of parental characteristics and cultural norms is indicated. © 2017 John Wiley & Sons Ltd.

  12. The Journey to Become a Health Literate Organization: A Snapshot of Health System Improvement

    Science.gov (United States)

    BRACH, Cindy

    2017-01-01

    A health literate health care organization is one that makes it easy for people to navigate, understand, and use information and services to take care of their health. This chapter explores the journey that a growing number of organizations are taking to become health literate. Health literacy improvement has increasingly been viewed as a systems issue, one that moves beyond siloed efforts by recognizing that action is required on multiple levels. To help operationalize the shift to a systems perspective, members of the National Academies Roundtable on Health Literacy defined ten attributes of health literate health care organizations. External factors, such as payment reform in the U.S., have buoyed health literacy as an organizational priority. Health care organizations often begin their journey to become health literate by conducting health literacy organizational assessments, focusing on written and spoken communication, and addressing difficulties in navigating facilities and complex systems. As organizations’ efforts mature, health literacy quality improvement efforts give way to transformational activities. These include: the highest levels of the organization embracing health literacy, making strategic plans for initiating and spreading health literate practices, establishing a health literacy workforce and supporting structures, raising health literacy awareness and training staff system-wide, expanding patient and family input, establishing policies, leveraging information technology, monitoring policy compliance, addressing population health, and shifting the culture of the organization. The penultimate section of this chapter highlights the experiences of three organizations that have explicitly set a goal to become health literate: Carolinas Healthcare System (CHS), Intermountain Healthcare, and Northwell Health. These organizations are pioneers that approached health literacy in a systematic fashion, each exemplifying different routes an

  13. The Journey to Become a Health Literate Organization: A Snapshot of Health System Improvement.

    Science.gov (United States)

    Brach, Cindy

    2017-01-01

    A health literate health care organization is one that makes it easy for people to navigate, understand, and use information and services to take care of their health. This chapter explores the journey that a growing number of organizations are taking to become health literate. Health literacy improvement has increasingly been viewed as a systems issue, one that moves beyond siloed efforts by recognizing that action is required on multiple levels. To help operationalize the shift to a systems perspective, members of the U.S. National Academies of Sciences, Engineering, Medicine Roundtable on Health Literacy defined ten attributes of health literate health care organizations. External factors, such as payment reform in the U.S., have buoyed health literacy as an organizational priority. Health care organizations often begin their journey to become health literate by conducting health literacy organizational assessments, focusing on written and spoken communication, and addressing difficulties in navigating facilities and complex systems. As organizations' efforts mature, health literacy quality improvement efforts give way to transformational activities. These include: the highest levels of the organization embracing health literacy, making strategic plans for initiating and spreading health literate practices, establishing a health literacy workforce and supporting structures, raising health literacy awareness and training staff system-wide, expanding patient and family input, establishing policies, leveraging information technology, monitoring policy compliance, addressing population health, and shifting the culture of the organization. The penultimate section of this chapter highlights the experiences of three organizations that have explicitly set a goal to become health literate: Carolinas Healthcare System (CHS), Intermountain Healthcare, and Northwell Health. These organizations are pioneers that approached health literacy in a systematic fashion, each

  14. How life stressors influence modifiable lifestyle factors, depressive symptoms, and physical and mental health among Vietnamese older women?

    Science.gov (United States)

    Dao-Tran, Tiet-Hanh; Anderson, Debra; Seib, Charrlotte

    2017-06-29

    Research has demonstrated that exposure to life stressors can influence health through a number of pathways. However, knowledge about the patterns of life stressors and their contributions to health in different populations is limited. Vietnamese older women have attracted little research to date in this area. This cross-sectional study used an interview-administered-questionnaire to collect data from 440 Vietnamese older women. Descriptive analysis was used to describe life stressors among Vietnamese older women. Binary analysis and Structural Equation Modelling statistical analysis were used to examine the influences of life stressors on modifiable lifestyle factors, depressive symptoms, physical and mental health among Vietnamese older women. Vietnamese older women in this study commonly reported the experience of losing a close person, including a baby/child, serious health or money problems, violence and disaster. Among the study participants, (1) exposure to more life stressors increased their depressive symptoms, and decreased their physical and mental health; (2) exposure to more life stressors also increased their physical health by increasing their physical activity levels. Life stressors influenced health among Vietnamese older women through different pathways. Interventions to manage stress and depressive symptoms are required for Vietnamese older women in the future.

  15. Factors Influencing the Job Satisfaction of Health System Employees in Tabriz, Iran

    Directory of Open Access Journals (Sweden)

    Shokoufe Bagheri

    2012-12-01

    Full Text Available Background: Employees can be counseled on how they feel about their job. If any particular dimension of their job is causing them dissatisfaction, they can be assisted to appropriately change it. In this study, we investigated the factors affecting job satisfaction from the perspective of employees working in the health system and thereby a quantitative measure of job satisfaction.Methods: Using eight focus group discussions (n=70, factors affecting job satisfaction of the employees were discussed. The factors identified from literature review were categorized in four groups: structural and managerial, social, work in it-self, environmental and welfare factors.Results: The findings confirmed the significance of structural and managerial, social, work in it-self, environmental and welfare factors in the level of job satisfaction. In addition, a new factor related to individual characteristics such as employee personal characteristics and development was identified.Conclusion: In order to improve the quality and productivity of work, besides, structural and managerial, social, work in it-self, environmental and welfare factors, policy makers should be taken into account individual characteristics of the employee as a factor affecting job satisfaction.

  16. Influences on participant reporting in the World Health Organisation drugs exposure pregnancy registry; a qualitative study.

    Science.gov (United States)

    Allen, Elizabeth N; Gomes, Melba; Yevoo, Lucy; Egesah, Omar; Clerk, Christine; Byamugisha, Josaphat; Mbonye, Anthony; Were, Edwin; Mehta, Ushma; Atuyambe, Lynn M

    2014-10-31

    The World Health Organisation has designed a pregnancy registry to investigate the effect of maternal drug use on pregnancy outcomes in resource-limited settings. In this sentinel surveillance system, detailed health and drug use data are prospectively collected from the first antenatal clinic visit until delivery. Over and above other clinical records, the registry relies on accurate participant reports about the drugs they use. Qualitative methods were incorporated into a pilot registry study during 2010 and 2011 to examine barriers to women reporting these drugs and other exposures at antenatal clinics, and how they might be overcome. Twenty-seven focus group discussions were conducted in Ghana, Kenya and Uganda with a total of 208 women either enrolled in the registry or from its source communities. A question guide was designed to uncover the types of exposure data under- or inaccurately reported at antenatal clinics, the underlying reasons, and how women prefer to be asked questions. Transcripts were analysed thematically. Women said it was important for them to report everything they had used during pregnancy. However, they expressed reservations about revealing their consumption of traditional, over-the-counter medicines and alcohol to antenatal staff because of anticipated negative reactions. Some enrolled participants' improved relationship with registry staff facilitated information sharing and the registry tools helped overcome problems with recall and naming of medicines. Decisions about where women sought care, which influenced medicines used and antenatal clinic attendance, were influenced by pressure within and outside of the formal healthcare system to conform to conflicting behaviours. Conversations also reflected women's responsibilities for producing a healthy baby. Women in this study commonly take traditional medicines in pregnancy, and to a lesser extent over-the-counter medicines and alcohol. The World Health Organisation pregnancy registry

  17. [The health system of Guatemala].

    Science.gov (United States)

    Becerril-Montekio, Víctor; López-Dávila, Luis

    2011-01-01

    This paper describes the health conditions in Guatemala and, in more detail, the characteristics of the Guatemalan health system, including its structure en coverage, its financial sources, the stewardship functions developed by the Ministry of Health, as well as the generation of health information and the development of research activities. It also discusses the recent efforts to extend coverage of essential health services, mostly to poor rural areas.The most recent innovations also discussed in this paper include the Program for the Expansion of Coverage of Essential Services, the Program to Expand Access to Essential Drugs and the agreements between the Ministry of Health and several non-governmental organizations to provide essential services in rural settings.

  18. Health-Seeking Behaviors of Filipino Migrants in Australia: The Influence of Persisting Acculturative Stress and Depression.

    Science.gov (United States)

    Maneze, Della; Salamonson, Yenna; Poudel, Chandra; DiGiacomo, Michelle; Everett, Bronwyn; Davidson, Patricia M

    2016-08-01

    This study examined the relationships among the constructs of acculturative stress, depression, English language use, health literacy, and social support and the influence of these factors on health-seeking behaviors of Filipino Australians. Using a self-administered questionnaire, 552 respondents were recruited from November 2010 to June 2011. Structural equation modelling was used to examine relationships. A direct and negative relationship between health-seeking behaviors and depression, and an indirect relationship with acculturative stress, was observed mediated through depression. Social support had an important moderating influence on these effects. Although there was an inverse relationship between age and English language usage and depression, age was positively related to health-seeking behavior. Despite their long duration of stay, Filipino Australian migrants continue to experience acculturative stress and depression leading to lower health-seeking behaviors. This study highlights the importance of screening for acculturative stress and depression in migrants and fostering social support.

  19. An analysis of the influence of framework aspects on the study design of health economic modeling evaluations.

    Science.gov (United States)

    Gurtner, Sebastian

    2013-04-01

    Research and practical guidelines have many implications for how to structure a health economic study. A major focus in recent decades has been the quality of health economic research. In practice, the factors influencing a study design are not limited to the quest for quality. Moreover, the framework of the study is important. This research addresses three major questions related to these framework aspects. First, we want to know whether the design of health economic studies has changed over time. Second, we want to know how the subject of a study, whether it is a process or product innovation, influences the parameters of the study design. Third, one of the most important questions we will answer is whether and how the study's source of funding has an impact on the design of the research. To answer these questions, a total of 234 health economic studies were analyzed using a correspondence analysis and a logistic regression analysis. All three categories of framework factors have an influence on the aspects of the study design. Health economic studies have evolved over time, leading to the use of more advanced methods like complex sensitivity analyses. Additionally, the patient's point of view has increased in importance. The evaluation of product innovations has focused more on utility concepts. On the other hand, the source of funding may influence only a few aspects of the study design, such as the use of evaluation methods, the source of data, and the use of certain utility measures. The most important trends in health care, such as the emphasis on the patients' point of view, become increasingly established in health economic evaluations with the passage of time. Although methodological challenges remain, modern information and communication technologies provide a basis for increasing the complexity and quality of health economic studies if used frequently.

  20. Health-related life satisfaction and its influencing factors: A cross-sectional study in China.

    Science.gov (United States)

    Wang, Shou-Qi; Ying, Jie; Zhang, Mei-Ling; Shi, Ying; Li, Yuan; Xing, Zhuang-Jie; Li, Huan-Huan; Sun, Jiao

    2018-01-24

    With the rapid development of science and technology, the pace of life has accelerated. Health and life satisfaction issues of persons are gaining more attention. China, Japan, Malaysia, and Taiwan conducted international cooperative research on health of four regional populations. This research was a part of the study in mainland China, which aimed to explore health-related life satisfaction and its influencing factors on large samples in mainland China. A random group of 1404 persons from universities, factories, companies, and elderly centers in Changchun completed a structured questionnaire. This study centered on life satisfaction indicators, which included the current whole life, income, family relationships, peer relationships, relationships with the neighbors, living environment, personal health, family health, spare time, and housework share. Other collected data included the Body Mass Index, blood pressure, self-rated health, Breslow's seven health practices, medical treatment within the past 6 months, physical examinations, General Health Questionnaire (GHQ)-12 Scale, social activities, networking relationships with persons around the community, social support, and sociodemographic variables. Associations between life satisfaction, demographics, and health-related variables were analyzed through a multiway ANOVA. The living environment and income of Chinese persons were related to their low life satisfaction. The multiway ANOVA showed that the independent relationship of self-rated health, regular physical examinations, GHQ-12 Scale, trust in the community, communication with the neighbors, education, and age related with life satisfaction accounting for 20.3% of the variance. Education and age showed interactive effects on life satisfaction. This study identified seven factors that influenced the life satisfaction of persons in mainland China. Life satisfaction can be enhanced through interventions to improve self-rated health, regular physical