WorldWideScience

Sample records for rural health zone

  1. Knowledge of nutritional and health needs of children among rural residents of Enugu north senatorial zone in Enugu State, Nigeria.

    Science.gov (United States)

    Okoye, Uzoma O; Ngwu, Christopher N; Tanyi, Perpetua L

    2015-01-01

    The article assessed knowledge of the nutritional and health needs of children among rural dwellers in Nigeria. Focus group discussions were conducted with all male and female groups in four purposively chosen rural communities in Nsukka Senatorial zone of Enugu State. These generated data on participants' knowledge on the nutritional and health needs of the children as well as their socio-demographic characteristics. All the participants were married with mean age of 41 and 36 years for males and females, respectively. The participants had six and four children on the average for male and female participants, respectively. Findings show that participants demonstrate knowledge of basic dietary needs of children; however, actual practice is lacking. Men believe women have the sole responsibility for children's nutrition. Exclusive breastfeeding is not adhered to by participants. Some reservation still exists about immunization. Sustained health education on exclusive breastfeeding and child immunization targeting both sexes is still needed.

  2. Rural Health Information Hub

    Science.gov (United States)

    ... issues that impact rural health in RHIhub’s Topic Guides. Recently updated: Social Determinants of Health for Rural People Browse all 50+ topics Community Health Gateway Find rural project examples in Rural Health Models and Innovations and proven strategies for strong rural programs with ...

  3. National Rural Health Association

    Science.gov (United States)

    ... History of Rural Health Globalization Urban Bias Dependency Theory Political Economy History of Rural Health IV: '60s ... Data Grassroots Action Center Policy Documents Legislative and Regulatory Agenda Medicaid News Response to 2013 OIG CAH ...

  4. New insight into the levels, distribution and health risk diagnosis of indoor and outdoor dust-bound FRs in colder, rural and industrial zones of Pakistan.

    Science.gov (United States)

    Khan, Muhammad Usman; Li, Jun; Zhang, Gan; Malik, Riffat Naseem

    2016-09-01

    This is the first robust study designed to probe selected flame retardants (FRs) in the indoor and outdoor dust of industrial, rural and background zones of Pakistan with special emphasis upon their occurrence, distribution and associated health risk. For this purpose, we analyzed FRs such as polybrominated diphenylethers (PBDEs), dechlorane plus (DP), novel brominated flame retardants (NBFRs) and organophosphate flame retardants (OPFRs) in the total of 82 dust samples (indoor and outdoor) collected three from each zone: industrial, rural and background. We found higher concentrations of FRs (PBDEs, DP, NBFRs and OPFRs) in industrial zones as compared to the rural and background zones. Our results reveal that the concentrations of studied FRs are relatively higher in the indoor dust samples being compared with the outdoor dust and they are ranked as: ∑OPFRs > ∑NBFRs > ∑PBDEs > ∑DP. A significant correlation in the FRs levels between the indoor and outdoor dust suggest the potential intermixing of these compounds between them. The principal component analysis/multiple linear regression predicts the percent contribution of FRs from different consumer products in the indoor and outdoor dust of industrial, rural and background zones to trace their source origin. The FRs detected in the background zones reveal the dust-bound FRs suspended in the air might be shifted from different warmer zones or consumers products available/used in the same zones. Hazard quotient (HQ) for FRs via indoor and outdoor dust intake at mean and high dust scenarios to the exposed populations (adults and toddlers) are found free of risk (HQ Pakistan.

  5. Office of Rural Health Policy

    Science.gov (United States)

    ... Information Hub Rural Health Research Gateway Rural Community Health Gateway White House Rural Council  Eligibility Analyzer Contact Us Subscribe to FORHP weekly announcement for rural health grantees and stakeholders by e-mail Subscribe to ...

  6. Oral Health in Rural Communities

    Science.gov (United States)

    ... Guide Rural Health Topics & States Topics View more Oral Health in Rural Communities Adequate access to oral healthcare ... about oral health programs in my area? What oral health disparities are present in rural America? According to ...

  7. Rural Health Clinics (RHCs)

    Science.gov (United States)

    ... rural healthcare organizations attract healthcare providers by posting job opportunities online by state. Candidates who are interested in ... areas may register with 3RNet to search for job opportunities. The National Health Service Corps (NHSC) provides scholarships ...

  8. Rural Mental Health Ecology

    DEFF Research Database (Denmark)

    Wilson, Rhonda L.; Wilson, G. Glenn; Usher, Kim

    2015-01-01

    The mental health of people in rural communities is influenced by the robustness of the mental health ecosystem within each community. Theoretical approaches such as social ecology and social capital are useful when applied to the practical context of promoting environmental conditions which...... maximise mental health helping capital to enhance resilience and reduce vulnerably as a buffer for mental illness. This paper explores the ecological conditions that affect the mental health and illness of people in rural communities. It proposes a new mental health social ecology framework that makes full...

  9. Rural Productivity Zones (RPZs) for microenterprises

    Energy Technology Data Exchange (ETDEWEB)

    Hansen, R.D.

    1997-12-01

    In this paper the authors discuss the concept of rural productivity zones (RPZs) which are defined as a business incubator to foster income-producing opportunities for the rural poor. The essential ingredients of such a program include: electric power; business development assistance; office services; and quality work space. The electric power source must be a good quality system, consisting of a diesel/wind/photovoltaic hybrid type system, providing reliable service, with a local maintenance program and a functional load management program.

  10. Pedagogy for rural health.

    Science.gov (United States)

    Reid, Stephen J

    2011-04-01

    As the body of literature on rural health has grown, the need to develop a unifying theoretical framework has become more apparent. There are many different ways of seeing the same phenomenon, depending on the assumptions we make and the perspective we choose. A conceptual and theoretical basis for the education of health professionals in rural health has not yet been described. This paper examines a number of theoretical frameworks that have been used in the rural health discourse and aims to identify relevant theory that originates from an educational paradigm. The experience of students in rural health is described phenomenologically in terms of two complementary perspectives, using a geographic basis on the one hand, and a developmental viewpoint on the other. The educational features and implications of these perspectives are drawn out. The concept of a 'pedagogy of place' recognizes the importance of the context of learning and allows the uniqueness of a local community to integrate learning at all levels. The theory of critical pedagogy is also found relevant to education for rural health, which would ideally produce 'transformative' graduates who understand the privilege of their position, and who are capable of and committed to engaging in the struggles for equity and justice, both within their practices as well as in the wider society. It is proposed that a 'critical pedagogy of place,' which gives due acknowledgement to local peculiarities and strengths, while situating this within a wider framework of the political, social and economic disparities that impact on the health of rural people, is an appropriate theoretical basis for a distinct rural pedagogy in the health sciences.

  11. Organizing Rural Health Care

    DEFF Research Database (Denmark)

    Bunkenborg, Mikkel

    2012-01-01

    The liberalization of health care in the course of three decades of ‘reform and opening up’ has given people in rural China access to a diverse range of treatment options, but the health care system has also been marred by accusations of price hikes, fake pharmaceuticals, and medical malpractice....... This chapter offers an ethnographic description of health as an issue in a Hebei township and it focuses on a popular and a statist response to the perceived inadequacy of the rural health care system. The revival of religious practices in rural China is obviously motivated by many factors, but in the township...... in question, various forms of healing play a significant role in religious movements and the rising cost of medical services as well as a general distrust of formal medical institutions seem to be part of the reason why people choose to follow spirit mediums and religious movements that offer alternative...

  12. Rural health clinics infrastructure

    Energy Technology Data Exchange (ETDEWEB)

    Olson, K.

    1997-12-01

    The author discusses programs which were directed at the installation of photovoltaic power systems in rural health clinics. The objectives included: vaccine refrigeration; ice pack freezing; lighting; communications; medical appliances; sterilization; water purification; and income generation. The paper discusses two case histories, one in the Dominican Republic and one in Colombia. The author summarizes the results of the programs, both successes and failures, and offers an array of conclusions with regard to the implementation of future programs of this general nature.

  13. Understanding Integrated Rural Health Networks

    OpenAIRE

    Moscovice, Ira; Wellever, Anthony; Christianson, Jon; Casey, Michelle; Yawn, Barbara; Hartley, David

    1997-01-01

    In an era of constraints on public and private sector health care budgets, organizational restructuring of hospital and physician practice, and the shifting of financial risk to patients and providers, rural health professionals and communities are grappling with the issue of how to assure access to a comprehensive and affordable set of health care services. In recent years, rural health providers have turned to the strategy of developing voluntary network relations as an alternative to syste...

  14. Rural Health Disparities

    Science.gov (United States)

    ... and International Patterns , the authors found that rural American Indian and Alaska Native (AI/AN) youth have a higher mortality rate than their urban counterparts. Additionally, the rate of substance abuse admissions was higher for rural AI/AN ...

  15. Zoning should promote public health.

    Science.gov (United States)

    Hirschhorn, Joel S

    2004-01-01

    Legally, governments use their police powers to protect public health, safety, and welfare through zoning. This paper presents a case for revisiting zoning on the basis of increasing evidence that certain types of community design promote public health, as opposed to the dominant pattern of sprawl development, which does not. Zoning, and the land use planning linked to it, that prohibits or disfavors health-promoting community designs contradicts the inherent public policy goal on which it is based. If there is a paradigm shift underway, from traditional sprawl to health-promoting community designs, then health professionals and others should understand why zoning must be reassessed.

  16. Medicare and Rural Health

    Science.gov (United States)

    ... 1.9 million rural beneficiaries participated in Medicare Advantage (MA) and other prepaid plans, accounting for 13.4% of MA enrollees. While rural participation is not proportionate to urban participation, strong rural enrollment in ... Medicare Advantage – The ACA reduces the payments to companies providing ...

  17. RURAL ZONING--PEOPLE, PROPERTY, AND PUBLIC POLICY.

    Science.gov (United States)

    BLOCK, WILLIAM J.

    WHILE COMPREHENSIVE PLANNING IS MANDATORY PRIOR TO PASSAGE OF ANY ZONING ORDINANCES, ZONING IN RURAL AREAS IS RELATIVELY NEW. ALTHOUGH MANY CONTROVERSIAL ISSUES ARISE DURING PLANNING, THE FACT REMAINS THAT THE BENEFITS ARE GREATER WHEN ZONING IS PROPERLY PLANNED AND EXECUTED. PROPERTY OWNERS OBJECT IN MANY INSTANCES TO PROBLEMS THAT MAY ARISE,…

  18. Reproductive health knowledge and services utilization among rural adolescents in east Gojjam zone, Ethiopia: a community-based cross-sectional study

    Science.gov (United States)

    2014-01-01

    Background According to World Health Organization, adolescents are people between 10 and 19 years of age; one-fifth of Ethiopian population constitutes adolescents and four-fifth live in rural areas. Local evidence about adolescents’ reproductive health knowledge, services utilization and associated factors are relevant to design age-appropriate program interventions and strategies. Hence, this study assessed the level of reproductive health knowledge and services utilization among rural adolescents in Machakel district, Northwest Ethiopia. Methods A community-based cross-sectional study was conducted to assess the level of reproductive health knowledge and services utilization of rural adolescents in Machakel district. The study employed both quantitative and qualitative methods. A systematic random sampling technique was used to select 415 adolescents from eligible households. Data were collected using pre-tested structured questionnaires and in-depth interview guides. The data were entered into Epi Info and analyzed by SPSS software for windows. Univariate, bivariate and multivariate analyses were done. Result More than two-third (67%) of the adolescents had knowledge about reproductive health. Age (AOR = 3.77, 95% CI: 3.1-8.98), living arrangement (AOR = 2.21, 95% CI: 1.81-6.04) and economic status (AOR = 3.37, 95% CI: 1.65-6.87) were associated with reproductive health knowledge. However, only one-fifth (21.5%) of the adolescents had ever used reproductive health services including family planning, sexually transmitted infections treatment and information, education and communication. Reproductive health services utilization was significantly associated with age (AOR = 2.18, 95% CI: 1.13-8.03) and knowledge for reproductive health (AOR = 1.23, 95% CI: 1.23-4.21). Parent disapproval, lack of basic information and pressure from partners were found to deter adolescents from accessing and using reproductive health services. Conclusion

  19. Rural migration and health care

    DEFF Research Database (Denmark)

    Svendsen, Gunnar Lind Haase; Jensen, Marit Vatn

    This literature study focuses on possible links between access to health services and migration in rural areas. Why do people move to or from rural areas or why do they stay? What determines where people settle? And, in this context, do local health care services play an important or minor role......, or no role at all? First, the paper reports on key findings from rural migration studies, in order to shed light on two migration trends: urbanization and counter-urbanization. Then we take a closer look on settlement preferences in rural areas, including the impact of health care facilities. Finally, we end...... up with a more deepgoing review of the relatively small number of studies, which explicitly deal with settlement preferences related to access to health care....

  20. Rural migration and health care

    DEFF Research Database (Denmark)

    Svendsen, Gunnar Lind Haase; Jensen, Marit Vatn

    This literature study focuses on possible links between access to health services and migration in rural areas. Why do people move to or from rural areas or why do they stay? What determines where people settle? And, in this context, do local health care services play an important or minor role......, or no role at all? First, the paper reports on key findings from rural migration studies, in order to shed light on two migration trends: urbanization and counter-urbanization. Then we take a closer look on settlement preferences in rural areas, including the impact of health care facilities. Finally, we end...... up with a more deepgoing review of the relatively small number of studies, which explicitly deal with settlement preferences related to access to health care....

  1. Factors Influencing Health Facility Delivery in Predominantly Rural Communities across the Three Ecological Zones in Ghana: A Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Yeetey Akpe Kwesi Enuameh

    Full Text Available Maternal and neonatal mortality indicators remain high in Ghana and other sub-Saharan African countries. Both maternal and neonatal health outcomes improve when skilled personnel provide delivery services within health facilities. Determinants of delivery location are crucial to promoting health facility deliveries, but little research has been done on this issue in Ghana. This study explored factors influencing delivery location in predominantly rural communities in Ghana.Data were collected from 1,500 women aged 15-49 years with live or stillbirths that occurred between January 2011 and April 2013. This was done within the three sites operating Health and Demographic Surveillance Systems, i.e., the Dodowa (Greater Accra Region, Kintampo (Brong Ahafo Region, and Navrongo (Upper-East Region Health Research Centers in Ghana. Multivariable logistic regression was used to identify the determinants of delivery location, controlling for covariates that were statistically significant in univariable regression models.Of 1,497 women included in the analysis, 75.6% of them selected health facilities as their delivery location. After adjusting for confounders, the following factors were associated with health facility delivery across all three sites: healthcare provider's influence on deciding health facility delivery, (AOR = 13.47; 95% CI 5.96-30.48, place of residence (AOR = 4.49; 95% CI 1.14-17.68, possession of a valid health insurance card (AOR = 1.90; 95% CI 1.29-2.81, and socio-economic status measured by wealth quintiles (AOR = 2.83; 95% CI 1.43-5.60.In addition to known factors such as place of residence, socio-economic status, and possession of valid health insurance, this study identified one more factor associated with health facility delivery: healthcare provider's influence. Ensuring care provider's counseling of clients could improve the uptake of health facility delivery in rural communities in Ghana.

  2. Medicaid and Rural Health

    Science.gov (United States)

    ... programs. How does Medicaid impact rural healthcare and the economy? In many ways, Medicaid plays a larger role ... supporting the social services infrastructure; and contributing to the economy through revenue and jobs it generates.” Findings in ...

  3. Leadership development for rural health.

    Science.gov (United States)

    Size, Tim

    2006-01-01

    Leadership is the capacity to help transform a vision of the future into reality. Individuals who can and will exercise leadership are like a river's current--a part past where we now stand, a part yet to come. We have an ongoing need to remember and to look toward the next "generation." A key responsibility of those here now, is to mentor and to create structures for mentoring, in order to maximize the flow and effectiveness of tomorrow's leaders. When recruiting organizational leaders, the recruitment and interview process must seek individuals who in addition to technical competence, also have demonstrated leadership in their prior work and activities. To exercise effective leadership, we must work to know who we are, how we relate to others, and the environment around us. "Servant leadership" is a perspective held by many throughout the rural health community and offers a key set attributes of leadership useful to rural health. To implement the Institute of Medicine's recommendations in Through Collaboration: the Future of Rural Health, we must develop leaders skilled in collaboration, both internal to their organization and across organizations. The National Advisory Committee on Rural Health and Human Services had it right when they said to the Secretary and to the rest of us, "the best way to honor Jim is to consciously work to help develop the next generation of rural health leaders." There are, of course, a multitude of leadership institutes, programs, and courses throughout America; this is not a call for yet another separate entity. But it is a call to each of us in rural health to assure that we are deliberate in how we identify "emerging leaders from and for rural communities and provide them with the training and resources to play a lead role in ensuring access to quality healthcare in their states and communities." Let's get started.

  4. Rural Mental Health

    Science.gov (United States)

    ... or mental health Peer mentoring School-based mental health services Crisis response Postvention See SAMHSA's Preventing Suicide: A Toolkit ... suicide and promote behavioral health. Offering a Mental ... are in a crisis. To review guidelines for school-based suicide prevention ...

  5. Rural health care in Mexico?

    Science.gov (United States)

    Cañedo, L

    1974-09-27

    A very large percentage of Mexico's population living in rural areas lacks resources for health care. Any new effort to provide such care must emphasize the health of the infant population because of the high percentage of infants in the country. Plans made at the national level have not been correlated with the conditions that exist in rural areas. For example, the majority of university programs are oriented toward urban medical practice, and the construction of more schools of medicine to solve the problem of doctors in rural areas is based on a mistaken premise. This problem has not been solved even in developed countries such as the United States where, as in Mexico, graduates in medicine migrate to the cities where optimal conditions are met for practicing the type of medicine for which they have been trained. Furthermore, it is both expensive and illogical to maintain urban doctors in rural areas where they cannot practice their profession for lack of resources; to do so is to deny the purpose of their education (27). Conventional schools of medicine, for reasons of investment and of structure, should teach only very selected groups of students who, on finishing their training, are fully capacitated to practice specialized medicine. A different system is required if we are to provide adequate health care in the rural communities. A system such as that described herein, adapted to the real need of rural communities, would avoid the necessity to create dysfunctional bureaucracies and would not destroy those institutions which have proved useful in the past. This study should be considered as one of the many pilot programs that should be initiated in order to determine the type of program that would best solve the problem of health care in rural Mexico. Other programs already being considered at the National Autonomous University of Mexico include the A36 plan of the Faculty of Medicine, now in operation; the work of C. Biro carried out in Netzahualcoyotl City

  6. Rural mental health: neither romanticism nor despair.

    Science.gov (United States)

    Wainer, J; Chesters, J

    2000-06-01

    This paper explores the relationship between rural places and mental health. It begins with a definition of mental health and an outline of the data that have led to the current concern with promoting positive mental health. We then consider aspects of rural life and place that contribute to positive mental health or increase the likelihood of mental health problems. Issues identified include environment, place, gender identity, violence and dispossession and the influence of the effects of structural changes in rural communities. The paper concludes with a discussion of some of the determinants of resilience in rural places, including social connectedness, valuing diversity and economic participation.

  7. Defining "Rural" for Veterans' Health Care Planning

    Science.gov (United States)

    West, Alan N.; Lee, Richard E.; Shambaugh-Miller, Michael D.; Bair, Byron D.; Mueller, Keith J.; Lilly, Ryan S.; Kaboli, Peter J.; Hawthorne, Kara

    2010-01-01

    Purpose: The Veterans Health Administration (VHA) devised an algorithm to classify veterans as Urban, Rural, or Highly Rural residents. To understand the policy implications of the VHA scheme, we compared its categories to 3 Office of Management and Budget (OMB) and 4 Rural-Urban Commuting Area (RUCA) geographical categories. Method: Using…

  8. 78 FR 17418 - Rural Health Information Technology Network Development Grant

    Science.gov (United States)

    2013-03-21

    ... award under the Rural Health Information Technology Network Development Grant (RHITND) to Grace... relinquishing its fiduciary responsibilities for the Rural Health Information Technology Network Development... HUMAN SERVICES Health Resources and Services Administration Rural Health Information Technology...

  9. Geospatial and age-related patterns of Taenia solium taeniasis in the rural health zone of Kimpese, Democratic Republic of Congo.

    OpenAIRE

    Madinga Ntwan, Joule; Kanobana, Kirezi; Lukanu, Philippe; Abatih, Emmanuel; Baloji, Sylvain; Linsuke, Sylvie; Praet, Nicolas; Kapinga, Serge; Polman,Katja; Lutumba, Pascal; Speybroeck, Niko; Dorny, Pierre; Harrison, Wendy; Gabriel, Sarah

    2016-01-01

    BACKGROUND: Taenia solium infections are mostly endemic in less developed countries where poor hygiene conditions and free-range pig management favor their transmission. Knowledge on patterns of infections in both human and pig is crucial to design effective control strategies. The aim of this study was to assess the prevalence, risk factors and spatial distribution of taeniasis in a rural area of the Democratic Republic of Congo (DRC), in the prospect of upcoming control activities. METHODS:...

  10. Arguing for Rural Health in Medicare: A Progressive Rhetoric for Rural America

    Science.gov (United States)

    Ricketts, Thomas C.

    2004-01-01

    Rural health policy is the laws, regulations, rules, and interpretations that benefit or affect health and health care for rural populations. This paper examines how rural health policy is viewed in the broader field of public policy, discusses the role of advocacy in developing rural health policy, and suggests ways to make that advocacy more…

  11. [Specialized reconstructive surgery in rural zones of Mexico].

    Science.gov (United States)

    Rozen-Fuller, Isaac; Cruz-Vega, Felipe; Franco-Bey, Rubén

    2011-01-01

    The Instituto Mexicano del Seguro Social program known as Surgical Encounters was created in 1996 to provide specialized medical and surgical care to the rural and indigenous population, the most marginalized group in the country, and to provide them health care at IMSS-Oportunidades rural hospitals by volunteer personnel. The aim of this paper is to describe the organization, logistics before, during and after the Encounter and the main results of operating room procedures. Fifty-seven Surgical Encounters had been carried out. During each encounter, three basic courses were given: The ABC of Plastic Surgery for rural medical practitioners with workshops for local dentists; Surgical Principles for Rural Nurses, and a Cardio-Pulmonary Reanimation course. They included 7,700 patients who were diagnosed and 4306 of these underwent to a surgical intervention (55.9%) with a total of 5,025 surgical procedures. The importance of this interaction between physicians, rural nurses and specialists at the most marginalized populations areas in the country must be emphasize as an action that lead to equity in health services.

  12. Observations on a rural health manpower project.

    Science.gov (United States)

    Pinchoff, D M; Ingall, J R; Crage, W D

    1977-02-01

    The Rural Externship Program was developed by the Lakes Area Regional Medical Program in conjunction with the State University of New York at Buffalo and the health professionals of western New York and northwestern Pennsylvania. It was designed to encourage health science students to practice in a rural area following graduation. This interdisciplinary program provides health science students with an eight-week summer living-working experience in a rural environment, supervised by practitioner-preceptors. The intent is to develop their appreciation of rural health care and life-styles. Since the summer of 1970, 240 students have participated. This paper describes and discusses the project and presents measures of the externs' changes in attitudes toward rural practice which occurred after they participated in the program. A survey of externs who have graduated shows the effect of the program on their decision to locate. Of the 61 externs contacted, 55 percent indicated that they were in rural practice, and 53 percent of the latter indicated that their experience in the Rural Externship Program was an important factor in their decision to practice in a rural area.

  13. Rural health service managers' perspectives on preparing rural health services for climate change.

    Science.gov (United States)

    Purcell, Rachael; McGirr, Joe

    2017-08-17

    To determine health service managers' (HSMs) recommendations on strengthening the health service response to climate change. Self-administered survey in paper or electronic format. Rural south-west of New South Wales. Health service managers working in rural remote metropolitan areas 3-7. Proportion of respondents identifying preferred strategies for preparation of rural health services for climate change. There were 43 participants (53% response rate). Most respondents agreed that there is scepticism regarding climate change among health professionals (70%, n = 30) and community members (72%, n = 31). Over 90% thought that climate change would impact the health of rural populations in the future with regard to heat-related illnesses, mental health, skin cancer and water security. Health professionals and government were identified as having key leadership roles on climate change and health in rural communities. Over 90% of the respondents believed that staff and community in local health districts (LHDs) should be educated about the health impacts of climate change. Public health education facilitated by State or Federal Government was the preferred method of educating community members, and education facilitated by the LHD was the preferred method for educating health professionals. Health service managers hold important health leadership roles within rural communities and their health services. The study highlights the scepticism towards climate change among health professionals and community members in rural Australia. It identifies the important role of rural health services in education and advocacy on the health impacts of climate change and identifies recommended methods of public health education for community members and health professionals. © 2017 National Rural Health Alliance Inc.

  14. Transformation of China's rural health care financing.

    Science.gov (United States)

    Liu, Y; Hsiao, W C; Li, Q; Liu, X; Ren, M

    1995-10-01

    In the late 1970s China launched its agricultural reforms which initiated a decade of continued economic growth and significant transformation of the Chinese society. The agricultural reforms altered the peasants' incentives, weakened community organization and lessened the central government's control over local communities. These changes largely caused the collapse of the widely acclaimed rural cooperative medical system in China. Consequently China experienced a decreased supply of rural health workers, increased burden of illnesses, disintegration of the three tier medical system, reduced primary health care, and an increased demand for hospital medical services. More than ten years have elapsed since China changed its agricultural economic system and China is still struggling to find an equitable, efficient and sustainable way of financing and organizing its rural health services. The Chinese experiences provided several important lessons for other nations: there is a need to understand the limits of the market forces and to redefine the role of the government in rural health care under a market economy; community participation in and control of local health financing schemes is essential in developing a sustainable rural health system; the rural health system needs to be dynamic, rather than static, to keep pace with changing demand and needs of the population.

  15. Reproductive Health in a Rural Ngwa Community

    African Journals Online (AJOL)

    the study were collected from a rural Ngwva community using two separate surveys — a ... factors that affect maternal reproductive health status. Little attempt has been made to investigate ... one point the Ngwa see the family in its nuclear.

  16. Utility Analysis on Supply of Rural Public Policies in North Bay Economic Zone

    Institute of Scientific and Technical Information of China (English)

    Changzhen; LI; Dafeng; YE

    2013-01-01

    From analysis on internal and external motive forces of development in North Bay Economic Zone, it indicates that public policies, as basic methods of government intervening against social and economic activities, are fundamental public goods produced by government. Effective supply of public policies brings rural economic growth, environmental protection and sustainable development, which greatly stimulates rural consumption, expands domestic demand and spurs economic growth, showing significant "multiplier effect". In this situation, this paper studies conditions for rural economic development and social transformation of the North Bay Economic Zone. Results show that social and economic development of rural areas of the North Bay Economic Zone needs scientific, reasonable and effective "public policies".

  17. Rural Adolescents and Mental Health: Growing Up in the Rural Community.

    Science.gov (United States)

    Hagen, Beverly Hartung

    1987-01-01

    Reviews relevant literature on the subject of rural adolescent mental health. Discusses demographics, unique situations, and problems of rural youth. Presents impact of the rural economic crisis. Suggests treatment strategies to deal with mental health problems of rural adolescents: individual therapy, family therapy, and peer group programs. (NEC)

  18. Politics of rural health in India.

    Science.gov (United States)

    Banerji, D

    2005-01-01

    The setting up of the National Rural Health Mission is yet another political move by the present government of India to make yet another promise to the long suffering rural population to improve their health status. As has happened so often in the past, it is based on questionable premises. It adopts a simplistic approach to a highly complex problem. The Union Ministry of Health and Family Welfare and its advisors, either because of ignorance or otherwise, have doggedly refused to learn from the many experiences of the past, both in terms of the efforts to earlier somewhat sincere efforts to develop endogenous mechanisms to offer access to health services as well as from the devastative impact on the painstakingly built rural health services of the imposition of prefabricated, ill-conceived, ill-formulated, techno-centric vertical programmes on the people of India. The also ignore some of the basic postulates of public health practice in a country like India. That did not substantiate the bases of some of their substantive contentions with scientific data obtained from health systems research reveals that they are not serious about their promise to rural population. This is yet another instance of what Romesh Thaper had called 'Baba Log playing government government'.

  19. 77 FR 62243 - Rural Health Network Development Program

    Science.gov (United States)

    2012-10-12

    ... Administration Rural Health Network Development Program AGENCY: Health Resources and Services Administration...-competitive replacement award under the Rural Health Network Development Program to the Siloam Springs... through the Rural Health Network Development Grant Program are to improve the capacity of network...

  20. A telecommunications journey rural health network.

    Science.gov (United States)

    Moore, Joe

    2012-01-01

    Utilizing a multi-gigabit statewide fiber healthcare network, Radiology Consultants of Iowa (RCI) set out to provide instantaneous service to their rural, critical access, hospital partners. RCIs idea was to assemble a collection of technologies and services that would even out workflow, reduce time on the road, and provide superior service. These technologies included PACS, voice recognition enabled dictation, HL7 interface technology, an imaging system for digitizing paper and prior films, and modern communication networks. The Iowa Rural Health Telecommunication Project was undertaken to form a system that all critical access hospitals would participate in, allowing RCI radiologists the efficiency of "any image, anywhere, anytime".

  1. 城乡结合部健康体检者血糖血脂水平调查分析%Blood glucose and blood lipid level among rural-urban fringe zone people receiving health examination

    Institute of Scientific and Technical Information of China (English)

    李艳玲; 王翠侠

    2013-01-01

    Objective To understand the levels of blood glucose and blood lipid among rural-urban fringe zone people receiving health examination. Methods The data of blood glucose, triglyceride and cholesterol of 1416 people receiving health examination in our hospital were analyzed statistically. Results The average level of serum glucose, cholesterol increased with the age, the average level of triglyceride increased with the age before age 60, but declined after age 60. The prevalence rate of blood glucose abnormality, cholesterol abnormality and triglyceride abnormality was 16.38%, 49.08% and 27.47% respectively, and the abnormal rate of blood glucose, cholesterol, and triglyceride increased with the age. More males were detected to be abnormal with blood glucose and triglyceride than females, but the abnormal rate of cholesterol in males (52.69%) was significantly higher than in males (41.79%). The abnormal rate of cholesterol and triglycerides in males aged 40-50 years was significantly higher than in males of other age groups, but the abnormal rate of cholesterol and triglycerides in females aged 50-60 years was significantly increased and to the highest in 60-years old. Conclusion The prevalence rate of blood glucose abnormality, cholesterol abnormality, triglyceride abnormality is high, especially cholesterol abnormality. It is necessary to conduct regular examination of blood glucose and blood fat among the people with abnormal indicators. More attentions should be paid to the regular, healthy examination and lifestyle of residents in order to improve the peoples' healthy level.%目的 了解城乡结合部健康体检人群血糖和血脂状况.方法 对2011年1416名在东风社区卫生服务中心进行体检者的血糖、胆固醇和甘油三酯的检测结果进行统计分析.结果 体检者血糖、胆固醇平均水平随年龄的增长而增加;血糖、胆固醇、甘油三酯异常检出率分别为16.38%、49.08%、27.47%,随着年龄的增

  2. HEALTH PRACTICE AMONG RURAL TURKMANS

    Directory of Open Access Journals (Sweden)

    Z. Hooshvar

    1979-03-01

    Full Text Available The purpose of this study which has been conducted among 1864 heads of Turkmans households or their wives in the north-east of Iran in 1979 was to rind the type and frequency of health practices in a traditional society, and the relation between these practices and variables such as age sex, literacy use of mass media and spatial mobility. As the pilot study uncovered the scarcity of health installations such as hot bath, water supply, clinic, and hospital in the study area, therefore, two most common health practices-i.e. to take a bath and brush teeth-were studied in relation with aforementioned variables. Finding revealed that: 1 - Elders take more a bath and youths brush more their teeth, and in both groups males are at higher level than females. However, females brush their teeth more regular than males. 2- Both practices are being more performed by literates than illiterates. 3- Turkmans are in 1general fatalistic people. In this regard those who are more fatalistic usually take a bath once a year while in contrast less fatalistic individuals take it once a week. 4- In spite of very low level of health awareness among Turkmans, pains such as, headache and/or bellyache (pain in the stomach is a kind of illness from their point of view. However, such recognition did not affect their health practices. 5- Those who had some knowledge of pathogens (microbes, or supposed the fly is a diffuse of illness, were more concerned about their hygiene and took more care of it. 6- Use of mass media (radio was effective in introducing health practices among Turkmans. Radio listeners took a bath or brushed their teeth more regular than non-listeners.

  3. Health visiting in rural Gambia.

    Science.gov (United States)

    Hoare, K

    1991-01-01

    A British nurse was the 1st health visitor in the village of Keneba in the Gambia. She was at a nutritional research center which provided basic medical services. In addition to visiting mothers in their homes to talk about health education, such as oral rehydration and advice on hand washing, she would also encourage them to bring their children to the infant welfare clinic for immunizations. She told the mothers that the health staff would check the growth and nutritional status of their children and why these activities were important. Staff at the clinic aimed to see all the children 2 years 9 times the 1st year and 4 times the 2nd year. All anthropometric data were forwarded to Cambridge, England to be included in a continuing study on the growth of the population. The clinic referred children with serious illnesses to the pediatrician or, if necessary, took them to a hospital on the coast. Children that came to the clinic with a fever 37.4 degrees Celsius during the wet season had a blood film taken to check for malaria parasites. Indeed cerebral malaria contributed greatly to child deaths in the Gambia. If malaria was present, children received their 1st dose of chloroquine immediately so the staff could determine tolerance. 3 doses followed this dose. The health visitor also organized the health education component of the clinic. The clinic dresser interpreted the British nurse's presentations to eventually conduct them alone. The nurse divided the mothers and fathers into 2 groups. In the future, she would evaluate the 2 groups to determine if weekly education on hand washing and skin hygiene would reduce diarrheal and cutaneous disease incidence in children 3 years old. The other group learned about family planning. Both groups learned about immunization, detection of illness, safety, sanitation, nutritional advice, dental care, and food preparation.

  4. Reproductive health issues in rural Western Kenya

    Directory of Open Access Journals (Sweden)

    Ouma Peter

    2008-03-01

    Full Text Available Abstract Background We describe reproductive health issues among pregnant women in a rural area of Kenya with a high coverage of insecticide treated nets (ITNs and high prevalence of HIV (15%. Methods We conducted a community-based cross-sectional survey among rural pregnant women in western Kenya. A medical, obstetric and reproductive history was obtained. Blood was obtained for a malaria smear and haemoglobin level, and stool was examined for geohelminths. Height and weight were measured. Results Of 673 participants, 87% were multigravidae and 50% were in their third trimester; 41% had started antenatal clinic visits at the time of interview and 69% reported ITN-use. Malaria parasitemia and anaemia (haemoglobin Conclusion In this rural area with a high HIV prevalence, the reported use of condoms before pregnancy was extremely low. Pregnancy health was not optimal with a high prevalence of malaria, geohelminth infections, anaemia and underweight. Chances of losing a child after birth were high. Multiple interventions are needed to improve reproductive health in this area.

  5. Developing district health systems in the rural Transvaal Issues ...

    African Journals Online (AJOL)

    Developing district health systems in the rural Transvaal Issues arising from the ... as a foundation for national health services based on primary health care. ... Close attention needs to be given to districtlevel health management, the ...

  6. Health Communications in Rural America: Lessons Learned from an Arthritis Campaign in Rural Arkansas

    Science.gov (United States)

    Balamurugan, Appathurai; Rivera, Mark; Sutphin, Kim; Campbell, Debbie

    2007-01-01

    Context: Lack of awareness about diseases and associated risk factors could partially account for some rural health disparities. Health communications campaigns can be an effective means of increasing awareness in these areas. Purpose: To review findings and lessons learned from a rural health communications campaign. Methods: The health…

  7. Annual health promotion programmes in remote rural Sabah

    Directory of Open Access Journals (Sweden)

    Naing Oo Tha

    2014-12-01

    Full Text Available Health promotion programmes in remote rural areas are conducted annually in Sabah, Malaysia by Faculty of Medicine and Health Science, University Malaysia Sabah. *Objectives* - To understand the concepts and principles of health promotion, to acquire knowledge and skills relevant to the assessment of the community diagnosis by using qualitative and quantitative approaches, to identify the limitation and issues of health promotion and its solution, to formulate the strategic plan and able to conduct the health promotion programme, to empower the rural community to improve rural health through health promotion activities. *Targeted population* is remote rural community. *Stake holders engaged* are UMS, medical and nursing students, local health authorities and rural community. *Methods* - Students were trained by series of lectures for health promotion concepts, approaches and activities and exposed to rural areas in Sabah and conducted practical health promotion programs annually. Students helped empowering the local community to improve their health with multi-approaches Health promotion methods under supervision of a lecturer. Medical and nursing students conducted health promotion programme together in 2 weeks duration . Health and health related problems were identified in selected rural villages .Various types of health promotion activities were conducted in prevention of communicable disease and non-communicable diseases.*Sustainability* - By having sustainable financing , cooperation from stake holders and strong commitment from faculty leadership and team members ,the annual health promotion programmes are conducted effectively in the rural community in Sabah. Although the impact of these health promotion activities cannot be seen in short duration, health issues in the rural community were explained by the students and advise them with causes, risk factors and precautions which would be useful in reducing the occurrence of common health

  8. Defining the medical imaging requirements for a rural health center

    CERN Document Server

    2017-01-01

    This book establishes the criteria for the type of medical imaging services that should be made available to rural health centers, providing professional rural hospital managers with information that makes their work more effective and efficient. It also offers valuable insights into government, non-governmental and religious organizations involved in the planning, establishment and operation of medical facilities in rural areas. Rural health centers are established to prevent patients from being forced to travel to distant urban medical facilities. To manage patients properly, rural health centers should be part of regional and more complete systems of medical health care installations in the country on the basis of a referral and counter-referral program, and thus, they should have the infrastructure needed to transport patients to urban hospitals when they need more complex health care. The coordination of all the activities is only possible if rural health centers are led by strong and dedicated managers....

  9. Disadvantaged Rural Health – Issues and Challenges: A Review

    Directory of Open Access Journals (Sweden)

    Anil K Chillimuntha

    2013-02-01

    Full Text Available Disadvantaged rural health reflected by significantly higher mortality rates in rural areas which indicate less attention paid by the government. The issue of health disadvantage to the rural area in the country is far from settled. The public expenditure on health in India is far too inadequate, less than 10% of the total health budget is allocated to rural area where 75% people live. In spite of rising budgetary provision, many of the rural populace dies without any medical attention. Access to high quality health care services plays an important part in the health of rural communities and individuals. Resolving the health problems of rural communities will require more than simply increasing the quality and accessibility of health services. Until governments begin to take an ‘upside-down’ perspective, focusing on building healthy communities rather than simply on building hospitals to make communities healthy, the disadvantages faced by rural people will continue to be exacerbated. Underutilization of existing rural hospitals and health care facilities can be addressed by a market-centered approach, and more effective government intervention for horizontal and vertical hospital integration. Tele-healthcare, Mobile Health Units and Community-based health insurance are proven helpful in rural areas. Autonomy enjoyed by women and exposure to media also has a significant impact on maternal health care utilization. Accessibility to health facilities is a critical factor in effective health treatment for people in rural areas. Location–allocation models prescribe optimal configurations of health facilities in order to maximize accessibility. [Natl J of Med Res 2013; 3(1.000: 80-82

  10. Lay meanings of health among rural older adults in Appalachia.

    Science.gov (United States)

    Goins, R Turner; Spencer, S Melinda; Williams, Kimberly

    2011-01-01

    Self-perceptions of health vary depending on one's social and cultural context. Rural residents have been characterized as having a distinct culture, and health differences by residence have been well documented. While there is evidence of poor health among rural older adults, little research has examined how they perceive and define health. Qualitative methods may help capture these lay meanings of health. The purpose of our study was to use a qualitative approach to examine what perceptions community-dwelling rural older adults have regarding their health. The study involved thirteen 90-minute focus groups and short self-administered surveys with community-dwelling persons aged 60 years or older residing in 6 rural West Virginia communities. A total of 101 participants were asked questions about their personal definitions of health. With professional transcribed tapes from the focus group discussions, we used a systematic text analysis approach. Discussions included 4 themes on the meaning of health: (1) health as a value, (2) dimensions of life, (3) holistic nature of health, and (4) health care use and adherence. Our results expand on previous studies and demonstrate that health is a subjective, multidimensional construct deeply embedded in the everyday experience of rural older adults. We found that older adults' perceptions about health contain components which most medical professionals would not take into account. Health care providers may consider supplementing traditional medical approaches with a more contextually sensitive recognition of rural elders' desired health goals and outcomes. © 2010 National Rural Health Association.

  11. Worry and bother: factors in rural women's health decision making.

    Science.gov (United States)

    McCulloch, B Jan; Jackson, Melanie N G; Lassig, Sara L

    2015-01-01

    This exploratory study examined older rural women's health decision making. Thirty-three rural women were recruited to participate in semistructured qualitative interviews. Major themes emerged that focused on rural women's comments regarding their concerns about not worrying or bothering their children with personal health matters. Themes were discussed in the context of an ethic of care. Results suggest that it is important for mental health professionals, family physicians, social workers, and other practitioners to be aware of the sense of worry and concern for others that older rural women bring to bear in decision making about personal health issues.

  12. ERP implementation in rural health care.

    Science.gov (United States)

    Trimmer, Kenneth J; Pumphrey, Lela D; Wiggins, Carla

    2002-01-01

    Enterprise resource planning (ERP) systems provide organizations with the opportunity to integrate individual, functionally-oriented information systems. Although much of the focus in the popular press has been placed on ERP systems in large for-profit organizations, small hospitals and clinics are candidates for ERP systems. Focusing information systems on critical success factors (CSFs) allows the organization to address a limited number of areas associated with performance. This limited number of factors can provide management with an insight into dimensions of information that must be addressed by a system. Focuses on CSFs for small health-care organizations. In addition, also considers factors critical to the implementation of health-care information systems. Presents two cases. The results indicate support for the continuing use of CSFs to help focus on the benefits of ERPs. Focusing on groups of tangible and intangible benefits can also assist the rural health-care organization in the use of ERPs.

  13. Effect of medicare payment on rural health care systems.

    Science.gov (United States)

    McBride, Timothy D; Mueller, Keith J

    2002-01-01

    Medicare payments constitute a significant share of patient-generated revenues for rural providers, more so than for urban providers. Therefore, Medicare payment policies influence the behavior of rural providers and determine their financial viability. Health services researchers need to contribute to the understanding of the implications of changes in fee-for-service payment policy, prospects for change because of the payment to Medicare+Choice risk plans, and implications for rural providers inherent in any restructuring of the Medicare program. This article outlines the basic policy choices, implications for rural providers and Medicare beneficiaries, impacts of existing research, and suggestions for further research. Topics for further research include implications of the Critical Access Hospital program, understanding how changes in payment to rural hospitals affect patient care, developing improved formulas for paying rural hospitals, determining the payment-to-cost ratio for physicians, measuring the impact of changes in the payment methodology used to pay for services delivered by rural health clinics and federally qualified health centers, accounting for the reasons for differences in historical Medicare expenditures across rural counties and between rural and urban counties, explicating all reasons for Medicare+Choice plans withdrawing from some rural areas and entering others, measuring the rural impact of proposals to add a prescription drug benefit to the Medicare program, and measuring the impact of Medicare payment policies on rural economies.

  14. Zoning of rural water conservation in China: A case study at Ashihe River Basin

    Directory of Open Access Journals (Sweden)

    Xiaoying Liu

    2015-06-01

    Full Text Available With the effective control of point source (PS pollution accomplished, water pollution problems caused by non-point source (NPS pollution have increased in recent years. The worsening agricultural NPS pollution has drawn the attention of the Chinese Government and researcher scientists and has resulted in the often mentioned “three red lines” on water resources management. One of the red lines is to control water pollution within a rational range. The Agricultural NPS pollution, which includes pollution from housing, and from livestock and crop production, is the main source. Based on the NPS pollution statutes, an index system for integrated evaluation of water quality, and a zoning scheme for rural water conservation were established. Using the method of one-dimensional Euclidean distance, this country is divided into 9 sub-zones at the provincial level, which are the first level zones. The zoning themes include natural resources, socio-economic development, water use efficiency, and pollutants emission intensity. According to pollution types of livestock, agriculture, or both, the first level zones are divided into 25 second level zones. The third class zoning is divided also based on pollution intensity of total nitrogen (TN, total phosphorus (TP, ammonia nitrogen (NH3-N, chemical oxygen demand (COD, and biochemical oxygen demand (BOD. On the basis of the second level zoning, there were formed 70 rural water conservation third level zones. This case study in the Ashihe river watershed indicated that the main pollution sources are consistent with the zoning research result, and this zoning has shown a good way to guide the agricultural NPS pollution control in not only the wide rural area of China but also other parts of the world.

  15. Study protocol: Evaluating the impact of a rural Australian primary health care service on rural health

    Directory of Open Access Journals (Sweden)

    Buykx Penny

    2011-03-01

    Full Text Available Abstract Background Rural communities throughout Australia are experiencing demographic ageing, increasing burden of chronic diseases, and de-population. Many are struggling to maintain viable health care services due to lack of infrastructure and workforce shortages. Hence, they face significant health disadvantages compared with urban regions. Primary health care yields the best health outcomes in situations characterised by limited resources. However, few rigorous longitudinal evaluations have been conducted to systematise them; assess their transferability; or assess sustainability amidst dynamic health policy environments. This paper describes the study protocol of a comprehensive longitudinal evaluation of a successful primary health care service in a small rural Australian community to assess its performance, sustainability, and responsiveness to changing community needs and health system requirements. Methods/Design The evaluation framework aims to examine the health service over a six-year period in terms of: (a Structural domains (health service performance; sustainability; and quality of care; (b Process domains (health service utilisation and satisfaction; and (c Outcome domains (health behaviours, health outcomes and community viability. Significant international research guided the development of unambiguous reliable indicators for each domain that can be routinely and unobtrusively collected. Data are to be collected and analysed for trends from a range of sources: audits, community surveys, interviews and focus group discussions. Discussion This iterative evaluation framework and methodology aims to ensure the ongoing monitoring of service activity and health outcomes that allows researchers, providers and administrators to assess the extent to which health service objectives are met; the factors that helped or hindered achievements; what worked or did not work well and why; what aspects of the service could be improved and how

  16. EMPOWERMENT OF RURAL MASSES IN HEALTH SECTOR

    Directory of Open Access Journals (Sweden)

    J S Mathur

    1995-09-01

    Full Text Available The health status of 80% population residing in rural areas has not improved to desired goals from the basic health services provided to them. Local people have remained indifferent to them. They should be equal partners in the management of health services operating in their areas, therefore, a process needs to be designed to create conditions to know of economic, social and health problems for the whole community with their active participation and fullest possible relience upon the communities initiative to solve them.A community development programme was launched on 2nd Oct. 1952 in first five year plan and was hailed as a programme "of the people, for the people, by the people" to exterminate the triple enemies - poverty illness and ignorance. The community development programmes were envisaged as a multipurpose programme cordinated for agriculture, social welfare, education and health.      .It is currently recognized that despite of expansion of the primary health care infra structure upto village level, a comprehensive and effective approach to community health has not been yet achieved. Local community is not sufficiently involved in its own health care, consequently the impact in terms of community health remains small. A comprehensive and integrated approach to community health for population control and response to family welfare planning depends more than any other factor but on an assurance of survival of the children and by creating the right environment for small family norms. All this and change in attitude for the desire of a male child and improvement in low status of women is possible by community itself. Low rate of literacy in women, early marriage of girls are seriously impending the

  17. Problems of health education in rural areas in Poland.

    Science.gov (United States)

    Charzyńska-Gula, Marianna; Sygit, Katarzyna; Sygit, Marian; Goździewska, Małgorzata; Dobrowolska, Beata; Gałęziowska, Edyta

    2013-01-01

    Health promotion is aimed at the reduction of the differences in society's access to factors determining the frequency of occurrence of pro-health behaviours. This means the construction of health resources and increase in the level of egalitarianism in access to these resources. Health education carried out on a high level in rural schools provides actual possibilities for gaining these resources. Many examples of educational practices confirm that the establishment of health conditioning and health behaviours of schoolchildren, and the diagnosis of rural school on the background of the specificity of the community in which it functions. These are a basis for the construction of effective educational programmes, and not analysis of the differences between urban and rural children and adolescents. In Poland, the performance of health education in rural schools encounters many problems associated both with the lack of infrastructure for health promotion, insufficient perception of the importance of health education at school by the educational authorities, underestimation of primary health care, low activity of the local governments, and lack of qualified rural health promoters. Current health education in Polish rural schools deepens inequalities in access to health, and postpones the moment of providing equal opportunities for rural and urban schoolchildren with access to the resources which condition the maintenance or even an enhancement of health. The objective of the study is to present selected problems in the performance of health education in a Polish rural school in the light of international trends, experiences and discussions related with an optimum form of health promotion in the environment of rural a school and the community.

  18. Zoning Rural Area For The Development Of Annual Plants

    Directory of Open Access Journals (Sweden)

    Bariot Hafif

    2013-01-01

    Full Text Available One strategy to protect land from degradation is to use the land according to their capability. Zoning of commodities is an effort in that direction and determination of commodities is based on the suitability of land with agronomic needs of crops and farming feasibility analysis. The purpose of this study was to determine the development zone of annual crops, based on the analysis of agro-ecological characteristics and agricultural viability. Analysis of land suitability for the cultivation of coffee, vanilla, pepper, cocoa, banana, durian, mango, and melinjo, found that land can be recommended for the development of the annual crops is about 29,230 ha from an area of 54,764 ha. The land was divided into six agro-ecological zones i.e. two zones at area with land slope of 3- 8%, each covering an area of 2,737 ha at an altitude of 15-50 m above sea level (asl, and 12,008 ha at an altitude of 50-300 m asl, the two zone at area with land slope of 8-15%, each covering 6119 ha at an altitude of 25-250 m asl and 1,221 ha at an altitude of 15-50 m asl, and two zones at area with land slope of 16-40% , each covering an area of 1,101 ha at an altitude of 400-700 m asl, and 6,134 ha at an altitude of 400-500 m asl. The soil types found are Typic /Vitrandic Eutrudepts, Typic Hapludands, and Vitrandic Hapludalfs. This study recommends that the banana is a perennial plant with the most potential to be developed and has good economic prospects in almost all agro-ecological zones. Other commodities are also preferred, coffee and vanilla.

  19. Rural Community as Context and Teacher for Health Professions Education.

    Science.gov (United States)

    Baral, Kedar; Allison, Jill; Upadhyay, Shambu; Bhandary, Shital; Shrestha, Shrijana; Renouf, Tia

    2016-11-07

    Nepal is a low-income, landlocked country located on the Indian subcontinent between China and India. The challenge of finding human resources for rural community health care settings is not unique to Nepal. In spite of the challenges, the health sector has made significant improvement in national health indices over the past half century. However, in terms of access to and quality of health services and impact, there remains a gross urban-rural disparity. The Patan Academy of Health Sciences (PAHS) has adopted a community-based education model, termed "community based learning and education" (CBLE), as one of the principal strategies and pedagogic methods. This method is linked to the PAHS mission of improving rural health in Nepal by training medical students through real-life experience in rural areas and developing a positive attitude among its graduates towards working in rural areas. This article outlines the PAHS approach of ruralizing the academy, which aligns with the concept of community engagement in health professional education. We describe how PAHS has embedded medical education in rural community settings, encouraging the learning context to be rural, fostering opportunities for community and peripheral health workers to participate in teaching-learning as well as evaluation of medical students, and involving community people in curriculum design and implementation.

  20. Developments in the relationship between large cities - the suburban zone and the rural/urban hinterland

    DEFF Research Database (Denmark)

    Nielsen, Thomas Alexander Sick; Hovgesen, Henrik Harder

    2006-01-01

    at the developments in the relationship between the urban core, its suburban areas and the rural/urban hinterland. The analysis uses data on commuting between small geographical zones to perform the analysis as “realistically” as possible. The paper combines a GIS-based approach (with maps of commuter...

  1. Health education: an experience in rural communities of Manabí, Ecuador

    OpenAIRE

    Noemi Bottasso; Jazmin Cazón

    2016-01-01

    Health is a very important issue for every human being. A person with deteriorated health can’t study, work and enjoy thoroughly of his/her life. Right to health is a fundamental right of every human being. Rural marginal zones of region Manabí inhabitants suffer serious difficulties in access of health services, for different reasons. With the objective of improve health access, we realized a training to 14 communities in order to introduce First Aid Kits with essential palliatives medicatio...

  2. Health behaviors and weight status among urban and rural children.

    Science.gov (United States)

    Davis, Ann M; Boles, Richard E; James, Rochelle L; Sullivan, Debra K; Donnelly, Joseph E; Swirczynski, Deborah L; Goetz, Jeannine

    2008-01-01

    Pediatric overweight is currently reaching epidemic proportions but little information exists on differences in weight related behaviors between urban and rural children. To assess health behaviors and weight status among urban and rural school-age children. Fifth-grade children at two urban and two rural schools were invited to participate in an assessment study of their health behaviors and weight status. A total of 138 children (mean age = 10 years; % female = 54.6) chose to participate. Children in rural and urban areas consumed equivalent calories per day and calories from fat, but rural children ate more junk food and urban children were more likely to skip breakfast. Urban children engaged in more metabolic equivalent tasks and had slightly higher total sedentary activity than rural children. The BMI percentile was equivalent across rural and urban children but rural children were more often overweight and urban children were more often at risk for overweight. Although some variables were equivalent across urban and rural children, results indicate some key health behavior differences between groups. Results should be interpreted with caution as the sample size was small and there were demographic differences between urban and rural samples.

  3. A comparison of mental health, substance use, and sexual risk behaviors between rural and non-rural transgender persons.

    Science.gov (United States)

    Horvath, Keith J; Iantaffi, Alex; Swinburne-Romine, Rebecca; Bockting, Walter

    2014-01-01

    The aim of this study was to compare the mental health, substance use, and sexual risk behaviors of rural and non-rural transgender persons. Online banner advertisements were used to recruit 1,229 self-identified rural and non-rural transgender adults (18+ years) residing in the United States. Primary findings include significant differences in mental health between rural and non-rural transmen; relatively low levels of binge drinking across groups, although high levels of marijuana use; and high levels of unprotected sex among transwomen. The results confirm that mental and physical health services for transgender persons residing in rural areas are urgently needed.

  4. Improving Sanitation and Health in Rural Alaska

    Science.gov (United States)

    Bubenheim, David L.

    2013-01-01

    In rural Alaskan communities personal health is threatened by energy costs and limited access to clean water, wastewater management, and adequate nutrition. Fuel-­-based energy systems are significant factors in determining local accessibility to clean water, sanitation and food. Increasing fuel costs induce a scarcity of access and impact residents' health. The University of Alaska Fairbanks (UAF) School of Natural Resources and Agricultural Sciences (SNRAS), NASA's Ames Research Center, and USDA Agricultural Research Service (ARS) have joined forces to develop high-efficiency, low­-energy consuming techniques for water treatment and food production in rural circumpolar communities. Methods intended for exploration of space and establishment of settlements on the Moon or Mars will ultimately benefit Earth's communities in the circumpolar north. The initial phase of collaboration is completed. Researchers from NASA Ames Research Center and SNRAS, funded by the USDA­-ARS, tested a simple, reliable, low-energy sewage treatment system to recycle wastewater for use in food production and other reuse options in communities. The system extracted up to 70% of the water from sewage and rejected up to 92% of ions in the sewage with no carryover of toxic effects. Biological testing showed that plant growth using recovered water in the nutrient solution was equivalent to that using high-purity distilled water. With successful demonstration that the low energy consuming wastewater treatment system can provide safe water for communities and food production, the team is ready to move forward to a full-scale production testbed. The SNRAS/NASA team (including Alaska students) will design a prototype to match water processing rates and food production to meet rural community sanitation needs and nutritional preferences. This system would be operated in Fairbanks at the University of Alaska through SNRAS. Long­-term performance will be validated and operational needs of the

  5. Evaluating the rural health placements of the Rural Support Network ...

    African Journals Online (AJOL)

    2011-10-19

    Oct 19, 2011 ... Objectives: The Rural Support Network (RSN) is an undergraduate student society that aims to raise awareness among the .... social ... the depth of the problems associated with what we .... Improvements in planning (n = 7), advertising (n = 1) and ... of daily journals during the placements as reflective tools.

  6. Rural-urban disparities in school nursing: implications for continuing education and rural school health.

    Science.gov (United States)

    Ramos, Mary M; Fullerton, Lynne; Sapien, Robert; Greenberg, Cynthia; Bauer-Creegan, Judith

    2014-01-01

    Little is known about the professional and educational challenges experienced by rural school nurses. We conducted this study to describe disparities between the urban and rural professional school nurse workforce in New Mexico and to identify how best to meet the continuing education needs of New Mexico's rural school nurse workforce. We analyzed state data from a 2009 New Mexico Department of Health school nurse workforce survey (71.7% response rate). We included all survey respondents who indicated working as a school nurse in a public school setting in any grade K-12 and who identified their county of employment (N = 311). Rural school nurses were twice as likely as metropolitan nurses to provide clinical services to multiple school campuses (67.3% compared to 30.1%, P LGBT) health (P = .0004), and suicide risk identification and prevention (P = .015). Online courses and telehealth were identified by rural school nurses as among the preferred means for receiving continuing education. Our findings support the provision of online courses and telehealth content to address urban-rural disparities in school nursing education and support rural school health. © 2014 National Rural Health Association.

  7. Formulating a coastal zone health metric for landuse impact management in urban coastal zones.

    Science.gov (United States)

    Anilkumar, P P; Varghese, Koshy; Ganesh, L S

    2010-11-01

    The need for ICZM arises often due to inadequate or inappropriate landuse planning practices and policies, especially in urban coastal zones which are more complex due to the larger number of components, their critical dimensions, attributes and interactions. A survey of literature shows that there is no holistic metric for assessing the impacts of landuse planning on the health of a coastal zone. Thus there is a need to define such a metric. The proposed metric, CHI (Coastal zone Health Indicator), developed on the basis of coastal system sustainability, attempts to gauge the health status of any coastal zone. It is formulated and modeled through an expert survey and pertains to the characteristic components of coastal zones, their critical dimensions, and relevant attributes. The proposed metric is applied to two urban coastal zones and validated. It can be used for more coast friendly and sustainable landuse planning/masterplan preparation and thereby for the better management of landuse impacts on coastal zones.

  8. Rural Health and Spiritual Care Development: A Review of Programs across Rural Victoria, Australia.

    Science.gov (United States)

    Carey, Lindsay B; Hennequin, Christine; Krikheli, Lillian; O'Brien, Annette; Sanchez, Erin; Marsden, Candace R

    2016-06-01

    Given declining populations in rural areas and diminishing traditional religious support, this research explores whether spiritual care education programs would be beneficial for and appreciated by those working in rural health and/or community organizations. An overview of literature identified three dominant rural health issues affecting the provision of spiritual care in rural areas, namely the disparity between rural and urban areas in terms of resources, the lack of access to services, plus the need for education and training within rural areas. Spiritual Health Victoria Incorporated (Victoria, Australia) sought to address these issues with the implementation of a variety of spiritual education programs within rural areas. Results of an evaluation of these programs are presented specifying participant demographics, reasons why participants attended, their evaluation of the program and any recommendations for future programs. In overall terms, the results indicated that at least 90% of participants favorably rated their attended program as either 'very good' or 'good' and indicated that the main reason for their attendance was to develop their own education and/or practice of spiritual care within their rural context for the benefit of local constituents. Several recommendations are made for future programs.

  9. Telemedicine and rural health care applications

    Directory of Open Access Journals (Sweden)

    Smith Anthony

    2005-01-01

    Full Text Available Telemedicine has the potential to help facilitate the delivery of health services to rural areas. In the right circumstances, telemedicine may also be useful for the delivery of education and teaching programmes and the facilitation of administrative meetings. In this paper reference is made to a variety of telemedicine applications in Australia and other countries including telepaediatrics, home telehealth, critical care telemedicine for new born babies, telemedicine in developing countries, health screening via e-mail, and teleradiology. These applications represent some of the broad range of telemedicine applications possible. An overriding imperative is to focus on the clinical problem first with careful consideration given to the significant organisational changes which are associated with the introduction of a new service or alternative method of service delivery. For telemedicine to be effective it is also important that all sites involved are adequately resourced in terms of staff, equipment, telecommunications, technical support and training. In addition, there are a number of logistical factors which are important when considering the development of a telemedicine service including site selection, clinician empowerment, telemedicine management, technological requirements, user training, telemedicine evaluation, and information sharing through publication.

  10. Understanding the Business Case for Telemental Health in Rural Communities.

    Science.gov (United States)

    Lambert, David; Gale, John; Hartley, David; Croll, Zachariah; Hansen, Anush

    2016-07-01

    Telemental health has been promoted to address long-standing access barriers to rural mental health care, including low supply and long travel distances. Examples of rural telemental health programs are common; there is a less clear picture of how widely implemented these programs are, their organization, staffing, and services. There is also a need to understand the business case for these programs and assess whether and how they might realize their promise. To address these gaps, a national study was conducted of rural telemental health programs including an online survey of 53 programs and follow-up interviews with 23 programs. This article describes the current landscape and characteristics of these programs and then examines their business case. Can rural telemental health programs be sustained within current delivery systems and reimbursement structures? This question is explored in four areas: need and demand, infrastructure and workforce, funding and reimbursement, and organizational fit and alignment.

  11. Indoor Air Pollution and Health Risks among Rural Dwellers in ...

    African Journals Online (AJOL)

    `123456789jkl''''#

    occurrence of air pollution related health problems among the rural dwellers, one questionnaire was administered to a male or ... with carbon dioxide in biomass smoke have been identified as ... approximate population size is put at 19,819.

  12. Transportation constraints to rural health accessibility in Ogun ...

    African Journals Online (AJOL)

    Open Access DOWNLOAD FULL TEXT Subscription or Fee Access. Transportation constraints to rural health accessibility in Ogun Waterside Local Government Area ... Secondary data was also sourced to serve as complement to the primary ...

  13. Climate change impacts on rural poverty in low-elevation coastal zones

    Science.gov (United States)

    Barbier, Edward B.

    2015-11-01

    This paper identifies the low-elevation coastal zone (LECZ) populations and developing regions most vulnerable to sea-level rise and other coastal hazards, such as storm surges, coastal erosion and salt-water intrusion. The focus is on the rural poor in the LECZ, as their economic livelihoods are especially endangered both directly by coastal hazards and indirectly through the impacts of climate change on key coastal and near-shore ecosystems. Using geo-spatially referenced malnutrition and infant mortality data for 2000 as a proxy for poverty, this study finds that just 15 developing countries contain over 90% of the world's LECZ rural poor. Low-income countries as a group have the highest incidence of poverty, which declines somewhat for lower middle-income countries, and then is much lower for upper middle-income economies. South Asia, East Asia and the Pacific and Sub-Saharan Africa account for most of the world's LECZ rural poor, and have a high incidence of poverty among their rural LECZ populations. Although fostering growth, especially in coastal areas, may reduce rural poverty in the LECZ, additional policy actions will be required to protect vulnerable communities from disasters, to conserve and restore key coastal and near-shore ecosystems, and to promote key infrastructure investments and coastal community response capability.

  14. Coaching mental health peer advocates for rural LGBTQ people.

    Science.gov (United States)

    Willging, Cathleen E; Israel, Tania; Ley, David; Trott, Elise M; DeMaria, Catherine; Joplin, Aaron; Smiley, Verida

    Lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) people are affected by mental health disparities, especially in rural communities. We trained peer advocates in rural areas in the fundamentals of mental health, outreach, education, and support for this population. The peer advocates were coached by licensed mental health professionals. We evaluated this process through iterative qualitative analysis of semi-structured interviews and written logs from coaches and advocates. The six major themes comprising the results centered on (1) coaching support, (2) peer advocate skills and preparation, (3) working with help seekers, (4) negotiating diversity, (5) logistical challenges in rural contexts, and (6) systemic challenges. We concluded that peer advocacy for LGBTQ people with mental distress offers an affirmative, community-based strategy to assist the underserved. To be successful, however, peer advocates will likely require ongoing training, coaching, and infrastructural support to negotiate contextual factors that can influence provision of community resources and support to LGBTQ people within rural communities.

  15. Reproductive health awareness among adolescent girls in rural Bangladesh.

    Science.gov (United States)

    Uddin, Md Jashim; Choudhury, Abdul Mannan

    2008-01-01

    This article presents the status of rural Bangladeshi adolescent girls' awareness about reproductive health. Analysis of data revealed that a sizable proportion of adolescent girls had incorrect knowledge or misconceptions about the fertile period, reproduction, sexually transmitted diseases, and HIV/AIDS. Age, education either of adolescents or their mothers, residence, and exposure to mass media were the significant predictors of adolescent girls' knowledge about reproductive health. Strong efforts are needed to improve awareness and to clarify misconceptions about reproductive health. Improved access to mass media and education could improve rural Bangladeshi adolescent girls' awareness about reproductive health.

  16. Collaborative mental health in rural and isolated Canada: stakeholder feedback.

    Science.gov (United States)

    Ryan-Nicholls, Kimberley D; Haggarty, John M

    2007-12-01

    This article presents research findings from the Rural and Isolated Working Group, one of six groups established by the Canadian Collaborative Mental Health Initiative (CCMHI). Funded through Health Canada's Primary Health Care Transition Fund, the goal of the CCMHI is to improve the mental health and well-being of Canadians by increasing collaboration among primary health care and mental health care providers, consumers, families, and caregivers. Qualitative data obtained from mental health care providers and consumers across all regions of Canada are presented in this article. Policy and regulation problems, barriers to mental health care access, service providers' perspectives of the challenges to consumer involvement, and solutions for addressing these issues are discussed. The article concludes by identifying how this research has informed and influenced initial steps toward mental health promotion and treatment of mental illness in rural and isolated Canada.

  17. Experience of the Checkerboard Area Health System in planning for rural health care.

    OpenAIRE

    1982-01-01

    The design of rural health care delivery systems often is based on concepts obtained from urban models. The implicit planning premises of successful urban models, however, may be inappropriate for many rural systems. An alternative model planned and implemented in the checkerboard region of rural northwest New Mexico has proved to be successful. This experience may be helpful to health care policymakers and planners confronted with environments that are not congruent with typical urban settin...

  18. The Health of Caregiving Grandmothers: A Rural-Urban Comparison

    Science.gov (United States)

    Bigbee, Jeri L.; Musil, Carol; Kenski, Diane

    2011-01-01

    Purpose: The purpose of this study was to compare the characteristics of rural versus urban caregiving grandmothers along with their physical and mental health status. Methods: A secondary analysis of data produced from the first wave of a longitudinal study of 485 Ohio grandmothers was conducted. Health status was measured using the SF-36 Health…

  19. Intergenerational and Urban-Rural Health Habits in Chinese Families

    Science.gov (United States)

    Li, Li; Lin, Chunqing; Cao, Haijun; Lieber, Eli

    2009-01-01

    Objective: To explore intergenerational health habits and compare differences between urban and rural families. Methods: A total of 2500 families with children ages 6-18 in China were surveyed regarding their health habits. Results: Urban families reported significantly greater food variety and more time exercising (for fathers and children) than…

  20. Kids into Health Careers: A Rural Initiative

    Science.gov (United States)

    Lauver, Lori S.; Swan, Beth Ann; West, Margaret Mary; Zukowsky, Ksenia; Powell, Mary; Frisby, Tony; Neyhard, Sue; Marsella, Alexis

    2011-01-01

    Purpose: To describe a project that introduces middle school and high school students living in Pennsylvania's rural geographic regions to nursing careers through outreach extended to students regardless of gender, ethnicity, or socioeconomic status. Method: The authors employed many strategies to inform students about careers in nursing. The…

  1. Portrait of a rural health graduate: exploring alternative learning spaces.

    Science.gov (United States)

    Ross, Andrew; Pillay, Daisy

    2015-05-01

    Given that the staffing of rural facilities represents an international challenge, the support, training and development of students of rural origin at institutions of higher learning (IHLs) should be an integral dimension of health care provisioning. International studies have shown these students to be more likely than students of urban origin to return to work in rural areas. However, the crisis in formal school education in some countries, such as South Africa, means that rural students with the capacity to pursue careers in health care are least likely to access the necessary training at an IHL. In addition to challenges of access, throughput is relatively low at IHLs and is determined by a range of learning experiences. Insight into the storied educational experiences of health care professionals (HCPs) of rural origin has the potential to inform the training and development of rural-origin students. Six HCPs of rural origin were purposively selected. Using a narrative inquiry approach, data were generated from long interviews and a range of arts-based methods to create and reconstruct the storied narratives of the six participants. Codes, categories and themes were developed from the reconstructed stories. Reid's four-quadrant model of learning theory was used to focus on the learning experiences of one participant. Alternative learning spaces were identified, which were made available through particular social spaces outwith formal lecture rooms. These offered opportunities for collaboration and for the reconfiguring of the participants' agency to be, think and act differently. Through the practices enacted in particular learning spaces, relationships of caring, sharing, motivating and mentoring were formed, which contributed to personal, social, academic and professional development and success. Learning spaces outwith the formal lecture theatre are critical to the acquisition of good clinical skills and knowledge in the development of socially accountable

  2. Research on the accessibility to health and educational services in the rural areas in Extremadura

    Directory of Open Access Journals (Sweden)

    Nieto Masot Ana

    2015-03-01

    Full Text Available As the competent laws on Health and Education of the Extremaduran Government read, all the Extremaduran people have the right to their benefits, irrespective of their social, economic and cultural characteristics. Nevertheless, in the Region of Extremadura there are still differences between the rural and urban areas, so, studying how the Extremaduran people can access, with the same conditions, to those services considered basic, such as health and education, is very significant. Using techniques as Network Analyst and the interpolation method IDW, we can note that in Extremadura there are still zones with a very-far- from- laws reality, rural areas with a difficult access to the named services and equipment due to the location on low developed in population and economy areas, and very far from the main communication roads

  3. Community Health Centers and the Rural Economy: The Struggle for Survival.

    Science.gov (United States)

    National Rural Health Association, Kansas City, MO.

    The intent of this project was to determine the financial impact of the rural economic crisis on rural community health centers. A 1986-87 survey reported changes in accounts receivable, bad debt, and sliding fee use, and the effect such changes may have on the cash position of rural community health centers. Of 284 rural community and migrant…

  4. Evaluation of computerized health management information system for primary health care in rural India

    OpenAIRE

    Singh Satyavir; Yadav Kapil; Nongkynrih Baridalyne; Krishnan Anand; Gupta Vivek

    2010-01-01

    Abstract Background The Comprehensive Rural Health Services Project Ballabgarh, run by All India Institute of Medical Sciences (AIIMS), New Delhi has a computerized Health Management Information System (HMIS) since 1988. The HMIS at Ballabgarh has undergone evolution and is currently in its third version which uses generic and open source software. This study was conducted to evaluate the effectiveness of a computerized Health Management Information System in rural health system in India. Met...

  5. [The green rural economy: challenges to research and to public health policies posed by agricultural modernization].

    Science.gov (United States)

    Rigotto, Raquel Maria; Carneiro, Fernando Ferreira; Marinho, Alice Maria Correia Pequeno; Rocha, Mayara Melo; Ferreira, Marcelo José Monteiro; Pessoa, Vanira Matos; Teixeira, Ana Cláudia de Araújo; da Silva, Maria de Lourdes Vicente; Braga, Lara de Queiroz Viana; Teixeira, Maiana Maia

    2012-06-01

    In this paper, we ask ourselves who should, can and has the will to promote health in the rural zone today. The fields of science and public policy were chosen as our primary focus of dialogue conducted from the perspective of the right to health and a healthy environment. Seven lessons emerged: (1) in addition to the surveillance of isolated chemical risks, the relation between agrochemicals and health should be investigated in the context of conservative agricultural modernization; (2) it is mandatory and urgent to discover the health problems related to the use of agrochemicals; (3) the State has been successful in its support of agribusiness, but highly inefficient at enforcing policies to safeguard social rights; (4) sectors of society linked to rural organizations have played an important role in the public policies combating agrochemicals and protecting health; (5) studies must help deconstruct the myths surrounding the Green Revolution model; (6) we are faced with the challenge of contributing to the construction of an emerging scientific paradigm founded on an ethical-political commitment to the most vulnerable social elements; (7) rural communities are creating agro-ecological alternatives for life in semiarid areas.

  6. Effects of rural-urban return migration on women's family planning and reproductive health attitudes and behavior in rural China.

    Science.gov (United States)

    Chen, Jiajian; Liu, Hongyan; Xie, Zhenming

    2010-03-01

    This study examines the effects of rural-urban return migration on women's family planning and reproductive health attitudes and behavior in the sending areas of rural China. Based on data from a survey of rural women aged 16-40 in Sichuan and Anhui Provinces in 2000, our study finds that migrant women returning from cities to the countryside, especially those who have been living in a large city, are more likely than nonmigrant women to adopt positive family planning and reproductive health attitudes and behavior in their rural communities of origin. We find, moreover, that living in a rural community where the prevalence of such return migrant women is higher is positively associated with new fertility and gender attitudes and with knowledge of self-controllable contraceptives. The findings of significant rural-urban return-migration effects have important policy implications for shaping family planning and reproductive health attitudes and behaviors in rural China.

  7. Assessing health literacy in rural settings: a pilot study in rural areas of Cluj County, Romania.

    Science.gov (United States)

    Pop, Oana M; Brînzaniuc, Alexandra; Sirlincan, Emanuela O; Baba, Catalin O; Chereches, Razvan M

    2013-12-01

    Health literacy improves knowledge and builds skills to help individuals make appropriate decisions regarding their health. Over the past 20 years, several studies have described associations between health literacy and health outcomes. With respect to Romania, evidence is scarce on the level of health literacy, as well as on its determinants. Thus, the objectives of this study were to briefly screen functional health literacy levels in a sample of rural inhabitants, to assess the relationship between health literacy and reported health status, as well as to explore health literacy determinants within this population. Data were collected between September-November 2010, in four villages in Cluj County, Romania, using a cross-sectional survey. The mean age of respondents in the sample was 56 years, with roughly half of respondents being retired. The brief screening of health literacy suggested inadequate to marginal levels within the sample. Significant associations were observed between health literacy score and education, and self-perceived health status, whereas the relationship between health literacy and gender, and the presence of a chronic disease was not statistically significant. Limited health literacy has been shown to be common in people who rated their health as poor, those who attended only middle school, and individuals lacking basic information about their body. In order to minimize the adverse effects of low health literacy on health and health outcomes, efforts should be invested in identifying and addressing the health needs of adults with low and marginal health literacy, especially in underserved areas such as rural and remote settings, where access to health-related information is limited.

  8. Health-Related Quality of Life and Health Service Utilization in Chinese Rural-to-Urban Migrant Workers

    Directory of Open Access Journals (Sweden)

    Chu-Hong Lu

    2015-02-01

    Full Text Available Objectives: The number of rural-to-urban migrant workers has been increasing rapidly in China over recent decades, but there is a scarcity of data on health-related quality of life (HRQOL and health service utilization among Chinese rural-to-urban migrant workers in comparison to local urban residents. We aimed to address this question. Methods: This was a cross-sectional study of 2315 rural-to-urban migrant workers and 2347 local urban residents in the Shenzhen-Dongguan economic zone (China in 2013. Outcomes included HRQOL (measured by Health Survey Short Form 36 and health service utilization (self-reported. Results: Compared to local urban residents, rural-to-urban migrant workers had lower scores in all domains of HRQOL, and were more likely to report chronic illnesses (9.2% vs. 6.0%, adjusted OR = 1.62, 95% CI 1.28–2.04 and recent two-week morbidity (21.3% vs. 5.0%, adjusted OR = 5.41, 95% CI 4.26–6.88. Among individuals who reported sickness in the recent two weeks, migrant workers were much less likely to see a doctor (32.7% vs. 66.7%, adjusted OR = 0.21, 95% CI 0.13–0.36. Conclusions: Chinese rural-to-urban migrant workers have lower HRQOL, much more frequent morbidity, but are also much less likely to see a doctor in times of sickness as compared to local urban residents, indicating the existence of significant unmet medical care needs in this population.

  9. Community participation in rural health: a scoping review

    Directory of Open Access Journals (Sweden)

    Kenny Amanda

    2013-02-01

    Full Text Available Abstract Background Major health inequities between urban and rural populations have resulted in rural health as a reform priority across a number of countries. However, while there is some commonality between rural areas, there is increasing recognition that a one size fits all approach to rural health is ineffective as it fails to align healthcare with local population need. Community participation is proposed as a strategy to engage communities in developing locally responsive healthcare. Current policy in several countries reflects a desire for meaningful, high level community participation, similar to Arnstein’s definition of citizen power. There is a significant gap in understanding how higher level community participation is best enacted in the rural context. The aim of our study was to identify examples, in the international literature, of higher level community participation in rural healthcare. Methods A scoping review was designed to map the existing evidence base on higher level community participation in rural healthcare planning, design, management and evaluation. Key search terms were developed and mapped. Selected databases and internet search engines were used that identified 99 relevant studies. Results We identified six articles that most closely demonstrated higher level community participation; Arnstein’s notion of citizen power. While the identified studies reflected key elements for effective higher level participation, little detail was provided about how groups were established and how the community was represented. The need for strong partnerships was reiterated, with some studies identifying the impact of relational interactions and social ties. In all studies, outcomes from community participation were not rigorously measured. Conclusions In an environment characterised by increasing interest in community participation in healthcare, greater understanding of the purpose, process and outcomes is a priority for

  10. Health and health-related indicators in slum, rural, and urban communities: a comparative analysis

    Directory of Open Access Journals (Sweden)

    Blessing U. Mberu

    2016-12-01

    Full Text Available Background: It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. Objective: The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. Design: We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. Results: In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to

  11. Rural placements in Tasmania: do experiential placements and background influence undergraduate health science student's attitudes toward rural practice?

    Science.gov (United States)

    Dalton, Lisa M; Routley, Georgina K; Peek, Karla J

    2008-01-01

    Each year growing numbers of undergraduate health science students, from a variety of disciplines, participate in a University of Tasmania Department of Rural Health supported rural placement program in Tasmania. This study aimed to investigate the influence rural placement and rural background had on students' intentions to live and work in a rural or remote location after graduation. Between January 2005 and December 2006, 336 students participated in the placement program. Students were requested to complete a survey at the completion of their placement. A response rate of 239 was achieved (71%). The survey measured students' stated rural career intentions and rural background status according to location of primary and secondary school attendance. A demographic analysis of respondents was undertaken and results cross tabulated according to the rural, remote and metropolitan area (RRMA) classification system. Statistical analyses, including paired t-tests and a Wilcoxon signed rank test, were conducted to compare reported mean intention to practise rurally both prior to and after placement. The results from this survey show that rural placements in the undergraduate health science programs have a predominantly positive influence on students' intention to work in a rural community post-graduation. While these findings were significant for the disciplines of nursing, medicine and allied health, the results were not significant for pharmacy students. Students' average intention to practise rurally significantly increased after the placement for students from RRMA classifications 1 and 3-5. The value of rural placements as a method for increasing health science students' intentionality to take up rural practice as a positive and viable career option is considerable.

  12. Experimental Investigation of Land Mobile Prediction Methods and Modeling of Radio Planning Tool Parameters along Indian Rail Road Rural Zones

    Directory of Open Access Journals (Sweden)

    M. V. S. N. Prasad

    2008-01-01

    Full Text Available Mobile communication networks in rural zones were not given enough importance and emphasis unlike their urban counter parts due to the unattractive revenues and economic considerations for the cellular operators. In order to identify the suitable prediction methods for Indian rail road rural zones, train-based measurements were conducted in the northern and western rural zones along rail roads. These were carried out by recording the carriers emitted by the trackside base stations inside the moving train. The observed signal levels converted into path losses were compared initially with various conventional prediction methods. The observed results were also compared with the predicted results of radio planning tool utilizing digital terrain data. The constants of the model incorporated in the radio planning tool were tuned separately for north Indian and west Indian base stations based on the observed results. The suitability of the models has been evaluated in terms of standard statistical parameters.

  13. Influences on the choice of health professionals to practise in rural ...

    African Journals Online (AJOL)

    Influences on the choice of health professionals to practise in rural areas. ... Training health care professionals (HCPs) to work in rural areas is a ... Themes identified included personal, facilitating, contextual, staying and reinforcing factors.

  14. An interprofessional health assessment program in rural amateur sport.

    Science.gov (United States)

    Grace, Sandra; Coutts, Rosanne

    2017-01-01

    Effective interprofessional learning (IPL) in multisectoral collaborations such as those linking health services within communities can provide an authentic experience for students and also appears to be the most effective way to achieve health changes in targeted population groups. The aim of this study was to facilitate the IPL of students at a rural university in a multisectoral health assessment programme and to promote health in players of rural amateur sport. Two rural rugby league teams took part in three pre-season health assessments conducted by general medical practitioners, practice nurses, and nursing, osteopathy, and exercise science students. The Readiness for Interprofessional Learning Scale questionnaire and a series of focus groups were used to evaluate participants' experiences of the programme. Results indicated that students saw the benefits for patients and 93% valued the opportunity to improve interprofessional communication, problem-solving and team skills. Some students felt they needed to learn more about their own professional role before learning about others, and instances of stereotyping were identified. The programme also enabled early detection of potential health risks and referral for medical care, management of musculoskeletal conditions, and health promotion. These health assessments would be readily transferred to other multisectoral sporting settings.

  15. Information-Seeking Activity of Rural Health Practitioners.

    Science.gov (United States)

    Matsuda, Sandra; Donaldson, Joe F.

    The information-seeking activity (ISA) of 16 rural health practitioners (occupational, physical, and respiratory therapists; radiological technologists; speech/language pathologists; and nurses) was explored using qualitative methods of participant observation, document collection, and in-depth interviews. Field notes and documents were collected…

  16. The Wellness Mobile: Bringing Preventative Health Services to Rural Communities.

    Science.gov (United States)

    Nilson, Ralph; And Others

    1996-01-01

    The Wellness Mobile transports medical supplies, equipment, informational materials, and staff to rural Saskatchewan communities to assist them in developing wellness programs that stress disease prevention. Staff from the Wellness Mobile offer health-risk screening and appraisal to community members and work with local practitioners and schools…

  17. Mobile technology for health care in rural China

    Directory of Open Access Journals (Sweden)

    Zhao Ni

    2014-09-01

    Full Text Available With the proliferation of mobile technologies in China, the Chinese mobile medical applications market is growing rapidly. This may be particularly useful for Chinese rural populations who have limited access to quality medical care where mobile technologies can reach across geographic and socioeconomic boundaries and potentially increase access to care and improve health outcomes.

  18. Explaining Late Life Urban vs. Rural Health Discrepancies in Beijing

    Science.gov (United States)

    Zimmer, Zachary; Kaneda, Toshiko; Tang, Zhe; Fang, Xianghua

    2010-01-01

    Social characteristics that differ by place of residence are consequential for health. To study implications of this among older adults in rural vs. urban China, this study employs data from the Beijing municipality, a region that has witnessed growth and gaps in development. Life and active life expectancy is assessed using a multistate life…

  19. Food Insecurity and Rural Adolescent Personal Health, Home, and Academic Environments

    Science.gov (United States)

    Shanafelt, Amy; Hearst, Mary O.; Wang, Qi; Nanney, Marilyn S.

    2016-01-01

    Background: Food-insecure (FIS) adolescents struggle in school and with health and mental health more often than food-secure (FS) adolescents. Rural communities experience important disparities in health, but little is known about rural FIS adolescents. This study aims to describe select characteristics of rural adolescents by food-security…

  20. Health education: an experience in rural communities of Manabí, Ecuador

    Directory of Open Access Journals (Sweden)

    Noemi Bottasso

    2016-12-01

    Full Text Available Health is a very important issue for every human being. A person with deteriorated health can’t study, work and enjoy thoroughly of his/her life. Right to health is a fundamental right of every human being. Rural marginal zones of region Manabí inhabitants suffer serious difficulties in access of health services, for different reasons. With the objective of improve health access, we realized a training to 14 communities in order to introduce First Aid Kits with essential palliatives medication.As an alternative choice to improve access to health services, we promote an educational training of 14 rural communities, in order to bring in medicine and first-aid kits. The process has made considering the perspective of Participatory action research, Popular Education, Gender and the last, but not the least the perspective of human rights, as first requirement for its development.The educational process successfully concluded with empowerment of 12 Health Promoters and with the respective assignment of first-aid kits. It’s recommended to accomplish others activities to follow the project up, for example: an evaluative study, workshops to review, amplify and update the matters. Finally it would be important to replicate the process in these close communities that was excluded in this first phase. 

  1. Determinants of Black women's health in rural and remote communities.

    Science.gov (United States)

    Etowa, Josephine; Wiens, Juliana; Bernard, Wanda Thomas; Clow, Barbara

    2007-09-01

    The On the Margins project investigated health status, health-care delivery, and use of health services among African-Canadian women residing in rural and remote regions of the province of Nova Scotia. A participatory action research approach provided a framework for the study. Triangulation of data-collection methods--interviews, focus groups, and questionnaires--formed the basis of data generation. A total of 237 in-depth one-on-one interviews were conducted and coded verbatim. Atlas-ti data-management software was used to facilitate coding and analysis. Six themes emerged from the data: Black women's multiple roles, perceptions of health, experiences with the health-care system, factors affecting health, strategies for managing health, and envisioning solutions. The authors focus on 1 of these themes, factors affecting Black women's health, and discuss 3 subthemes: race and racism, poverty and unemployment, and access to health care.

  2. Sources of health information among rural women in Western Kentucky.

    Science.gov (United States)

    Simmons, Leigh Ann; Wu, Qishan; Yang, Nancy; Bush, Heather M; Crofford, Leslie J

    2015-01-01

    To identify sources of general and mental health information for rural women to inform the development of public health nursing interventions that consider preferences for obtaining information. One thousand women (mean age = 57 years; 96.9% White) living in primarily nonmetropolitan areas of Western Kentucky participated via a random-digit-dial survey. Data were collected on demographics, sources of health information, depression, and stigma. Most participants preferred anonymous versus interpersonal sources for both general (68.1%) and mental health (69.4%) information. All participants reported at least one source of general health information, but 20.8% indicated not seeking or not knowing where to seek mental health information. The Internet was the most preferred anonymous source. Few women cited health professionals as the primary information source for general (11.4%) or mental (9.9%) health. Public stigma was associated with preferring anonymous sources and not seeking information. Public health nurses should understand the high utilization of anonymous sources, particularly for mental health information, and focus efforts on helping individuals to navigate resources to ensure they obtain accurate information about symptoms, effective treatments, and obtaining care. Reducing stigma should remain a central focus of prevention and education in rural areas. © 2014 Wiley Periodicals, Inc.

  3. Transportation Matters: A Health Impact Assessment in Rural New Mexico

    Directory of Open Access Journals (Sweden)

    Michelle Del Rio

    2017-06-01

    Full Text Available This Health Impact Assessment (HIA informed the decision of expanding public transportation services to rural, low income communities of southern Doña Ana County, New Mexico on the U.S./Mexico border. The HIA focused on impacts of access to health care services, education, and economic development opportunities. Qualitative and quantitative data were collected from surveys of community members, key informant interviews, a focus group with community health workers, and passenger surveys during an initial introduction of the transit system. Results from the survey showed that a high percentage of respondents would use the bus system to access the following: (1 84% for health services; (2 83% for formal and informal education opportunities; and (3 81% for economic opportunities. Results from interviews and the focus group supported the benefits of access to services but many were concerned with the high costs of providing bus service in a rural area. We conclude that implementing the bus system would have major impacts on resident’s health through improved access to: (1 health services, and fresh foods, especially for older adults; (2 education opportunities, such as community colleges, universities, and adult learning, especially for young adults; and (3 economic opportunities, especially jobs, job training, and consumer goods and services. We highlight the challenges associated with public transportation in rural areas where there are: (1 long distances to travel; (2 difficulties in scheduling to meet all needs; and (3 poor road and walking conditions for bus stops. The results are applicable to low income and fairly disconnected rural areas, where access to health, education, and economic opportunities are limited.

  4. Transportation Matters: A Health Impact Assessment in Rural New Mexico.

    Science.gov (United States)

    Del Rio, Michelle; Hargrove, William L; Tomaka, Joe; Korc, Marcelo

    2017-06-13

    This Health Impact Assessment (HIA) informed the decision of expanding public transportation services to rural, low income communities of southern Doña Ana County, New Mexico on the U.S./Mexico border. The HIA focused on impacts of access to health care services, education, and economic development opportunities. Qualitative and quantitative data were collected from surveys of community members, key informant interviews, a focus group with community health workers, and passenger surveys during an initial introduction of the transit system. Results from the survey showed that a high percentage of respondents would use the bus system to access the following: (1) 84% for health services; (2) 83% for formal and informal education opportunities; and (3) 81% for economic opportunities. Results from interviews and the focus group supported the benefits of access to services but many were concerned with the high costs of providing bus service in a rural area. We conclude that implementing the bus system would have major impacts on resident's health through improved access to: (1) health services, and fresh foods, especially for older adults; (2) education opportunities, such as community colleges, universities, and adult learning, especially for young adults; and (3) economic opportunities, especially jobs, job training, and consumer goods and services. We highlight the challenges associated with public transportation in rural areas where there are: (1) long distances to travel; (2) difficulties in scheduling to meet all needs; and (3) poor road and walking conditions for bus stops. The results are applicable to low income and fairly disconnected rural areas, where access to health, education, and economic opportunities are limited.

  5. Responding to rural health disparities in the United States

    Directory of Open Access Journals (Sweden)

    Ian Jones

    2013-04-01

    Full Text Available The paper focuses on the need to address territorial inequalities in American healthcare services. It shows how much the situation has become critical in the United States. It discusses to what extent telemedicine is a sustainable option to reduce the negative consequences of the economic, professional and physical barriers to care in rural areas. As far as healthcare is concerned, rural and urban environments in the United States do not have to face the same barriers and challenges. The article first details what specific health issues have to be dealt with in rural areas. The case of emergency care in Vermont is then developed to illustrate what could be the benefits of using ICTs to improve access to care.

  6. Reproductive Health in a. Rural Ngvva Community

    African Journals Online (AJOL)

    It was found out that Ngwa women view reproductive health as vital t0 a woman's identity .... ber of their family and a guarantee for good treat— ment. The main purpose ..... health-seeking behaviour and notions among the people. Conclusions ...

  7. Health Literacy in Rural Areas of China: Hypertension Knowledge Survey

    Directory of Open Access Journals (Sweden)

    Hude Quan

    2013-03-01

    Full Text Available We conducted this study to determine levels and correlates of hypertension knowledge among rural Chinese adults, and to assess the association between knowledge levels and salty food consumption among hypertensive and non-hypertensive populations. This face-to-face cross sectional survey included 665 hypertensive and 854 non-hypertensive respondents in the rural areas of Heilongjiang province, China. Hypertension knowledge was assessed through a 10-item test; respondents received 10 points for each correct answer. Among respondents, the average hypertension knowledge score was 26 out of a maximum of 100 points for hypertensive and 20 for non-hypertensive respondents. Hypertension knowledge was associated with marital status, education, health status, periodically reading books, newspapers or other materials, history of blood pressure measurement, and attending hypertension educational sessions. Hypertension knowledge is extremely low in rural areas of China. Hypertension education programs should focus on marginal populations, such as individuals who are not married or illiterate to enhance their knowledge levels. Focusing on educational and literacy levels in conjunction with health education is important given illiteracy is still a prominent issue for the Chinese rural population.

  8. Health literacy in rural areas of China: hypertension knowledge survey.

    Science.gov (United States)

    Li, Xia; Ning, Ning; Hao, Yanhua; Sun, Hong; Gao, Lijun; Jiao, Mingli; Wu, Qunhong; Quan, Hude

    2013-03-18

    We conducted this study to determine levels and correlates of hypertension knowledge among rural Chinese adults, and to assess the association between knowledge levels and salty food consumption among hypertensive and non-hypertensive populations. This face-to-face cross sectional survey included 665 hypertensive and 854 non-hypertensive respondents in the rural areas of Heilongjiang province, China. Hypertension knowledge was assessed through a 10-item test; respondents received 10 points for each correct answer. Among respondents, the average hypertension knowledge score was 26 out of a maximum of 100 points for hypertensive and 20 for non-hypertensive respondents. Hypertension knowledge was associated with marital status, education, health status, periodically reading books, newspapers or other materials, history of blood pressure measurement, and attending hypertension educational sessions. Hypertension knowledge is extremely low in rural areas of China. Hypertension education programs should focus on marginal populations, such as individuals who are not married or illiterate to enhance their knowledge levels. Focusing on educational and literacy levels in conjunction with health education is important given illiteracy is still a prominent issue for the Chinese rural population.

  9. Mental Health in Rural Caregivers of Persons With Dementia

    Directory of Open Access Journals (Sweden)

    Alexandra J. Werntz

    2015-12-01

    Full Text Available Informal caregiving for dementia is common and often affects caregiver mental health. In addition to typical stressors faced by caregivers of persons with dementia (PWDs, rural caregivers often face additional stressors associated with living in more remote locations; unfortunately, this group is largely understudied. Ninety-three caregiver–PWD dyads completed measures of social support, perceived control, self-efficacy, burden, and cognitive functioning. Measures of PWD activities of daily living and mental functioning were also collected. These variables were hypothesized to predict caregiver self-reported symptoms of depression, anxiety, and stress. Contrary to predictions, only caregiving-related self-efficacy and caregiver burden predicted the caregiver’s mental health. Future interventions for improving rural caregiver self-reported mental health should target cognitions associated with caregiving self-efficacy and caregiver burden. Health care providers for rural families should focus on ways to reduce feelings of caregiver burden and provide caregivers with useful skills and tools for caregiving.

  10. Awareness and perception regarding health insurance in Bangalore rural population

    Directory of Open Access Journals (Sweden)

    Suwarna Madhukumar

    2012-04-01

    Full Text Available Background: Awareness and perception regarding health insurance was still very preliminary. Although health insurance is not a new concept and people are also getting familiar with it, yet this awareness has not reached to the level of subscription of health insurance products. Insurance as not been able to make inroads in the rural areas because of key reasons such as high cost of delivery and low awareness among the rural population about insurance products. There is a felt need to provide financial protection to rural families for the treatment of major ailments, requiring hospitalization and surgery. The present study is an effort in the area of health insurance to assess the individuals’ awareness level and willingness to join and pay for it. The present study is an effort to examine what are the reasons behind those who have not in favour of subscription. Methods: Nandagudi a village in Bangalore rural district was selected because the Rural Health Training Centre of MVJ Medical College & RH is located. The houses were listed and by using systematic random sampling every 2nd house was included in the study. 331 houses were interviewed. The interview was taken either from the head of the family or the family member who takes financial decisions in the house. Data was collected and analysed. Findings were described in terms of proportions and percentages. Statistical analysis was performed by SPSS statistical package. Results: In our study population majority were males (94.9%, Hindus (60%, literate (85%,and manual workers (79.5%.Only one third of the houses were aware of health insurance but only 22% had health insurance coverage. The coverage was not for all family members. The subscription depended on education, socio–economic status, type of family. The willingness to pay a premium was Rs 500 per year in 31% of the families. It was observed that the main barriers for the subscription of health insurance were low income or uncertainty

  11. Analysis and environmental diagnosis of rural habitat in arid zones of the Province of San Juan, Argentina

    Directory of Open Access Journals (Sweden)

    María Guillermina Re

    2015-03-01

    Full Text Available This paper presents the environmental analysis on rural communities on arid zones of the province of San Juan. The objective of this research is to perform a diagnosis and to develop proposals for future improvements on this region. The analysis was carried out at two different scales: one on the natural environment (macro scale, and another one, on the humanized environment (micro scale, represented by the productive farms, considered as the core of the rural domestic and productive habitat. This research allowed a characterization of the environment and an understanding of the rules that structure the rural habitat in San Juan, and also to perform an evaluation and diagnosis of this type of rural habitat.

  12. Health and Civil War in Rural Burundi

    Science.gov (United States)

    Bundervoet, Tom; Verwimp, Philip; Akresh, Richard

    2009-01-01

    We combine household survey data with event data on the timing and location of armed conflicts to examine the impact of Burundi's civil war on children's health status. The identification strategy exploits exogenous variation in the war's timing across provinces and the exposure of children's birth cohorts to the fighting. After controlling for…

  13. Risky health seeking practice among pregnant women in rural Congo

    DEFF Research Database (Denmark)

    Hørby, Laila

    2007-01-01

    delays, Culture, Field and Capital, Democratic Republic Congo (DRC). Title: Risky health seeking practice, among pregnant women in rural Congo (DRC). Background Statement: Worldwide more than half a million women still die each year of pregnancy and childbirth related reasons. Most of these women live...... about 60 % of the women have a professional help at birth, and even fewer delivers in a health centre, which is far from the Unicef and WHO goal trying to combat high Maternal Mortality Rate (MMR). In the southern and rural part of DRC, is a small well equipped and well staffed dispensary and maternity...... professional assistance for normal pregnancy and delivery; delay in reaching an adequate medical facility, which includes accessibility, availability and cost of transportation and conditions of roads; and delays in obtaining the care needed to manage the situation. Following that I have analysed...

  14. Rural health efforts in the urban-dominated political economy: three Third World examples.

    Science.gov (United States)

    Donahue, J M

    1989-06-01

    The theme of this paper is to demonstrate that the urban preference in governmental health delivery programs does exists in capitalist and socialist political economies and that efficient rural health programs exist in capitalist and socialist developing countries. The purpose of the article is to determine strategies to promote accessible rural health care by studying 3 examples. In the State of Kerala, India between 1956-1959, land reforms were carried out, and political parties and agrarian cooperatives involving rural people were organized. rural needs were given top priority in this capitalist economy which resulted in agrarian reform, education, and health delivery. In 1971, food production increased to 5.4 million tons. During this period, the nutritional status rose, the mortality rated declined, and the fertility rates decreased. Thus, the health status for the rural population improved. Bolivia's Montero health program was developed in 1975. This case demonstrates the urban/rural conflict in a capitalist economy with preference given to the urban side. This proposed health program resulted in the urban communities receiving greater resources compared to the rural population. This result is attributed to lack of organization within the rural population. The final case examined was Nicaragua which in 1979 was socialist. The National Unified Health System was established by the Sandinistas and had 4 priorities: revolution defense, economy, education, and health. This movement by the Sandinistas addressed rural health problems and challenged the urban medical organization. Health care workers were trained to deliver more curative and preventative services. The Popular Health Councils in Nicaragua is unique; it provides discussion regarding the urban/rural conflict. A change in the Minister of Health also indicated concern for rural health care delivery. Nicaragua's health status also improved as a result of rural organization. From the 3 cases, it was

  15. Adaptation to study design challenges in rural health disparities community research

    Science.gov (United States)

    Intervention research in rural health disparities communities presents challenges for study design, implementation, and evaluation, thus threatening scientific rigor, reducing response rates, and confounding study results. A multisite nutrition intervention was conducted in the rural Lower Mississip...

  16. Medical student attitudes before and after participation in rural health fairs

    Directory of Open Access Journals (Sweden)

    David C Landy

    2012-01-01

    Full Text Available Background: Despite an increased need, residents of rural communities have decreased access to healthcare and oftenpresentuniquehealthcare challenges associated with their rurality. Ensuring medical students receive adequate exposure to these issues is complicated by the urban location of most medical schools. Health fairs (fairs conducted in rural communities can provide students exposure to ruralhealth;however, it is unknown how participation affects attitudes regarding these issues. Materials and Methods: During the 2010-2011 academic year, first-year medical students were surveyed before and after participating in a rural fair regarding the importance of rural health issues, the need for exposure to rural healthcare, their plans to practice in a rural community,andthe educational impact of fairs. Results : Of the 121participating students, 77% and 61% completed pre- and post-fair surveys, respectively. Few had lived in a rural area or planned to practice primary care. Participants strongly agreed that the delivery of healthcare in rural areas was important, and that all physicians should receive rural health training (4.8 and 3.7 out of 5, respectively despite less than halfplanning to practice in a rural community.After participating in a rural fair, student attitudes were unchanged, although 87% of participants strongly agreed their involvement had contributed to improving patient health and 70% that the fairs provided rural medicine experience. Conclusions : Among urban medical school students with varied interests in primary care, there was strong interest in volunteering at rural fairs and appreciation for the importance of rural health. Fairs provided interested students with rural medicine experience that reinforced student attitudes regarding rural health. Further, students felt their participation improved patient health.

  17. [Health, work and environment at the Brazilian rural].

    Science.gov (United States)

    Peres, Frederico

    2009-01-01

    This manuscript discusses the implications of the productive paradigm changes in health and environment of rural area of Brazil. It analyzes production, economy and demography data, facing social and structural determinants with health and environmental reflexes, revealing a serious panorama that includes: a) environmental impacts associated to large productive chains, such as corn, soy-bean, cotton and sugar cane; b) chemical contamination of diverse environment compartments due to pesticides and fertilizers used in agriculture; c) the use of natural land in the expansion of agriculture and cattle farming activities; and d) the reflexes of these actions on individuals, workers or not, that are more and more forced to deal with extreme vulnerability situations because of the risk of rural work processes. Thus, the present article points that macro-determinants (or driven-forces) tends to configure the health status of Rural Brazil inhabitants which, day after day, face a series of challenges in order to guarantee dignity in their work and quality of life.

  18. Occupational health and the rural worker: agriculture, mining, and logging.

    Science.gov (United States)

    Pratt, D S

    1990-10-01

    More than 50 million Americans live in rural areas. These rural residents often work for small businesses or in the extraction industries (farming, mining, and logging). Because of the size of the businesses, the mandate of the Occupation Safety and Health Administration (OSHA) does not cover these workers and they are seldom afforded the same protection as urban workers. This review focuses on the special health problems facing farm workers, farmers, miners, and loggers. Farm workers are often ill and are affected by psychological illness, injuries, parasites, skin diseases, and the dangers of agrichemicals. Farm owners also face the hazards of stress and have very high rates of suicide. In addition, they are often injured on the job and suffer the highest rate of job related fatality of any work group. The complex farm environment presents a continuous threat to the lungs. This danger has worsened with the increased use of confinement buildings for poultry, hogs, and cattle. As farming has changed with increased mechanization, attendant medical problems have arisen. These "illnesses of innovation" are important. Mining and logging also are dangerous occupations with acute and chronic problems including respiratory illness, vascular problems, and malignancy. The decade of the 1990s must be one of increased attention to rural occupational health care and research.

  19. From recipes to recetas: health beliefs and health care encounters in the rural Dominican Republic.

    Science.gov (United States)

    Babington, L M; Kelley, B R; Patsdaughter, C A; Soderberg, R M; Kelley, J E

    1999-01-01

    With the growing influx of immigrants from the Dominican Republic entering the U.S. yearly, it is important for nurses to become familiar with their traditional health beliefs and health care experiences. The purpose of this study was: (a) to identify health beliefs of rural Dominicans and (b) to describe health care encounters between rural Dominicans and a visiting team of U.S. nurses. The data on health beliefs were collected in six focus groups and were analyzed using content analysis techniques. Health encounter data were collected from 693 Dominicans as they presented to mobile clinics for care. Findings from the focus group interviews suggested that health beliefs fall into two major categories: physical and spiritual/mystical. The most frequently occurring health problems, summaries of medications dispensed, treatments provided, referrals made, and health teaching information are presented.

  20. Recommendations for health information technology implementation in rural hospitals.

    Science.gov (United States)

    Huang, Yuan-Han; Gramopadhye, Anand K

    2016-05-09

    Purpose - The purpose of this paper is to investigate violations against work standards associated with using a new health information technology (HIT) system. Relevant recommendations for implementing HIT in rural hospitals are provided and discussed to achieve meaningful use. Design/methodology/approach - An observational study is conducted to map medication administration process while using a HIT system in a rural hospital. Follow-up focus groups are held to determine and verify potential adverse factors related to using the HIT system while passing drugs to patients. Findings - A detailed task analysis demonstrated several violations, such as only relying on the barcode scanning system to match up with patient and drugs could potentially result in the medical staff forgetting to provide drug information verbally before administering drugs. There was also a lack of regulated and clear work procedure in using the new HIT system. In addition, the computer system controls and displays could not be adjusted so as to satisfy the users' expectations. Nurses prepared medications and documentation in an environment that was prone to interruptions. Originality/value - Recommendations for implementing a HIT system in rural healthcare facilities can be categorized into five areas: people, tasks, tools, environment, and organization. Detailed remedial measures are provided for achieving continuous process improvements at resource-limited healthcare facilities in rural areas.

  1. Role of AYUSH Doctors in Filling the Gap of Health Workforce Inequality in Rural India with Special Reference to National Rural Health Mission: A Situational Analysis

    Directory of Open Access Journals (Sweden)

    Janmejaya Samal

    2013-08-01

    Full Text Available Paucity of health workforce in rural India has always been a problem. Lack of interest of modern allopathic graduates in serving the rural poor has worsened the situation little more. The National Rural Health Mission brought an innovative concept of mainstreaming of AYUSH and revitalization of local health tradition by collocating AYUSH doctors at various rural health facilities such as community health centers and primary health centers. In this context a study was aimed, based on secondary data, to make a situational analysis of health workforce in rural India and thereby analyzing the status and role of AYUSH Doctors in filling this gap of health workforce inequality. As on 01/01/2010 there were 61% of Ayurveda, 31.40% of Homoeopathy, 6.50% of Unani, 0.90% of Siddha and 0.20% of Naturopathy doctors serving in India. AYUSH facilities had been collocated in 240 district hospitals, 1716 community health centers and 8938 primary health centers in 2010. About 39.8% District Hospitals (DH, 38% Community Health Centers (CHC and 38.2% Primary Health Centers (PHC had been collocated with AYUSH facilities by 2010. About 30.9 lakhs rural population were being served by district hospitals, 4.3 lakhs of rural population were being served by CHCs and 0.8 lakhs of rural population were being served by PHCs in various states/UTs wherever the corresponding facilities exist. Equitable distribution of health workforce is of paramount importance in achieving both the horizontal and vertical health equity in rural India which is doable with proper implementation of AYUSH workforce.

  2. Human resource development in rural health care facilities.

    Science.gov (United States)

    Johnson, L

    1991-01-01

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

  3. Rural Health Care Information Access and the Use of the Internet: Opportunity for University Extension

    Science.gov (United States)

    Das, Biswa R.; Leatherman, John C.; Bressers, Bonnie M.

    2015-01-01

    The Internet has potential for improving health information delivery and strengthening connections between rural populations and local health service providers. An exploratory case study six rural health care markets in Kansas showed that about 70% of adults use the Internet, with substantial use for accessing health information. While there are…

  4. Rural Public Libraries as Community Change Agents: Opportunities for Health Promotion

    Science.gov (United States)

    Flaherty, Mary Grace; Miller, David

    2016-01-01

    Rural residents are at a disadvantage with regard to health status and access to health promotion activities. In many rural communities, public libraries offer support through health information provision; there are also opportunities for engagement in broader community health efforts. In a collaborative effort between an academic researcher and a…

  5. Rural Public Libraries as Community Change Agents: Opportunities for Health Promotion

    Science.gov (United States)

    Flaherty, Mary Grace; Miller, David

    2016-01-01

    Rural residents are at a disadvantage with regard to health status and access to health promotion activities. In many rural communities, public libraries offer support through health information provision; there are also opportunities for engagement in broader community health efforts. In a collaborative effort between an academic researcher and a…

  6. Good Health Status of Rural Women in the Reproductive Ages

    Directory of Open Access Journals (Sweden)

    Joan Rhule

    2009-07-01

    Full Text Available Background: Women are traditionally over represented among the poor and therefore in the long run, have less access to remuneration and health resources, including health insurance and social security services. Women are disadvantaged on some fundamental economic indicators such as unemployment and access to economic resources. In 2007 in Jamaica, for instance among the 124 500 unemployed persons in the labour force, 65.4% were women (Planning Institute of Jamaica, 2008. Thus, women's health and the control that they can exercise over resources are key factors in achieving effectiveness, efficiency, and sustainability in health interventions. Aims and Objectives: This study examined the good health status of rural women in the reproductive ages of 15 to 49 years. Having extensively reviewed the literature, this paper is the first study of its kind in Jamaica and will provide pertinent information on this cohort for the purpose of public health planning. Method/Study Design: The current research extracted a sample of 3450 respondents who indicated that they were rural women ages 15 to 49 years. This sample was taken from a national cross-sectional survey from the 14 parishes in Jamaica. The survey used a stratified random probability sampling technique to draw the original 25 018 respondents. The non-response rate for the survey was 29.7%. Descriptive statistics were used to provide background information on the sample and logistic regression was used to establish a good health model. Results/Findings: Using logistic regression analyses, 6 variables emerged as statistically significant predictors of current good health status of rural women (i.e. ages 15 to 49 years in Jamaica. These are social standing (two wealthiest quintile – OR=0.524, 95%CI: 0.350,0.785; marital status (separated, divorced or widowed – OR=0.382, 95%CI: 0.147, 0.991; health insurance (OR=0.041, 95%CI: 0.024, 0.069; negative affective psychological conditions (OR=0.951, 95

  7. The Health Status and Unique Health Challenges or Rural Older Adults in California

    OpenAIRE

    Durazo, Eva; Jones, Melissa; Wallace,Steven; Van Arsdale, Jessica; Aydin, May; Stewart, Connie

    2011-01-01

    Despite living in the countryside where open space is plentiful and there is often significant agricultural production, rural older adults have higher rates of overweight/obesity, physical inactivity and food insecurity than older adults living in suburban areas. All three conditions are risk factors for heart disease, diabetes and repeated falls. This policy brief examines the health of rural elders and, by contrast, their urban counterparts, and finds that both groups lmost one in five Cali...

  8. RURAL FARMERS’ PERCEPTION OF CLIMATE CHANGE IN CENTRAL AGRICULTURAL ZONE OF DELTA STATE, NIGERIA

    Directory of Open Access Journals (Sweden)

    A.U. Ofuoku

    2011-10-01

    Full Text Available Farmer perception of their environment is a factor of climate change. Adaptation to climate change requires farmers to realize that the climate has changed and they must identify useful adaptations and implement them. This study analyzed the per-ception of climate change among rural farmers in central agri-cultural zone of Delta State, Nigeria. Climate change studies often assume certain adaptations and minimal examination of how, when, why, and conditions under which adaptations usually take place in any economic and social systems. The study was conducted by survey method on 131 respondents using struc-tured interview schedule and questionnaire. Data were analyzed with descriptive statistics and linear regression model to test that education, gender, and farming experience influenced farmers’ perception of climate change. The results showed that the farmers were aware of climate change. The identified causes of climate change were ranging from intensified agriculture, population explosion, increased use of fossil fuel, loss of in-digenous know practice to gas flaring. The effects of climate change on crops and livestocks were also identified by the rural farmers. Many of the farmers adapted to climate change by planting trees, carrying out soil conservation practice, changing planting dates, using different crop varieties, installing fans in livestock pens, and applying irrigation. Almost half of them did not adapt to climate change. The linear regression analysis revealed that education, gender, and farming experience influ-enced farmers’ perception of climate change. The major barriers to adaptation to climate change included lack of information, lack of money, and inadequate land.

  9. Health Information Technology: An Expanded Care Coordination in Rural Tennessee.

    Science.gov (United States)

    Wodarski, John S; Green, Philip D

    2015-01-01

    The Expanded Care Coordination through the Use of Health Information Technology in Rural Tennessee was a 3-year initiative implemented by The University of Tennessee Children's Mental Health Services Research Center and the Helen Ross McNabb Center Regional Mental Health System. The program targeted rural adults in the East Tennessee area. This intervention utilized the Alcohol Use Disorder Identification Test (AUDIT), Drug Abuse Screening Test (DAST), and AC-COD screening tools. After the initial screening, the appropriate level of intervention was assessed. Clients completed modules on the program's website and met with a clinician for a minimum for four face-to-face meetings. Alcohol use and drug use declined significantly over the course of the program. Alcohol use and outpatient treatment for alcohol and substance abuse declined significantly over the course of the program. There were also significant decreases in days of probations, depression, physical complaints, and violent behaviors. Health information technology is becoming more common in mental health treatment facilities. However, more testing needs to be done with larger samples to assess the efficacy of the program.

  10. Building consensus on key priorities for rural health care in South Africa using the Delphi technique

    Directory of Open Access Journals (Sweden)

    Marije Versteeg

    2013-01-01

    Full Text Available Background: South Africa is currently undergoing major health system restructuring in an attempt to improve health outcomes and reduce inequities in access. Such inequities exist between private and public health care and within the public health system itself. Experience shows that rural health care can be disadvantaged in policy formulation despite good intentions. The objective of this study was to identify the major challenges and priority interventions for rural health care provision in South Africa thereby contributing to pro-rural health policy dialogue. Methods: The Delphi technique was used to develop consensus on a list of statements that was generated through interviews and literature review. A panel of rural health practitioners and other stakeholders was asked to indicate their level of agreement with these statements and to rank the top challenges in and interventions required for rural health care. Results: Response rates ranged from 83% in the first round (n=44 to 64% in the final round (n=34. The top five priorities were aligned to three of the WHO health system building blocks: human resources for health (HRH, governance, and finance. Specifically, the panel identified a need to focus on recruitment and support of rural health professionals, the employment of managers with sufficient and appropriate skills, a rural-friendly national HRH plan, and equitable funding formulae. Conclusion: Specific policies and strategies are required to address the greatest rural health care challenges and to ensure improved access to quality health care in rural South Africa. In addition, a change in organisational climate and a concerted effort to make a career in rural health appealing to health care workers and adequate funding for rural health care provision are essential.

  11. Factors shaping interactions among community health workers in rural Ethiopia: rethinking workplace trust and teamwork.

    Science.gov (United States)

    Dynes, Michelle M; Stephenson, Rob; Hadley, Craig; Sibley, Lynn M

    2014-01-01

    Worldwide, a shortage of skilled health workers has prompted a shift toward community-based health workers taking on greater responsibility in the provision of select maternal and newborn health services. Research in mid- and high-income settings suggests that coworker collaboration increases productivity and performance. A major gap in this research, however, is the exploration of factors that influence teamwork among diverse community health worker cadres in rural, low-resource settings. The purpose of this study is to examine how sociodemographic and structural factors shape teamwork among community-based maternal and newborn health workers in Ethiopia. A cross-sectional survey was conducted with health extension workers, community health development agents, and traditional birth attendants in 3 districts of the West Gojam Zone in the Amhara region of Ethiopia. Communities were randomly selected from Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) sites; health worker participants were recruited using a snowball sampling strategy. Fractional logit modeling and average marginal effects analyses were carried out to identify the influential factors for frequency of work interactions with each cadre. One hundred and ninety-four health workers participated in the study. A core set of factors-trust in coworkers, gender, and cadre-were influential for teamwork across groups. Greater geographic distance and perception of self-interested motivations were barriers to interactions with health extension workers, while greater food insecurity (a proxy for wealth) was associated with increased interactions with traditional birth attendants. Interventions that promote trust and gender sensitivity and improve perceptions of health worker motivations may help bridge the gap in health services delivery between low- and high-resource settings. Inter-cadre training may be one mechanism to increase trust and respect among diverse health workers, thereby increasing

  12. TERRITORIAL DISCREPANCIES IN THE RURAL-URBAN FRINGE ZONE OF BUCHAREST

    Directory of Open Access Journals (Sweden)

    Florentina ION

    2015-06-01

    Full Text Available The rural-urban fringe area of Bucharest is the most economically dynamic region of Romania, and, at the same time, is the one, which suffered the most from the recent economic decline. The article is focused on the analysis of inequalities of social-economic variables, including differences in their spatial patterns, before and after the 2008 economic crisis. We involved two methods of inequality analysis. Gini coefficient was used to determine the overall level of inequalities in the region. Comparison with the region’s mean value was used for identification of spatial patterns of these inequalities. Our results highlight four trends in the overall level of inequality dynamics, while all the studied variables follow more or less accurately the same pattern of spatial dynamics. Our findings provide new arguments in support of the idea that the new processes in the Bucharest fringe zone follow the circular pattern, which privileges the northern part of the area, while south is the last to benefit from any new development.

  13. Spatial Patterns of Soil Heavy Metals in Urban-Rural Transition Zone of Beijing

    Institute of Scientific and Technical Information of China (English)

    HU Ke-Lin; ZHANG Feng-Rong; LI Hong; HUANG Feng; LI Bao-Guo

    2006-01-01

    To identify the main sources responsible for soil heavy metal contamination, 70 topsoils were sampled from the Daxing County in the urban-rural transition zone of Beijing. The concentrations of heavy metals Cu, Zn, Pb, Cr, Cd, Ni,As, Se, Hg, and Co; the soil texture; and the organic matter content were determined for each soil sample. Descriptive statistics and geostatistics were used to analyze the data, and Kriging analysis was used to estimate the unobserved points and to map the spatial patterns of soil heavy metals. The results showed that the concentrations of all the soil heavy metals exceeded their background levels with the exception of As and Se. However, only the Cd concentration in some areas exceeded the critical value of the national soil quality standard. The semivariance analysis showed that the spatial correlation distances for soil Cu, Zn, Cr, Cd, As, Ni, and Co ranged from 4.0 to 7.0 km, but soil Se, Pb, and Hg had a larger correlation distance. Soil Co, Se, Cd, Cu and Zn showed a strong spatial correlation, whereas the other soil heavy metals showed medium spatial correlation. Soil heavy metal concentrations were related to soil texture, organic matter content, and the accumulation of heavy metals in the soils, which was because of air deposition and use of water from the Liangshui, Xinfeng, and Fenghe rivers that are contaminated by wastewater and sewage for the purpose of irrigation of fields. Hence, a comprehensive treatment plan for these rivers should be formulated.

  14. A technical framework for costing health workforce retention schemes in remote and rural areas

    NARCIS (Netherlands)

    Zurn, P.; Vujicic, M.; Lemiere, C.; Juquois, M.; Stormont, L.; Campbell, J.; Rutten, M.M.; Braichet, J.M.

    2011-01-01

    Background: Increasing the availability of health workers in remote and rural areas through improved health workforce recruitment and retention is crucial to population health. However, information about the costs of such policy interventions often appears incomplete, fragmented or missing, despite

  15. A technical framework for costing health workforce retention schemes in remote and rural areas

    NARCIS (Netherlands)

    Zurn, P.; Vujicic, M.; Lemiere, C.; Juquois, M.; Stormont, L.; Campbell, J.; Rutten, M.M.; Braichet, J.M.

    2011-01-01

    Background: Increasing the availability of health workers in remote and rural areas through improved health workforce recruitment and retention is crucial to population health. However, information about the costs of such policy interventions often appears incomplete, fragmented or missing, despite

  16. Developing of National Accreditation Model for Rural Health Centers in Iran Health System.

    Directory of Open Access Journals (Sweden)

    Jafar Sadegh Tabrizi

    2013-12-01

    Full Text Available The primary health care has notable effects on community health and accreditation is one of the appropriate evaluation methods that led to health system performance improvement, therefore, this study aims to developing of national accreditation model for rural health centers in Iran Health System.Firstly the suitable accreditation models selected to benchmarking worldwide via systematic review, the related books and medical university's web site surveyed and some interviews hold with experts. Then the obtain standards surveyed from the experts' perspectives via Delphi technique. Finally, the obtainedmodel assessedvia the experts' perspective and pilot study.The researchers identified JCAHO and CCHSA as the most excellent models. The obtained standards and their quality accepted from experts' perspective and pilot study, and finally the number of 55 standards acquired.The designed model has standards with acceptable quality and quantity, and researchers' hopeful that its application in rural health centers led to continues quality improvement.

  17. Job satisfaction of rural public and home health nurses.

    Science.gov (United States)

    Juhl, N; Dunkin, J W; Stratton, T; Geller, J; Ludtke, R

    1993-03-01

    Based on Vroom's expectancy theory, this study was conducted to identify differences in job satisfaction between nurses working in public health settings, and staff nurses and administrators working in both settings. Questionnaires containing an adaptation of a job satisfaction scale were mailed to all 258 registered nurses practicing in public health and home health settings (response rate 57%) in a rural midwestern state. Respondents were asked to rate their satisfaction with various dimensions of their jobs, as well as how important each aspect was to them. Although both groups of nurses reported low satisfaction with salary, public health nurses were significantly less satisfied with their salaries than were home health nurses (F = 32.96, P < or = 0.001); home health nurses, however, were significantly less satisfied with benefits/rewards (F = 11.85, P < or = 0.001), task requirements (F = 8.37, P < or = 0.05), and professional status (F = 5.30, P < or = 0.05). Although administrators did not differ significantly from staff nurses on job satisfaction, they did perceive organizational climate (F = 4.50, P < or = 0.05) to be an important feature of satisfaction. These differences may be partially explained by divergent salaries, roles, and responsibilities between public health and home health nurses.

  18. 42 CFR 440.20 - Outpatient hospital services and rural health clinic services.

    Science.gov (United States)

    2010-10-01

    ... Definitions § 440.20 Outpatient hospital services and rural health clinic services. (a) Outpatient hospital... agency may exclude from the definition of “outpatient hospital services” those types of items and... 42 Public Health 4 2010-10-01 2010-10-01 false Outpatient hospital services and rural health...

  19. Barriers and Enablers to Clinical Fieldwork Education in Rural Public and Private Allied Health Practice

    Science.gov (United States)

    Maloney, Phoebe; Stagnitti, Karen; Schoo, Adrian

    2013-01-01

    There is a need to maximise rural clinical fieldwork placement to build health workforce capacity. This study investigated allied health professionals' (AHPs) experience of supervising students as part of work-integrated learning in public and private rural health settings. An anonymous postal questionnaire with 30 questions was used to collect…

  20. 77 FR 51543 - National Advisory Committee on Rural Health and Human Services; Notice of Meeting

    Science.gov (United States)

    2012-08-24

    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Committee on Rural Health...-second meeting. Name: National Advisory Committee on Rural Health and Human Services. Dates and Times...:15 a.m. Place: Radisson Hotel & Suites Austin Downtown, 111 East Cesar Chavez Street, Austin,...

  1. VA Puget Sound Telemental Health Service to rural veterans: a growing program.

    Science.gov (United States)

    Barnwell, Sara V Smucker; Juretic, Meghan A; Hoerster, Katherine D; Van de Plasch, Richard; Felker, Bradford L

    2012-05-01

    The VA Puget Sound Health Care System Telemental Health program connects veterans with psychologists, psychiatrists, and social workers via live clinical video teleconferencing. Providers deliver care to veterans in rural Veteran Affairs medical centers, community-based outpatient clinics and residences, and thus, increase access to specialty mental health care for rural and medically underserved veteran communities.

  2. Strengthening rural Latinos' civic engagement for health: The Voceros de Salud project.

    Science.gov (United States)

    López-Cevallos, Daniel; Dierwechter, Tatiana; Volkmann, Kelly; Patton-López, Megan

    2013-11-01

    This article describes the Latino Health Ambassadors Network (Voceros de Salud ) project created to support and mobilize Latino community leaders to address health inequalities in a rural Oregon county. Voceros de Salud is discussed as a model that other rural communities may implement towards strengthening Latino civic engagement for health.

  3. The health perception rural community adolescents: between the ideal and the real

    Directory of Open Access Journals (Sweden)

    Anny Giselly Milhome da Costa

    2013-12-01

    Full Text Available This qualitative exploratory-descriptive study was performed by means of the Community Based Participant Research. The main objective was to understand the health perception of adolescents from a rural community. The focal group and field journal techniques were used to collect data from 26 adolescents of a rural community. The results were analyzed and qualitatively interpreted, expressed through two thematic categories that showed the ideal and real health conception of the adolescents. From this group’s perspective, the health of rural community adolescents is determined by positive and negative aspects, with reveal their perception of health and disease. It is concluded that nursing can reduce the distance between the ideal and real health in the rural community by taking hold of the sociocultural approach of becoming adolescent and developing intersectoral interventions to promote satisfactory sanitary conditions and encourage the adolescent’s potential as a social actor. Descriptors: Adolescent; Rural Population; Public Health; Health Education; Community Health Nursing.

  4. Urbanicity and Paediatric Bacteraemia in Ghana-A Case-Control Study within a Rural-Urban Transition Zone.

    Directory of Open Access Journals (Sweden)

    Peter Sothmann

    Full Text Available Systemic bacterial infections are a major cause of paediatric febrile illness in sub-Saharan Africa. Aim of this study was to assess the effects of social and geographical determinants on the risk of bacteraemia in a rural-urban transition zone in Ghana.Children below 15 years of age with fever were recruited at an outpatient department in the suburban belt of Kumasi, Ghana's second largest city. Blood was taken for bacterial culture and malaria diagnostics. The socio-economic status of participants was calculated using Principle Component Analysis. A scale, based on key urban characteristics, was established to quantify urbanicity for all communities in the hospital catchment area. A case-control analysis was conducted, where children with and without bacteraemia were cases and controls, respectively.Bacteraemia was detected in 72 (3.1% of 2,306 hospital visits. Non-typhoidal Salmonella (NTS; n = 24; 33.3% and Salmonella typhi (n = 18; 25.0% were the most common isolates. Logistic regression analysis showed that bacteraemia was negatively associated with urbanicity (odds ratio [OR] = 0.8; 95% confidence interval [CI]: 0.7-1.0 and socio-economic status (OR = 0.8; 95% CI: 0.6-0.9. Both associations were stronger if only NTS infections were used as cases (OR = 0.5; 95% CI: 0.3-0.8 and OR = 0.6; 95% CI: 0.4-1.0, respectively.The results of this study highlight the importance of individual as well as community factors as independent risk factors for invasive bacterial infection (IBI and especially NTS. Epidemiological data support physicians, public health experts and policy makers to identify disease prevention and treatment needs in order to secure public health in the transitional societies of developing countries.

  5. Effect of In-Vehicle Audio Warning System on Driver's Speed Control Performance in Transition Zones from Rural Areas to Urban Areas

    National Research Council Canada - National Science Library

    Yan, Xuedong; Wang, Jiali; Wu, Jiawei

    2016-01-01

    Speeding is a major contributing factor to traffic crashes and frequently happens in areas where there is a mutation in speed limits, such as the transition zones that connect urban areas from rural areas...

  6. Health Insurance Marketplaces: Premium Trends in Rural Areas.

    Science.gov (United States)

    Barker, Abigail R; Kemper, Leah M; McBride, Timothy D; Meuller, Keith J

    2016-05-01

    Since 2014, when the Health Insurance Marketplaces (HIMs) authorized by the Patient Protection and Affordable Care Act (ACA) were implemented, considerable premium changes have been observed in the marketplaces across the 50 states and the District of Columbia. This policy brief assesses the changes in average HIM plan premiums from 2014 to 2016, before accounting for subsidies, with an emphasis on the widening variation across rural and urban places. Since this brief focuses on premiums without accounting for subsidies, this is not intended to be an analysis of the "affordability" of ACA premiums, as that would require assessment of premiums, cost-sharing adjustments, and other factors.

  7. Gouvernance de l’eau potable et dynamiques locales en zone rurale au Bénin

    Directory of Open Access Journals (Sweden)

    Bernard G. Hounmenou

    2006-05-01

    écision ainsi que la participation des communautés à l’investissement et à la gestion des points d’eau. La concrétisation de cette volonté d’améliorer les systèmes d’alimentation en eau potable se traduit par exemple, par l’adhésion des communautés à travers leurs contributions financières à la réalisation des ouvrages et la mise en place de structures de gestion chargées de l’entretien et de la maintenance de ces derniers. Les structures de gestion ont entre autres tâches, de mobiliser la participation financière des populations à la construction des ouvrages, de fixer le prix de l’eau, de choisir les vendeurs et de gérer la maintenance des équipements. La nouvelle stratégie se traduit aussi par l’entrée dans le système local lié à la gouvernance de l’eau potable en zone rurale, de nouveaux acteurs tels que les collectivités locales (les nouvelles communes, les ONG, les entreprises du secteur privé et les organisations d’usagers d’eau, qui ont un fonctionnement assez proche de celui des entreprises sociales. A partir d’éléments empiriques, cet article se focalise sur les analyses liées aux dynamiques socio-économiques des acteurs impliqués dans le processus d’approvisionnement en eau des populations rurales au Bénin.In populations’ basic service supplying, the public policies, especially those of developing countries, have met deep changes in the last recent years. The most important changes are relative to the withdrawal of gratuitous public service. Beside the fundamental necessity of states to clean their economies, those reforms aim to favour populations’ participation in the management of operations linked to their needs satisfaction. The participation question constitutes actually a major element, for services organisation at community level. Indeed, several experiences have shown that the projects realised without the concerned populations’ participation, have failed at the execution moment, or by the lack

  8. Personal Factors as Determinants of Utilization of Development Information in Rural Communities of South-South Geo-Political Zone, Nigeria

    Science.gov (United States)

    Edet, Itari Paul; Bullem, Anthony Godwin; Okeme, Isaac

    2015-01-01

    This study investigated the extent to which personal factors relate to the utilization of development information in the rural communities of South-South Geo-political Zone, Nigeria. The study adopted the descriptive survey design. The population comprised all adult male and female rural dwellers from the three out of the six states in the Zone…

  9. Health-Related Quality of Life of Rural Clients Seeking Telepsychology Services

    Directory of Open Access Journals (Sweden)

    Kevin R. Tarlow

    2014-01-01

    Full Text Available Sixty million US residents live in rural areas, but health policies and interventions developed from an urban mindset often fail to address the significant barriers to health experienced by these local communities. Telepsychology, or psychological services delivered by distance via technology, is an emerging treatment modality with special implications for underserved rural areas. This study found that a sample of rural residents seeking telepsychology services (n=94 had low health-related quality of life (HRQOL, often due to cooccurring physical and mental health diagnoses including high rates of depression. However, a brief telepsychology treatment delivered to rural clients (n=40 was associated with an improvement in mental health-related quality of life (d = 0.70,  P<.001. These results indicate that despite the complex health needs of these underserved communities, telepsychology interventions may help offset the disparities in health service access in rural areas.

  10. Rural health under colonialism and neocolonialism: a survey of the Ghanaian experience.

    Science.gov (United States)

    Aidoo, T A

    1982-01-01

    This paper discusses some of the implications of colonialism and neocolonialism for rural health in Ghana. The starting point for discussion is a critical review of the dominant ahistorical, atheoretical, and technocratic conception of the underdevelopment of rural health. It is argued that the problems of rural health cannot be fully explained without a consideration of Ghana's colonial and neocolonial experiences. It is necessary to examine the impact of the colonial capitalist mode of production on rural health and health care, as well as the mechanisms underlying the post-colonial entrenchment of the colonial legacy. The implications of the reformist approach to the problems of health are examined, and the possibility of a structural transformationist solution, which must start from the elimination of imperialist control, is assessed. It is concluded that the Ghanaian social formation, given its current constitution and crises, makes structural transformation the only viable alternative to solving the problems of rural health.

  11. Evaluation of Mental Health Integration in Primary Health Care in View of Participants and Rural Health Workers of Dezful, Khuzestan

    Directory of Open Access Journals (Sweden)

    Khosrotaj

    2015-04-01

    Full Text Available Background Evaluation and determination of different achievements of interventions in health care is one of the important responsibilities of the health system. Objectives The aim of present study was to evaluate the integration of mental health program in the primary health care (PHC system in rural areas of Dezful district in view of participants and health workers. Patients and Methods In this descriptive-cross sectional research, which was done in rural areas of Dezful during year 2014, the main indexes of mentioned integration such as knowledge, attitude and performance of physicians, health workers and participants were measured. The data collection instrument was valid and reliable questionnaires, which are often used by the mental health department of the health ministry. Validity and reliability of questionnaires have frequently been confirmed by researchers in different studies. The study population included all 19 rural physicians, 89 health workers and a random sample of 15 - 60 year-old participants in the health network of Dezful. Frequency of distribution and computation of central and distribution indexes were used for data analysis. Results The amount of physicians’ knowledge was about 50%, while the rate of health workers’ knowledge was 62%. The rate of health workers’ attitude was 92%, while the rate of participants’ knowledge was 50% and the rate of participants’ attitude was 19%. Consequently, the integration of mental health in primary health care system of rural areas of Dezful district has been relatively successful. Conclusions The integration of mental health into primary health care is an important priority in the Iranian health system. Monitoring and evaluation of this strategic project to remove its weaknesses is essential.

  12. Rural food insecurity in the United States as an overlooked site of struggle in health communication.

    Science.gov (United States)

    Ramadurai, Vandhana; Sharf, Barbara F; Sharkey, Joseph R

    2012-01-01

    This article indicates the need for health communication scholars to attend to the growing national problem of rural food insecurity. A review of the health communication literature reveals that food insecurity and rural health overall are research issues that have been overlooked. Using the Culture-Centered Approach ( Dutta, 2008 ), while simultaneously searching for community assets as well as problems, we explore aspects of rural residents' food environments, culture, and institutional structures that empower and constrain their communities. Twelve focus groups (n = 86), segmented by race/ethnicity, were conducted in rural central Texas. Results were analyzed using grounded theory methodology. Our findings outline problems and personal obstacles described by participants, as well as creative solutions and coping mechanisms illustrative of individual agency and social capital inherent in their rural culture. We conclude by providing suggestions for future research that will aid health communication scholars to further the conversation on rural food insecurity.

  13. Drought, drying and climate change: emerging health issues for ageing Australians in rural areas.

    Science.gov (United States)

    Horton, Graeme; Hanna, Liz; Kelly, Brian

    2010-03-01

    Older Australians living in rural areas have long faced significant challenges in maintaining health. Their circumstances are shaped by the occupations, lifestyles, environments and remoteness which characterise the diversity of rural communities. Many rural regions face threats to future sustainability and greater proportions of the aged reside in these areas. The emerging changes in Australia's climate over the past decade may be considered indicative of future trends, and herald amplification of these familiar challenges for rural communities. Such climate changes are likely to exacerbate existing health risks and compromise community infrastructure in some instances. This paper discusses climate change-related health risks facing older people in rural areas, with an emphasis on the impact of heat, drought and drying on rural and remote regions. Adaptive health sector responses are identified to promote mitigation of this substantial emerging need as individuals and their communities experience the projected impact of climate change.

  14. Occupational health-related experiences in rural Tasmania.

    Science.gov (United States)

    Newman, Barbara; Berens, Heidi

    2010-07-01

    This descriptive, explorative study sought to identify the occupational-related health experiences of community nurses in their workday within rural North West Tasmania. Tasmania is one of eight states and territories that form Australia. The findings indicate the majority of community nurses consider their health average or better, although 30% reported being overweight; 5% reported smoking; 60% reported feeling tense, anxious or depressed sometimes during the week. In the 12 months prior to survey 48% of participants had experienced a work-related injury or illness. At least two thirds of participants spent an average of 1.5 hours teaching nursing students and 2 hours teaching medical students, per week. Hazards (needlestick injury, items obstructing passageways, debris within homes), dogs and use of mobile telephones were regularly associated with weekly work incidents. Interestingly, more time was spent in a day on documentation than with clients or professional development.

  15. Rural origin as a risk factor for maternal and child health in periurban Bolivia.

    Science.gov (United States)

    Bender, D E; Rivera, T; Madonna, D

    1993-12-01

    Rapid migration in Latin America is settling rural women and their families next to those of urban origin in sprawling urban settings. Those born and reared in rural areas bring with them knowledge and skills learned and adapted to rural areas; those same skills may be maladaptive in urban areas. Hypothesized is that urban women of rural origin are more likely to have poorer health outcomes for themselves and their children than lifelong urban counterparts. Identification of specific risk factors affecting child and/or maternal health status in peri-urban barrios can assist health workers to target limited resources to those least likely to access available services.

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

    Directory of Open Access Journals (Sweden)

    Okoli Ugo

    2016-08-01

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

  17. 'I could never have learned this in a lecture': transformative learning in rural health education.

    Science.gov (United States)

    Prout, Sarah; Lin, Ivan; Nattabi, Barbara; Green, Charmaine

    2014-05-01

    Health indicators for rural populations in Australia continue to lag behind those of urban populations and particularly for Indigenous populations who make up a large proportion of people living in rural and remote Australia. Preparation of health practitioners who are adequately prepared to face the 'messy swamps' of rural health practice is a growing challenge. This paper examines the process of learning among health science students from several health disciplines from five Western Australian universities during 'Country Week': a one-week intensive experiential interprofessional education program in rural Western Australia. The paper weaves together strands of transformative theory of learning with findings from staff and student reflections from Country Week to explore how facilitated learning in situ can work to produce practitioners better prepared for rural health practice.

  18. Defining the role of primary health care nurse practitioners in rural Nova Scotia.

    Science.gov (United States)

    Martin-Misener, Ruth; Reilly, Sandra M; Vollman, Ardene Robinson

    2010-06-01

    This article reports on a mixed methods study to define the role of nurse practitioners (NPs) in rural Nova Scotia, Canada, by collecting the perceptions of rural health board chairpersons and health-care providers. Qualitative data were collected in telephone interviews with health board chairpersons. Quantitative data were collected in a survey of NPs, family physicians, public health nurses, and family practice nurses.The authors describe participants' perspectives on the health needs of rural communities, the gaps in the current model of primary health care services, the envisaged role of NPs in rural communities, and the facilitators of and barriers to NP role implementation. Optimizing the benefits of the NP role for residents of rural communities requires attention to the barriers that impede deployment and integration of the role.

  19. Overcoming the Triad of Rural Health Disparities: How Local Culture, Lack of Economic Opportunity, and Geographic Location Instigate Health Disparities

    Science.gov (United States)

    Thomas, Tami L.; DiClemente, Ralph; Snell, Samuel

    2014-01-01

    Objective: To discuss how the effects of culture, economy, and geographical location intersect to form a gestalt triad determining health-related disparities in rural areas. Methods: We critically profile each component of the deterministic triad in shaping current health-related disparities in rural areas; evaluate the uniquely composed…

  20. Breastfeeding training improves health worker performance in rural Nigeria.

    Science.gov (United States)

    Davies-Adetugbo, A A; Fabiyi, A K; Ojoofeitimi, E O; Adetugbo, K

    1997-08-01

    The training of health workers in breastfeeding and lactation management is to enable them make correct breastfeeding recommendations to mothers. This study aims to provide answers to two research questions: what components of breastfeeding training are easily achieved with extension health workers, and what health worker variables affect these outcomes. Multivariable analysis of the outcomes of a controlled breastfeeding training programme for community health workers (CHW) in rural communities of Osun State, Nigeria, was performed by logistic regression. The results show that the training was the most powerful predictor of correct CHW recommendations on breastfeeding (OR = 60.25, p-0.0000), and of 'perfect' breastfeeding knowledge (OR = 192.49, p = 0.0000). Younger CHWs (in the age bracket 20 to 29 years) were significantly more likely to make correct recommendations on exclusive breastfeeding (OR = 3.02, p = 0.0304). Other CHW variables such as sex, experience, job status, and marital status did not make consistently significant independent contributions to the outcomes. The results suggest that breastfeeding education can enhance CHW professional recommendations on breastfeeding and should be extended to all categories of health workers.

  1. Home on the Range--Health Literacy, Rural Elderly, Well-Being

    Science.gov (United States)

    Young, David; Weinert, Clarann; Spring, Amber

    2012-01-01

    The demographic and socioeconomic impacts of the baby boomer generation turning 65 in 2011 will be magnified in rural areas where elderly are already disproportionately represented. The overall goal of a collaborative, community-based project was to improve the health literacy, health outcomes, and overall well-being of rural elderly in four…

  2. 77 FR 58913 - Veterans' Rural Health Advisory Committee, Notice of Meeting

    Science.gov (United States)

    2012-09-24

    ... AFFAIRS Veterans' Rural Health Advisory Committee, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that the Veterans' Rural Health Advisory Committee will hold a meeting on October 25-26, 2012, at the Waterfront Place Hotel,...

  3. [Use of maternal health services in rural Mexico].

    Science.gov (United States)

    Potter, J E

    1988-01-01

    Because of the spread of western health care into rural Mexican communities through primary health care programs and medical school graduates performing their year of community service, the proportion of rural Mexican women whose deliveries were attended by physicians increased from 17.7% in 1969 to 45.8% in 1981. The primary objective of this work is to identify factors involved in the utilization of the modern medical system for prenatal care and of hospital delivery in transitional rural areas. A secondary objective is to evaluate the impact of modern prenatal care and hospital delivery on perinatal and neonatal mortality. The data came from a 1981 survey by the Mexican Institute of Social Security of a nationally representative sample of 7953 fertile-aged women in 410 communities with fewer than 2500 inhabitants. The survey provided information on both utilization of health services and on medical and biological conditions that might have prompted women to seek modern medical care. This study was limited to 1579 pregnancies which arrived at term in the 13 months preceding the survey. Among dependent variables, the variable for prenatal care was a 1st prenatal visit in the 1st 5 months of pregnancy. 486 women, about 31% of the sample, had such a visit. 69% of the subsample of 1579 women had had some form of prenatal care, of whom 63% had their 1st consultation in the 1st 5 months. 36% of deliveries occurred in hospitals. There were 64 prenatal or neonatal deaths in the 1579 pregnancies, including 38 deaths in the 1st month and 26 stillbirths. The independent variables included 5 factors measuring health facilities available in the community, 3 assessing the commercial center used by the community, and 2 assessing the respondent's housing. The 2 individual factors were birth order and education. 7 factors concerned symptoms of pregnancy and 4 complications during delivery. The multivariate analysis of these factors was carried out by logistic regression. The

  4. Changing Symbolic and Geographical Boundaries between Penal Zones and Rural Communities in the Russian Federation

    Science.gov (United States)

    Pallot, Judith

    2012-01-01

    The article examines the processes involved in the integration of the USSR's secret places into mainstream rural society in the Russian Federation. Taking the example of one rural district in the Volga-Ural region that has been the site of a large prison complex over a period of ninety years, the article examines how economic changes and local…

  5. The effect of health on urban-settlement intention of rural-urban migrants in China.

    Science.gov (United States)

    Xie, Shenghua; Wang, Jinxian; Chen, Juan; Ritakallio, Veli-Matti

    2017-09-01

    Previous studies have not paid enough attention to the effect of health on urban-settlement intention of rural-urban migrants in China. Using survey data from the Rural Urban Migration in China project, this article examines how self-rated physical and mental health influence rural-urban migrants' intention to settle down in cities. First, the results show that both self-rated physical and mental health are significant factors influencing the migrants' intention to permanently move to cities. Second, the effect of physical health on rural-urban migrants' intentions to permanently reside in cities can be moderated by their length of urban residence. Third, the impact of health on rural-urban migrants' urban-settlement intention shows no generational differences. According to the research findings, this paper discusses how urban-settlement intention of rural-urban migrants based on health selection might impair urbanization, exacerbate health disparity between the rural and urban areas, and aggravate the burden on healthcare system in rural areas of China in the long run. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Public Health Service Act, Rural Physician Training Grant Program, definition of "underserved rural community." Interim final rule with request for comment.

    Science.gov (United States)

    2010-05-26

    This interim final rule (IFR) with request for comment is meant to comply with the statutory directive to issue a regulation defining "underserved rural community" for purposes of the Rural Physician Training Grant Program in section 749B of the Public Health Service Act, as amended by the Patient Protection and Affordable Care Act of 2010. This IFR is technical in nature. It will not change grant or funding eligibility for any other grant program currently available through the Office of Rural Health Policy (ORHP) or HRSA. For purposes of the Rural Physician Training Grant Program only, HRSA has combined existing definitions of "underserved" and "rural" by using the definition of rural utilized by the ORHP Rural Health Grant programs and the definition of "underserved" established by HRSA's Office of Shortage Designation (OSD) in the Bureau of Health Professions (BHPr).

  7. Poverty status and health equity: evidence from rural Bangladesh.

    Science.gov (United States)

    Karim, F; Tripura, A; Gani, M S; Chowdhury, A M R

    2006-03-01

    Many studies have examined the health inequities between different social groups, often measured by individual independent variables, such as education, gender, ethnicity, geography, rich, poor, etc. Although inequities are increasingly widening, a few studies have looked at the health inequity between different poverty groups within the poor. The present study, using equity terms, examined the use of health services in two rural areas of Bangladesh. Using a multistage sampling method, a total of 80 villages were selected from the Bogra and Dinajpur sadar thanas (subdistricts) for the study. A total of 4003 households in these villages were visited for data collection on mortality and fertility, while data related to use of health services was collected from a subsample of 1032 households. A poverty index, constructed using three variables (household landholding, education level of head of household, and self-rated categorization of household's annual food security), categorized the households into three groups: extreme poor, moderate poor and non-poor. Overall, the data revealed considerable inequities in many study indicators between the poor and the non-poor. However, inequities of varying degrees were also found between the extreme poor and the moderate poor. Lower levels of inequities were found between the poor and the non-poor in the use of health services, which were easily accessible and free of charge (immunization, vitamin A capsule, etc.). On the whole, the extreme poor were less likely to use health services than the moderate poor and the non-poor, suggesting the need for a more appropriate programme to address their pressing health needs.

  8. Changing the Care Process: A New Concept in Iranian Rural Health Care

    Directory of Open Access Journals (Sweden)

    Abbas Abbaszadeh, RN, BSCN, PhD

    2013-03-01

    Conclusion: The findings of this study indicate that the process of health care in Iranian rural society is changing rapidly with community health workers encountering new challenges. There is diminished efficiency in responding to the changing care process in Iran's rural society. Considering this change in process of care, therefore, the health care system should respond to these new challenges by establishing new health care models.

  9. Social capital and health in rural and urban communities in South Australia.

    Science.gov (United States)

    Ziersch, Anna M; Baum, Fran; Darmawan, I Gusti Ngurah; Kavanagh, Anne M; Bentley, Rebecca J

    2009-02-01

    This paper seeks to compare the relationships between social capital and health for rural and urban residents of South Australia. Using data from a South Australian telephone survey of 2,013 respondents (1,402 urban and 611 rural), separate path analyses for the rural and urban samples were used to compare the relationships between six social capital measures, six demographic variables, and mental and physical health (measured by the SF-12). Higher levels of networks, civic participation and cohesion were reported in rural areas. Education and income were consistently linked with social capital variables for both rural and urban participants, with those on higher incomes and with higher educational achievement having higher levels of social capital. However, there were also differences between the rural and urban groups in some of the other predictors of social capital variables. Mental health was better among rural participants, but there was no significant difference for physical health. Social capital was associated with good mental health for both urban and rural participants, but with physical health only for urban participants. Higher levels of social capital were significantly associated with better mental health for both urban and rural participants, but with better physical health only for urban participants. The study found that social capital and its relationship to health differed for participants in rural and urban areas, and that there were also differences between the areas in associations with socioeconomic variables. Policies aiming to strengthen social capital in order to promote health need to be designed for specific settings and particular communities within these.

  10. A comparative analysis of policies addressing rural oral health in eight English-speaking OECD countries.

    Science.gov (United States)

    Crocombe, Leonard A; Goldberg, Lynette R; Bell, Erica; Seidel, Bastian

    2017-01-01

    Oral health is fundamental to overall health. Poor oral health is largely preventable but unacceptable inequalities exist, particularly for people in rural areas. The issues are complex. Rural populations are characterised by lower rates of health insurance, higher rates of poverty, less water fluoridation, fewer dentists and oral health specialists, and greater distances to access care. These factors inter-relate with educational, attitudinal, and system-level issues. An important area of enquiry is whether and how national oral health policies address causes and solutions for poor rural oral health. The purpose of this study was to examine a series of government policies on oral health to (i) determine the extent to which such policies addressed rural oral health issues, and (ii) identify enabling assumptions in policy language about problems and solutions regarding rural communities. Eight current oral health policies were identified from Australia, New Zealand, Canada, the USA, England, Scotland, Northern Ireland, and Wales. Validated content and critical discourse analyses were used to document and explore the concepts in these policy documents, with a particular focus on the frequency with which rural oral health was mentioned, and the enabling assumptions in policy language about rural communities. Seventy-three concepts relating to oral health were identified from the textual analysis of the eight policy documents. The rural concept addressing oral health issues occurred in only 2% of all policies and was notably absent from the oral health policies of countries with substantial rural populations. It occurred most frequently in the policy documents from Australia and Scotland, less so in the policy documents from Canada, Wales, and New Zealand, and not at all in the oral health policies from the US, England, and Northern Ireland. Thus, the oral health needs of rural communities were generally not the focus of, nor included in, the oral health policy

  11. Mental health professionals' perspectives of telemental health with remote and rural First Nations communities.

    Science.gov (United States)

    Gibson, Kerri; O'Donnell, Susan; Coulson, Heather; Kakepetum-Schultz, Tina

    2011-01-01

    We conducted an online survey and interviews amongst mental health workers in Canada who reported experience in working with rural and remote First Nations (although not necessarily telemental health). Sixty-three respondents (of the 164) to the online survey reported experience in working with clients in remote and rural First Nations. Only 16 of the online survey respondents with remote and rural First Nations experience reported having received training in videoconferencing use. When asked how frequently they used videoconferencing with clients, 51% reported never using it, 19% used it once every few months and 10% reported using it a few times a month. Approximately 50% of participants reported finding it useful. Approximately 38% found the technology easy or very easy to use, and 15% found it very difficult. Individual in-depth interviews were also conducted with professionals who had First Nations telemental health experience specifically (n = 5). A quantitative data analysis was used to explore their perceptions of usefulness and ease of use of telemental health, as well as the relationships among these constructs. Advantages, disadvantages and challenges in using the technology were identified from the qualitative data. Promising ways forward include incorporating traditional practices and the Seven Teachings into telemental health services.

  12. 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

  13. Health Care Expenditure of Rural Households in Pondicherry, India

    Directory of Open Access Journals (Sweden)

    Poornima Varadarajan

    2013-11-01

    Full Text Available Background: Shortcomings in healthcare delivery has led people to spend a substantial proportion of their incomes on medical treatment. World Health Organization (2005 estimates reveal that every year 25 million households are forced into poverty by illness and the struggle to pay for healthcare. Thus we planned to calculate the health care expenditure of rural households and to assess the households incurring catastrophic health expenditure. Methods: A cross-sectional study was conducted in the service area of Sri Manakula Vinayagar Medical College and Hospital from May to August 2011. A total of 100 households from the 4 adjoining villages of our Institute were selected for operational and logistic feasibility. The household’s capacity to pay, out of pocket expenditure and catastrophic health expenditure were calculated. Data collection was done using a pretested questionnaire by the principal investigator and the analysis was done using SPSS (version 16. Results: The average income in the highest income quintile was Rs 51,885 but the quintile ratio was 14.98. The median subsistence expenditure was Rs 4,520. About 18% of households got impoverished paying for health care. About 81% of households were incurring out of pocket expenditure and 66% were facing catastrophic health expenses of 40%.Conclusion There was very high out of pocket spending and a high prevalence of catastrophic expenditure noted. Providing quality care at affordable cost and appropriate risk pooling mechanism are warranted to protect households from such economic threats.

  14. A "health commons" approach to oral health for low-income populations in a rural state.

    Science.gov (United States)

    Beetstra, Stephen; Derksen, Daniel; Ro, Marguerite; Powell, Wayne; Fry, Donald E; Kaufman, Arthur

    2008-09-01

    Oral health needs are urgent in rural states. Creative, broad-based, and collaborative solutions can alleviate these needs. "Health commons" sites are enhanced, community-based, primary care safety net practices that include medical, behavioral, social, public, and oral health services. Successful intervention requires a comprehensive approach, including attention to enhancing dental service capacity, broadening the scope of the dental skills of locally available providers, expanding the pool of dental providers, creating new interdisciplinary teams in enhanced community-based sites, and developing more comprehensive oral health policy. By incorporating oral health services into the health commons primary care model, access for uninsured and underserved populations is increased. A coalition of motivated stakeholders includes community leaders, safety net providers, legislators, insurers, and medical, dental, and public health providers.

  15. headspace: National Youth Mental Health Foundation: making headway with rural young people and their mental health.

    Science.gov (United States)

    Hodges, Craig A; O'Brien, Matthew S; McGorry, Patrick D

    2007-04-01

    Mental health is the number one health issue affecting young people in Australia today, yet only one in four of these young people receive professional help. Approximately 14% of 12- to 17-year-olds and 27% of 18- to 25-year-olds experience mental health problems each year. However, many do not have ready access to treatment or are reluctant to seek that help. These issues might be exacerbated in the rural and remote regions of Australia where sociocultural barriers such as stigma, lack of anonymity and logistic difficulties including cost and availability of transport can hinder young people accessing mental health services. headspace: the National Youth Mental Health Foundation has been funded to address these issues. headspace will provide funding for the establishment of communities of youth services across Australia, provide national and local community awareness campaigns and plans, establish a centre of excellence that will identify and disseminate evidence-based practice in addressing youth mental health issues, and translate findings into education and training programs that are targeted at service providers to work with youth mental health. The communities of youth services will build the capacity of local communities to identify early, and provide effective responses to, young people aged 12-25 years with mental health and related substance use disorders. Specific approaches in rural, regional and remote areas will be developed as well as specific programs to involve young Indigenous people.

  16. Health And Social Status Of Senior Citizens In Rural Areas

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    Sunder Lal

    1997-12-01

    Full Text Available Research Problem: What is the quality of life of the elderly people, as also the available support system, in rural areas?    ■Objectives:i             To determine the demographic profile of eld­erlyii            To assess the socio-economic, nutritional, health, morbidity and dependency status, and health care utilization.Study Design: Population based cross sectional study.Setting:        Community        Development   Block     -LakhanmajraParticipants: Persons above the age of 65 years.Sample Size: 809 elderly above the age of 65 years.Study Variables: Demographic profile, Literacy, Oc­cupation, Health, Nutrition, Mobility, Dependency, Substance abuse, Support system.Statistical Analysis: By simple proportions.Result: In this study, majority ofthe elderly were self reliant and mobile, being an asset to the family and led socially useful and productive lives. Their pre­dominant problems were visual impairment, joint pains, respiratory diseases and hearing impairment. Joint family and government pension was the major support system to the elderly. However, there is an imperative need to organize education, training and special service programmes for the elderly at the village level.

  17. What Explains Divorced Women's Poorer Health? The Mediating Role of Health Insurance and Access to Health Care in a Rural Iowan Sample

    Science.gov (United States)

    Lavelle, Bridget; Lorenz, Frederick O.; Wickrama, K. A. S.

    2012-01-01

    Economic restructuring in rural areas in recent decades has been accompanied by rising marital instability. To examine the implications of the increase in divorce for the health of rural women, we examine how marital status predicts adequacy of health insurance coverage and health care access, and whether these factors help to account for the…

  18. Developing strategies to enhance health services research capacity in a predominantly rural Canadian health authority.

    Science.gov (United States)

    Miller, Jennifer; Bryant Maclean, Leslie; Coward, Patricia; Broemeling, Anne-Marie

    2009-01-01

    This article outlines the planning, implementation and preliminary evaluation of a research capacity building (RCB) initiative within a predominantly rural Canadian health authority, Interior Health (IH), including initiative characteristics and key activities designed to initiate and enhance health services research capacity within the organization. Interior Health is one of 5 geographic health authorities in British Columbia. Over half of the population IH serves is considered to be rural/remote (approximately 3 people/km2), contributing to difficulties in sharing research information (ie geographical distance to meet in-person and a diverse set of needs and/or priority topics that warrant research support). An initial assessment of IH research capacity in 2006, using an organizational self-assessment tool and discussions with key stakeholders, revealed a need for enhanced communication of health research results, research education and networking opportunities for staff at all levels of the organization. Staff noted barriers to using and sharing research such as lack of time, resources and skills for, and value placed on, participating in research, as well as lack of awareness of linkages with local academic health researchers, including faculty located at two universities within the region. In response to this baseline assessment and stakeholder feedback, short-term funding has allowed for the initial development of RCB strategies in both urban and rural/remote areas of the region, including: IH Research Brown Bag Lunch Seminars; IH Research Skills Workshop Series; literature syntheses/summaries on priority topic areas; research collaboration/partnerships with health authorities, research networks and academic researchers; and an annual IH Research Conference. Although currently a poorly defined term, RCB is a concept that speaks to the need for improvement in the skills and assets that can facilitate the production and application research. It is difficult to

  19. Rural health care delivery amidst federal retrenchment: lessons from the Robert Wood Johnson Foundation's Rural Practice Project.

    Science.gov (United States)

    Moscovice, I S; Rosenblatt, R A

    1982-12-01

    This paper examines the experience of the Robert Wood Johnson Foundation's Rural Practice Project (RPP), a major non-governmental effort in the last decade concentrating on the direct delivery of rural health services. The nine RPP sites started prior to 1977 showed a slow but steady increase in their utilization levels and improvement in their financial status during their initial operational years. The tempo of their development was remarkably similar to that of federally sponsored practices in underserved rural areas. After four years of operation, all of the practices had completed their period of grant support; the practices survived in all cases, with almost all of the practices still retaining community sponsorship, salaried physicians, and a commitment to comprehensive care. Practices in sparsely populated rural areas and in areas with fewer hospital beds grew more slowly than those set in rural areas with higher population density and more ancillary resources. We conclude that the use of time-limited initial subsidies is an effective strategy in starting new rural practices in underserved areas and that those practices have a good chance of surviving their start-up phase.

  20. Diagnostic work-up of neurological syndromes in a rural African setting: knowledge, attitudes and practices of health care providers.

    Directory of Open Access Journals (Sweden)

    Alain Mpanya

    Full Text Available BACKGROUND: Neurological disorders of infectious origin are common in rural sub-Saharan Africa and usually have serious consequences. Unfortunately, these syndromes are often poorly documented for lack of diagnostic tools. Clinical management of these diseases is a major challenge in under-equipped rural health centers and hospitals. We documented health care provider knowledge, attitudes and practices related to this syndrome in two rural health zones in Bandundu Province, Democratic Republic of Congo. METHODS: We used a qualitative research approach combining observation, in-depth interviews and focus group discussions. We observed 20 patient-provider contacts related to a neurological syndrome, conducted 12 individual interviews and 4 focus group discussions with care providers. All interviews were audiotaped and the transcripts were analyzed with the software ATLAS.ti. RESULTS: Care providers in this region usually limit their diagnostic work-up to clinical examination primarily because of the financial hurdles in this entirely out-of-pocket payment system. The patients prefer to purchase drugs rather than diagnostic tests. Moreover the general lack of diagnostic tools and the representation of the clinician as a "diviner" do not enhance any use of laboratory or other diagnostic methods. CONCLUSION: Innovation in diagnostic technology for neurological disorders is badly needed in Central-Africa, but its uptake in clinical practice will only be a success if tools are simple, affordable and embedded in a patient-centered approach.

  1. The Changing Landscape of Health Care Financing and Delivery: How Are Rural Communities and Providers Responding?

    OpenAIRE

    Mueller, Keith J.; Coburn, Andy; Cordes, Sam; Crittenden, Robert; Hart, J. Patrick; McBride, Timothy; Myers, Wayne

    1999-01-01

    Rural communities have not kept pace with the recent dramatic changes in health care financing and organization. However, the Medicare provisions in the Balanced Budget Act of 1997 will require rural providers to participate in the new systems. Case studies revealed the degree of readiness for change in six rural communities and charted their progress along a continuum, as reflected in three sets of activities: the development of networking; the creation of new strategies for managing patient...

  2. Spatial access disparities to primary health care in rural and remote Australia.

    Science.gov (United States)

    McGrail, Matthew Richard; Humphreys, John Stirling

    2015-01-01

    Poor spatial access to health care remains a key issue for rural populations worldwide. Whilst geographic information systems (GIS) have enabled the development of more sophisticated access measures, they are yet to be adopted into health policy and workforce planning. This paper provides and tests a new national-level approach to measuring primary health care (PHC) access for rural Australia, suitable for use in macro-level health policy. The new index was constructed using a modified two-step floating catchment area method framework and the smallest available geographic unit. Primary health care spatial access was operationalised using three broad components: availability of PHC (general practitioner) services; proximity of populations to PHC services; and PHC needs of the population. Data used in its measurement were specifically chosen for accuracy, reliability and ongoing availability for small areas. The resultant index reveals spatial disparities of access to PHC across rural Australia. While generally more remote areas experienced poorer access than more populated rural areas, there were numerous exceptions to this generalisation, with some rural areas close to metropolitan areas having very poor access and some increasingly remote areas having relatively good access. This new index provides a geographically-sensitive measure of access, which is readily updateable and enables a fine granulation of access disparities. Such an index can underpin national rural health programmes and policies designed to improve rural workforce recruitment and retention, and, importantly, health service planning and resource allocation decisions designed to improve equity of PHC access.

  3. Effectiveness of the Rural Trauma Team Development Course for Educating Nurses and Other Health Care Providers at Rural Community Hospitals.

    Science.gov (United States)

    Zhu, Thein Hlaing; Hollister, Lisa; Scheumann, Christopher; Konger, Jennifer; Opoku, Dazar

    2016-01-01

    The study evaluates (1) health care provider perception of the Rural Trauma Team Development Course (RTTDC); (2) improvement in acute trauma emergency care knowledge; and (3) early transfer of trauma patients from rural emergency departments (EDs) to a verified trauma center. A 1-day, 8-hour RTTDC was given to 101 nurses and other health care providers from nine rural community hospitals from 2011 to 2013. RTTDC participants completed questionnaires to address objectives (1) and (2). ED and trauma registry data were queried to achieve objective (3) for assessing reduction in ED time (EDT), from patient arrival to decision to transfer and ED length of stay (LOS). The RTTDC was positively perceived by health care providers (96.3% of them completed the program). Significant improvement in 13 of the 19 knowledge items was observed in nurses. Education intervention was an independent predictor in reducing EDT by 28 minutes and 95% confidence interval (CI) [-57, -0.1] at 6 months post-RTTDC, and 29 minutes and 95% CI [-53, -6] at 12 months post-RTTDC. Similar results were observed with ED LOS. The RTTDC is well-perceived as an education program. It improves acute trauma emergency care knowledge in rural health care providers. It promotes early transfer of severely injured patients to a higher level of care.

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

    OpenAIRE

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

    2016-01-01

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

  5. Variations between post- and pre-harvest seasons in stunting, wasting, and Infant and Young Child Feeding (IYCF) practices among children 6-23 months of age in lowland and midland agro-ecological zones of rural Ethiopia.

    Science.gov (United States)

    Roba, Kedir Teji; O'Connor, Thomas Pacelli; Belachew, Tefera; O'Brien, Nora Mary

    2016-01-01

    Food availability and access are strongly affected by seasonality in Ethiopia. However, there are little data on seasonal variation in Infant and Young Child Feeding (IYCF) practices and malnutrition among 6-23 months old children in different agro-ecological zones of rural Ethiopia. Socio-demographic, anthropometry and IYCF indicators were assessed in post- and pre-harvest seasons among children aged 6-23 months of age randomly selected from rural villages of lowland and midland agro-ecological zones. Child stunting and underweight increased from prevalence of 39.8% and 26.9% in post-harvest to 46.0% and 31.8% in pre-harvest seasons, respectively. The biggest increase in prevalence of stunting and underweight between post- and pre-harvest seasons was noted in the midland zone. Wasting decreased from 11.6% post-harvest to 8.5% pre-harvest, with the biggest decline recorded in the lowland zone. Minimum meal frequency, minimum acceptable diet and poor dietary diversity increased considerably in pre-harvest compared to post-harvest season in the lowland zone. Feeding practices and maternal age were predictors of wasting, while women's dietary diversity and children age was predictor of child dietary diversity in both seasons. There is seasonal variation in malnutrition and IYCF practices among children 6-23 months of age with more pronounced effect in midland agro-ecological zone. A major contributing factor for child malnutrition may be poor feeding practices. Health information strategies focused on both IYCF practices and dietary diversity of mothers could be a sensible approach to reduce the burden of child malnutrition in rural Ethiopia.

  6. Le retour des jeunes diplômés en zone rurale au Maroc: Quelles interactions entre trajectoires individuelles et projets collectifs ?

    Directory of Open Access Journals (Sweden)

    Nabila Aroussi Bachari

    2015-06-01

    Full Text Available l y a, dans les zones rurales du Maroc, une présence de plus en plus affirmée de jeunes diplômés. Ces jeunes peuvent jouer un rôle important pour le développement de ces zones rurales, mais à condition de se construire un rôle économique et social, qui leur permette de fonder un projet de vie en zone rurale. L’étude porte sur 11 jeunes diplômés qui ont initié des projets collectifs en zone rurale dans la province de Séfrou, grâce à des financements publics. Nous étudions les interactions entre les trajectoires individuelles de ces jeunes diplômés et leur projet collectif. Ces jeunes ont étudié voire travaillé pendant un temps en ville avant d’initier un projet collectif en zone rurale, à la fois du fait des difficultés d’insertion en ville mais aussi pour contribuer au développement de leur douar d’origine. Les projets de ces jeunes peuvent être d’ordre purement économique (coopérative de séchage de prune par exemple ou bien d’animation rurale. Plusieurs des jeunes enquêtés sont actifs à la fois dans la sphère économique et dans l’animation rurale, et jugent ces deux acticités comme complémentaires et non en opposition. Ces projets collectifs offrent à leur tour des opportunités de « projets de vie » en zone rurale pour ces jeunes. Si la capacité de ces projets de générer un revenu stable est un critère fort pour que ces jeunes se construisent un tel projet de vie en zone rurale, le rôle d’animateur de développement rural est aussi un élément important. Ces différents projets ont obtenu des financements publics de différents types qui ont, dans deux des quatre cas étudiés, explicitement pris en compte la présence de jeunes diplômés dans les projets. Cependant, ces financements ont souvent été accordés dans le cadre de démarches ponctuelles, qui pourraient être menées de façon plus institutionnalisée.

  7. Fever prevalence and management among three rural communities in the North West Zone, Somalia.

    Science.gov (United States)

    Youssef, R M; Alegana, V A; Amran, J; Noor, A M; Snow, R W

    2010-06-01

    Between March and August 2008 we undertook 2 cross-sectional surveys among 1375 residents of 3 randomly selected villages in the district of Gebiley in the North-West Zone, Somalia. We investigated for the presence of malaria infection and the period prevalence of self-reported fever 14 days prior to both surveys. All blood samples examined were negative for both species of Plasmodium. The period prevalence of 14-day fevers was 4.8% in March and 0.6% in August; the majority of fevers (84.4%) were associated with other symptoms including cough, running nose and sore throat; 48/64 cases had resolved by the day of interview (mean duration 5.4 days). Only 18 (37.5%) fever cases were managed at a formal health care facility: 7 within 24 hours and 10 within 24-72 hours of onset. None of the fevers were investigated for malaria; they were treated with antibiotics, antipyretics and vitamins.

  8. Older adult social participation and its relationship with health: Rural-urban differences.

    Science.gov (United States)

    Vogelsang, Eric M

    2016-11-01

    In an aging world, there is increased need to identify places and characteristics of places that promote health among older adults. This study examines whether there are rural-urban differences in older adult social participation and its relationship with health. Using the 2003 and 2011 waves of the Wisconsin Longitudinal Study (n=3006), I find that older adults living in rural counties are less socially active than their counterparts in more-urban counties. I also find that relationships between social participation and health vary by the type of activity and rural-urban context.

  9. A theory of how rural health services contribute to community sustainability.

    Science.gov (United States)

    Farmer, Jane; Prior, Maria; Taylor, Judy

    2012-11-01

    Study and opinion suggest that health services play a significant role in supporting the social fabric of fragile rural communities. We draw on empirical evidence about the added-value contributions of health services to communities and unite it with theory of capitals to propose a theoretical model depicting how rural health services contribute to community sustainability. While providing an analytical framework, the paper also points to construction of a measurement tool for enabling planners to measure the contributions of diverse sectors to community sustainability and predict or measure the impact of changes to models of service delivery on the future of rural communities.

  10. Rural population travel time to health services, mapped on Geographic Information System (GIS

    Directory of Open Access Journals (Sweden)

    Ricardo Vicente Ferreira

    2014-04-01

    Full Text Available Distance and travel time are important parameters in the evaluation of access to health services, especially for the population living in the countryside. In the present work, a GIS-based methodology is developed for the mapping of rural road networks and the determination of travel impedances in order to optimize the travel time of the rural population to health care facilities. Data on rural roads classes, slope, sinuosity, visibility and land use are considered in the composition of the impedances synthesis and its application on car travel time. The methodology was applied to the region of Registro (SP, and the results indicate an unequal distribution of health services.

  11. The impact of health education on reproductive health knowledge among adolescents in a rural Nigerian community.

    Science.gov (United States)

    Mba, C I; Obi, S N; Ozumba, B C

    2007-07-01

    This intervention study was to evaluate the impact of reproductive health education on the knowledge and attitude of adolescents in a rural Nigerian community to reproductive health issues. It compared adolescents in a secondary school (study group), which received health education on reproductive health with another secondary school (control group), which did not receive any. The impact of the programme was evaluated with a pre-test baseline knowledge and post-test gain in the knowledge 6 weeks later, using the same questionnaire. A total of 180 students selected by systematic sampling from each of the two randomly selected schools in Item, a rural community in south-east Nigeria participated in the programme. While all the respondents have heard of reproductive health and could identify at least one of its components, their knowledge of it prior to the health education were defective and were obtained mainly from peers and the mass media. Such information was incomplete and often coloured with cultural and religious bias. However, there was a significant (p health education. The students in the study group showed a positive and permissive attitude towards reproductive health education and there was a drop in risky sexual behaviour following the intervention. Pre-marital sex (94.3%), pregnancy prevention and abortion (88.5%) and sexually transmitted infections (82.8%) were common reproductive health problems raised by the students. Reproductive health education as part of the school curriculum will provide an effective means of improving knowledge and reducing reproductive health problems among adolescents in developing countries.

  12. Energia Renovable para Centros de Salud Rurales (Renewable Energy for Rural Health Clinics)

    Energy Technology Data Exchange (ETDEWEB)

    Jimenez, T.; Olson, K.

    1999-07-28

    Esta es la primera de una serie de guias de aplicaciones que el Programa de Energia de Villas de NREL esta comisionando para acoplar sistemas comerciales renovables con aplicaciones rurales, incluyendo agua, escuelas rurales y micro empresas. La guia esta complementada por las actividades de desarrollo del Programa de Energia de Villas de NREL, proyectos pilotos internacionales y programas de visitas profesionales.

  13. Understanding Contexts of Family Violence in Rural, Farming Communities: Implications for Rural Women's Health

    Science.gov (United States)

    Wendt, Sarah; Hornosty, Jennie

    2010-01-01

    Research on family violence in rural communities in Australia and Canada has shown that women's experience of family violence is shaped by social and cultural factors. Concern for economic security and inheritance for children, closeness and belonging, and values of family unity and traditional gender roles are factors in rural communities that…

  14. 75 FR 8789 - Veterans' Rural Health Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2010-02-25

    ... AFFAIRS Veterans' Rural Health Advisory Committee; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that the Veterans' Rural... Carnegie Hotel, 1216 West State of Franklin Road, Johnson City, Tennessee. The sessions will begin at 8...

  15. 76 FR 60965 - Veterans' Rural Health Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2011-09-30

    ... AFFAIRS Veterans' Rural Health Advisory Committee; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that the Veterans' Rural... Hotel, 363 Maine Mall Road, Portland, ME. The sessions will begin at 8 a.m. each day and adjourn at 4...

  16. Addressing the Shortage of Health Professionals in Rural China: Issues and Progress; Comment on “Have Health Human Resources Become More Equal between Rural and Urban Areas after the New Reform?”

    Directory of Open Access Journals (Sweden)

    Jianlin Hou

    2015-05-01

    Full Text Available Maldistribution of health professionals between urban and rural areas has been a serious problem in China. Urban hospitals attract most of the health professionals with serious shortages in rural areas. To address this issue, a number of policies have been implemented by the government, such as free medical education in exchange for obligatory rural service.

  17. National rural health mission--opportunity for Indian Public Health Association.

    Science.gov (United States)

    Ray, Sandip Kumar

    2005-01-01

    Indian Public Health Association (IPHA) welcomes the release of National Rural Health Mission (NRHM) documents. It suggests that manpower requirements of the Community Health Centre (CHC) should be rationally determined on the basis of work and patient load of the CHC. Importance should be given on availability of simple & life saving equipment, female staff when male staff is not available. Safe drinking water, an adequate sanitation and excreta disposal facility through Panchayet Raj Institution (PRI) or privatization was proposed. Accredited Social Health Activist (ASHA) has been accepted more streamlining based on the community was suggested. Capacity building or training should be CHC based for grass-root level functionaries with incentive to Medical officer (MO). IPHA proposes to extend support in capacity building, development of manual for ASHA & other categories of health professional as well as Program Implementation Plan (PIP).

  18. Descriptive analysis of the inequalities of health information resources between Alberta's rural and urban health regions.

    Science.gov (United States)

    Stieda, Vivian; Colvin, Barb

    2009-01-01

    In an effort to understand the extent of the inequalities in health information resources across Alberta, SEARCH Custom, HKN (Health Knowledge Network) and IRREN (Inter-Regional Research and Evaluation Network) conducted a survey in December 2007 to determine what library resources currently existed in Alberta's seven rural health regions and the two urban health regions. Although anecdotal evidence indicated that these gaps existed, the analysis was undertaken to provide empirical evidence of the exact nature of these gaps. The results, coupled with the published literature on the impact, effectiveness and value of information on clinical practice and administrative decisions in healthcare management, will be used to build momentum among relevant stakeholders to support a vision of equitably funded health information for all healthcare practitioners across the province of Alberta.

  19. Developing a Learner-Centered Curriculum for a Rural Public Health Program

    Science.gov (United States)

    Njoku, Anuli; Wakeel, Fathima; Reger, Michael; Jadhav, Emmanuel; Rowan, Julie

    2017-01-01

    Rural communities, compared with their urban counterparts, have higher rates of disease and adverse health conditions, fueling disparities in health outcomes. This encourages the need for effective curricula to engage students and enable them to address such disparate health outcomes as imminent health professionals. Incorporating learner-centered…

  20. Trends in Perinatal and Infant Health Disparities Between Rural American Indians and Alaska Natives and Rural Whites

    Science.gov (United States)

    Grossman, David C.; Murowchick, Elise; Larson, Eric H.; Hollow, Walter B.; Sugarman, Jonathan R.; Freeman, William L.; Hart, L. Gary

    2009-01-01

    Objectives. We examined disparities in perinatal care, birth outcomes, and infant health between rural American Indian and Alaska Native (AIAN) persons and rural Whites over time. Methods. We compared perinatal and infant health measures for 217 064 rural AIAN births and 5 032 533 rural non-Hispanic White births. Results. Among American Indians and Alaska Natives, unadjusted rates of inadequate prenatal care (1985–1987, 36.3%; 1995–1997, 26.3%) and postneonatal death (1985–1987, 7.1 per 1000; 1995–1997, 4.8 per 1000) improved significantly. However, disparities between American Indians and Alaska Natives and Whites in adjusted odds ratios (AORs) of postneonatal death (1985–1987, AOR = 1.55; 95% confidence interval [CI] = 1.41, 1.71; 1995–1997, AOR = 1.46; 95% CI = 1.31, 1.64) and adjusted risk ratios (ARRs) of inadequate prenatal care (1985–1987, ARR = 1.67; 95% CI = 1.65, 1.69; 1995–1997, ARR = 1.84; 95% CI = 1.81, 1.87) persisted. Conclusions. Despite significant decreases in inadequate prenatal care and postneonatal death among American Indians and Alaska Natives, additional measures are needed to close persistent health gaps for this group. PMID:18703453

  1. Rural health systems' perceptions of referral to community pharmacists during transitions of care.

    Science.gov (United States)

    Paul, Stephanie; DiDonato, Kristen L; Liu, Yifei; Hartwig, D Matthew; May, Justin; Schramm, Andrew M

    2016-01-01

    To identify rural health systems' perceptions of value, benefits, barriers, and opportunities associated with community pharmacist involvement in patient transitions of care. Rural health systems in northwest and central Missouri. Qualitative descriptive study of key informant interviews with self-identified decision makers of rural health systems within a 50-mile radius of 15 independent community pharmacy chain locations. Interviews were recorded, transcribed, and coded to evaluate themes in participant responses. Fifteen interviews were conducted at 8 rural health systems. Participants expressed significant value in community pharmacist involvement in transitions of care and highlighted several benefits, barriers, and opportunities related to potential collaboration. Benefits that were identified included medication monitoring, resource for patient information, and desire among health care providers to work with community pharmacists. Barriers included legal and regulatory issues with referral, communication, and prescriber utilization. Opportunities described included: patient education, monitoring, and follow-up; targeted interventions; medication access assistance; bedside medication delivery; and collaboration between community pharmacies and health care entities. Rural health system informants perceived community pharmacy involvement to be valuable and were receptive to collaboration during transitional care to improve patient outcomes. They highlighted barriers to overcome to truly incorporate community pharmacists into the transitional care arena. Understanding these rural health systems' perceptions can guide community pharmacies in developing collaborative relationships and patient care services to assist with care transitions. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  2. Evaluation of computerized health management information system for primary health care in rural India

    Directory of Open Access Journals (Sweden)

    Singh Satyavir

    2010-11-01

    Full Text Available Abstract Background The Comprehensive Rural Health Services Project Ballabgarh, run by All India Institute of Medical Sciences (AIIMS, New Delhi has a computerized Health Management Information System (HMIS since 1988. The HMIS at Ballabgarh has undergone evolution and is currently in its third version which uses generic and open source software. This study was conducted to evaluate the effectiveness of a computerized Health Management Information System in rural health system in India. Methods The data for evaluation were collected by in-depth interviews of the stakeholders i.e. program managers (authors and health workers. Health Workers from AIIMS and Non-AIIMS Primary Health Centers were interviewed to compare the manual with computerized HMIS. A cost comparison between the two methods was carried out based on market costs. The resource utilization for both manual and computerized HMIS was identified based on workers' interviews. Results There have been no major hardware problems in use of computerized HMIS. More than 95% of data was found to be accurate. Health workers acknowledge the usefulness of HMIS in service delivery, data storage, generation of workplans and reports. For program managers, it provides a better tool for monitoring and supervision and data management. The initial cost incurred in computerization of two Primary Health Centers was estimated to be Indian National Rupee (INR 1674,217 (USD 35,622. Equivalent annual incremental cost of capital items was estimated as INR 198,017 (USD 4213. The annual savings is around INR 894,283 (USD 11,924. Conclusion The major advantage of computerization has been in saving of time of health workers in record keeping and report generation. The initial capital costs of computerization can be recovered within two years of implementation if the system is fully operational. Computerization has enabled implementation of a good system for service delivery, monitoring and supervision.

  3. Evaluation of computerized health management information system for primary health care in rural India

    Science.gov (United States)

    2010-01-01

    Background The Comprehensive Rural Health Services Project Ballabgarh, run by All India Institute of Medical Sciences (AIIMS), New Delhi has a computerized Health Management Information System (HMIS) since 1988. The HMIS at Ballabgarh has undergone evolution and is currently in its third version which uses generic and open source software. This study was conducted to evaluate the effectiveness of a computerized Health Management Information System in rural health system in India. Methods The data for evaluation were collected by in-depth interviews of the stakeholders i.e. program managers (authors) and health workers. Health Workers from AIIMS and Non-AIIMS Primary Health Centers were interviewed to compare the manual with computerized HMIS. A cost comparison between the two methods was carried out based on market costs. The resource utilization for both manual and computerized HMIS was identified based on workers' interviews. Results There have been no major hardware problems in use of computerized HMIS. More than 95% of data was found to be accurate. Health workers acknowledge the usefulness of HMIS in service delivery, data storage, generation of workplans and reports. For program managers, it provides a better tool for monitoring and supervision and data management. The initial cost incurred in computerization of two Primary Health Centers was estimated to be Indian National Rupee (INR) 1674,217 (USD 35,622). Equivalent annual incremental cost of capital items was estimated as INR 198,017 (USD 4213). The annual savings is around INR 894,283 (USD 11,924). Conclusion The major advantage of computerization has been in saving of time of health workers in record keeping and report generation. The initial capital costs of computerization can be recovered within two years of implementation if the system is fully operational. Computerization has enabled implementation of a good system for service delivery, monitoring and supervision. PMID:21078203

  4. Differences in health care seeking behaviour between rural and urban communities in South Africa

    Directory of Open Access Journals (Sweden)

    van der Hoeven Marinka

    2012-06-01

    Full Text Available Abstract Objective The aim of this study was to explore possible differences in health care seeking behaviour among a rural and urban African population. Design A cross sectional design was followed using the infrastructure of the PURE-SA study. Four rural and urban Setswana communities which represented different strata of urbanisation in the North West Province, South Africa, were selected. Structured interviews were held with 206 participants. Data on general demographic and socio-economic characteristics, health status, beliefs about health and (access to health care was collected. Results The results clearly illustrated differences in socio-economic characteristics, health status, beliefs about health, and health care utilisation. In general, inhabitants of urban communities rated their health significantly better than rural participants. Although most urban and rural participants consider their access to health care as sufficient, they still experienced difficulties in receiving the requested care. The difference in employment rate between urban and rural communities in this study indicated that participants of urban communities were more likely to be employed. Consequently, participants from rural communities had a significantly lower available weekly budget, not only for health care itself, but also for transport to the health care facility. Urban participants were more than 5 times more likely to prefer a medical doctor in private practice (OR:5.29, 95% CI 2.83-988. Conclusion Recommendations are formulated for infrastructure investments in rural communities, quality of health care and its perception, improvement of household socio-economical status and further research on the consequences of delay in health care seeking behaviour.

  5. Health Care Provider Mobility Counseling Provision to Older Adults: A Rural/Urban Comparison.

    Science.gov (United States)

    Huseth-Zosel, Andrea L; Sanders, Gregory; O'Connor, Melissa; Fuller-Iglesias, Heather; Langley, Linda

    2016-02-01

    The current study examined rural-urban differences in health care provider (HCP) perceptions, attitudes, and practices related to driving safety/cessation-related anticipatory guidance provision to older adults. A cross-sectional survey was conducted with HCPs in several north central states. Exploratory factor analysis was used to examine dimensions of HCP perceptions and attitudes related to mobility counseling. Binary logistic regression analyses were conducted to determine if HCP rurality was significantly predictive of HPC provision of mobility counseling by age. Rural HCPs were less likely than urban HCPs to provide mobility counseling to their patients aged 75 or older. Rural HCPs were less likely to refer patients to a driving fitness evaluation resource if they had questions related to driving issues, and were less likely to perceive there were adequate resources to help with driving issues. Rural-urban differences in HCP mobility counseling provision may contribute to potential health disparities between urban and rural patients. Both rural and urban HCPs need training about older driver issues, so they may educate their patients about driving safety/cessation. Future research should examine the association between rural-urban differences in HCP mobility counseling provision and rural older adult overrepresentation in motor vehicle injuries and fatalities statistics.

  6. "Remnants of feudalism"? Women's health and their utilization of health services in rural China.

    Science.gov (United States)

    Anson, O; Haanappel, F W

    1999-01-01

    Almost five decades ago, the Chinese Communist Party wished to abolish all "remnants of feudalism," including the patriarchal social order. Just one year after the revolution, the Marriage Law endorsed women's rights within the family, but no operative measures were taken to enforce it. Some of the economic reforms since independence even strengthened patrilocality and, possibly, patriarchal values. The purpose of this study was to explore the degree to which patrilocality served to maintain the traditional patriarchal stratification among women in the household by exploring women's health patterns and utilization of health services. Data were collected from 3859 women residing in rural Hebei, and variation in health and help seeking of six categories of relation to household head--mothers, wives, daughters, daughters-in-law, family heads, and other relatives--were explored. Utilization of health services is not dependent on women's position in the household, but primarily on per-capita income. Health patterns seem to indicate that mothers of the head of the household still have a considerable power to define their roles and share of household work. Women head of family, most of whom are married, appear to be under strain, which could be a result of their culturally "deviant" position. We conclude that old patriarchal values are intertwined with values of equality in current rural China.

  7. Getting Started: Initiating Critical Ethnography and Community-Based Action Research in a Program of Rural Health Studies

    Directory of Open Access Journals (Sweden)

    Jennifer B. Averill

    2006-06-01

    Full Text Available Rural populations experience higher rates of illness, less access to health care resources, and lower rates of health insurance coverage than do urban populations. A need exists to identify and address the health care needs of rural communities and other isolated populations and to contextualize the findings in the larger rural health environment. Critical ethnography combined with community-based action research is a constructive approach for improving the health status of rural elders as well as other members of isolated communities. Detailed guidelines on how to initiate an ethnographic community-based action study, as shown through a study that explores the definitions of health, health care perceptions, and health care issues for rural elders in the southwestern United States, highlight the value of this type of research for the study of the health care issues of rural populations.

  8. Depression and Rural Environment are Associated With Poor Oral Health Among Pregnant Women in Northern Appalachia.

    Science.gov (United States)

    McNeil, Daniel W; Hayes, Sarah E; Randall, Cameron L; Polk, Deborah E; Neiswanger, Kathy; Shaffer, John R; Weyant, Robert J; Foxman, Betsy; Kao, Elizabeth; Crout, Richard J; Chapman, Stella; Brown, Linda J; Maurer, Jennifer L; Marazita, Mary L

    2016-01-01

    Both oral health problems and depression among pregnant women contribute to maternal-infant health outcomes. Little is known, however, about the potential effects of clinically significant depression on the oral health status of pregnant women. The purpose of the present study was to determine the influence of clinically significant depression and rural- or urban-dwelling status on oral health outcomes among pregnant women. Pregnant women (N = 685) in rural (i.e., West Virginia) and urban (i.e., Pittsburgh, PA) areas of northern Appalachia were assessed by calibrated examiners regarding gingivitis, oral hygiene, and DMFT (decayed, missing, and filled teeth), completed the Center for Epidemiologic Studies-Depression Scale (CES-D) and provided demographics. Participants were categorized based on clinically significant depressive symptoms (CES-D ≥ 16) and rural/urban domicile. Women with depression and those living in rural areas had worse oral health on all three indices than their non-depressed and urban counterparts. Depression, particularly among women in rural areas, affects certain oral health indices and represents a modifiable target for intervention. Moreover, treatments designed specifically for rural populations may be of particular utility. Women who are pregnant or planning to become pregnant may benefit from regular depression screenings from their dental and medical health care providers.

  9. A rural-urban comparison of allied health professionals' average hourly wage.

    Science.gov (United States)

    Richardson, Indira; Slifkin, Rebecca; Randolph, Randy; Holmes, George M

    2010-01-01

    Nationwide, demand for allied health services is projected to grow significantly in the next several decades, and there is evidence that allied health shortages already exist in many states. Given the longstanding history of health professional shortages in rural areas, the existing and impending shortages in allied health professions may be particularly acute in these areas. To assess whether rural areas are potentially at a recruiting disadvantage because of relative wages, this report uses data from the Bureau of Labor Statistics to describe the extent to which rural-urban differentials exist in wages for eight allied health professions, focusing on professions that are both likely to be found in rural communities and have adequate data to support hourly wage estimates. Overall the data show that the national average wage of each of the eight allied health professions is higher in metropolitan than nonmetropolitan areas. On average, the unadjusted rural hourly wage is 10.3% less than the urban wage, although the extent of the difference varies by profession and by geographic area. Adjustment for the cost of living narrows the discrepancy, but does not eliminate it. It is likely that rural providers in areas with the greatest wage discrepancies find it more difficult to recruit allied health professionals, but the extent to which this is the case needs to be assessed through further research with data on workforce vacancy rates.

  10. Work motivation and job satisfaction of health workers in urban and rural areas

    National Research Council Canada - National Science Library

    Grujicic, Maja; Jovicic-Bata, Jelena; Radjen, Slavica; Novakovic, Budimka; Sipetic-Grujicic, Sandra

    2016-01-01

    .... The aim of this study was to investigate whether there was a difference in work motivation and job satisfaction between health workers in urban and rural areas in the region of Central Serbia. Methods...

  11. Health Insurance Reform and Efficiency of Township Hospitals in Rural China: An Analysis from Survey Data

    OpenAIRE

    Audibert, Martine; Xiao Xian HUANG; Mathonnat, Jacky; Pelissier, Aurore; Anning MA

    2012-01-01

    In the rural health-care organization of China, township hospitals ensure the delivery of basic medical services. Particularly damaged by the economic reforms implemented from 1975 to the end of the 1990s, township hospitals efficiency is questioned, mainly with the implementation since 2003 of the reform of health insurance in rural areas. From a database of 24 randomly selected township hospitals observed over the period 2000-2008 in Weifang prefecture (Shandong), the study examines the eff...

  12. Partnership for implementation of evidence-based mental health practices in rural federally qualified health centers: theory and methods.

    Science.gov (United States)

    Hunt, Justin B; Curran, Geoffrey; Kramer, Teresa; Mouden, Sip; Ward-Jones, Susan; Owen, Richard; Fortney, John

    2012-01-01

    Mental health and substance abuse are among the most commonly reported reasons for visits to Federally Qualified Health Centers (CHCs), yet only 6.5% of encounters are with on-site behavioral health specialists. Rural CHCs are significantly less likely to have on-site behavioral specialists than urban CHCs. Because of this lack of mental health specialists in rural areas, the most promising approach to improving mental health outcomes is to help rural primary care (PC) providers deliver evidence-based practices (EBPs). Despite the scope of these problems, no research has developed an effective implementation strategy for facilitating the adoption of mental health EBPs for rural CHCs. We sought to describe the conceptual components of an implementation partnership that focuses on the adaption and adoption of mental health EBPs by rural CHCs in Arkansas. We present a conceptual model that integrates seven separate frameworks: (1) Jones and Wells' Evidence-Based Community Partnership Model, (2) Kitson's Promoting Action on Research Implementation in Health Services (PARiHS) implementation framework, (3) Sackett's definition of evidence-based medicine, (4) Glisson's organizational social context model, (5) Rubenstein's Evidence-Based Quality Improvement (EBQI) facilitation process, (6) Glasgow's RE-AIM evaluation approach, and (7) Naylor's concept of shared decision making. By integrating these frameworks into a meaningful conceptual model, we hope to develop a successful implementation partnership between an academic health center and small rural CHCs to improve mental health outcomes. Findings from this implementation partnership should have relevance to hundreds of clinics and millions of patients, and could help promote the sustained adoption of EBPs across rural America.

  13. On Rural Medical Care and Health Undertaking Development during New Medical Reform

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yi-huan

    2012-01-01

    Based on in-depth survey of township hospitals in Lushan County of Henan Province, this paper studies the development situations of rural medical care and health undertaking in the course of new medical reform. Results show that both rural medical institution and public health undertaking have considerable development in this course. Working capital situation gradually turns better. However, there are still problems and challenge of shortage of high quality medical care personnel, lack of employment mechanism, poor medical environment, and imperfect bidding and purchasing system of medicines. To further develop rural medical situation, it should improve medical environment, speed up informationization construction, and give prominence to functional orientation.

  14. Work motivation and job satisfaction of health workers in urban and rural areas

    Directory of Open Access Journals (Sweden)

    Grujičić Maja

    2016-01-01

    Full Text Available Background/Aim. Motivated and job satisfied health professionals represent a basis of success of modern health institutions. The aim of this study was to investigate whether there was a difference in work motivation and job satisfaction between health workers in urban and rural areas in the region of Central Serbia. Methods. The study included 396 health professionals from urban setting, and 436 from a rural area, employed in four randomly selected health facilities. An anonymous questionnaire was used for data gathering. Statistical analysis was performed using χ2, Student t-test, Spearman's correlation coefficient, and logistic regression analysis. Results. Urban health professionals were significantly more motivated and job satisfied than respondents from rural area. In relation to work motivation factors and job satisfaction of health professionals in urban and rural areas, there were no significant differences in working conditions and current equipment, and in terms of job satisfaction there were no significant differences in relation to income either. Conclusion. In order to increase the level of work motivation and job satisfaction of health workers in rural areas, apart from better income, they should get more assistance and support from their supervisors, and awards for good job performance; interpersonal relationships, promotion and advancement opportunities, managerial performance and cooperation at work should be improved; employment security should be provided, as well as more independence at work, with professional supervision of health workers.

  15. Nutritional status and its health-related factors among older adults in rural and urban areas.

    Science.gov (United States)

    Chen, Su-Hui; Cheng, Hsin-Yi; Chuang, Yeu-Hui; Shao, Jung-Hua

    2015-01-01

    To compare health-related characteristics, nutrition-related factors and nutritional status of older adults living in rural and urban counties of Taiwan. The older adult population of Taiwan is increasing. Furthermore, older people living in rural areas have shorter life expectancy and more chronic diseases than their urban counterparts. However, little is known about the health-related characteristics, nutrition-related factors and nutritional status of older adults living in rural and urban areas of Taiwan, limiting nurses' ability to identify and care for older adults at risk of poor nutritional health. Cross-sectional, comparative. Older adults were randomly selected from names of residents of an adjacent rural and urban area of northern Taiwan and having completing the 2009 health evaluation. From March-July 2010, older adult participants (N = 366) provided data on demographic and health-related information, nutritional self-efficacy, health locus of control and nutritional status. Data were analysed by descriptive statistics and compared using chi-square and t-test. Older rural participants had significantly lower educational level, less adequate income, higher medication use, lower scores on self-rated health status and researcher-rated health status and lower self-rated healthy eating status than their urban counterparts. Moreover, rural participants had significantly lower nutritional self-efficacy, higher chance health locus of control and poorer nutritional status than their urban counterparts. Our results suggest that nurses should assess older adults living in rural areas for nutritional health and nutrition knowledge. Based on this assessment, nurses should develop easy, practical and accessible nutritional programmes for this population. © 2014 John Wiley & Sons Ltd.

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

    Science.gov (United States)

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

    2017-01-01

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

  17. Community Residency Programme (CRP)--a tool for research and rural health training for medical students.

    Science.gov (United States)

    Yadav, H

    2002-12-01

    Rural health training is an important element in the training of medical students in the University of Malaya. There is a need for the undergraduates to be familiar with the rural health infrastructure and to understand the social and economic aspects of the rural poor. The objective of the training is to make the students understand the problems faced by the poor in the rural areas so that when they practice in rural health areas, after graduation, they will understand the problems of the rural poor. They will have the knowledge of the diseases in the rural areas and also understand the community and the environmental factors that contribute to the disease. The training lasts' for 4 weeks, one week for lectures on health survey, two weeks for the field trip and one week of data analysis and presentation of their findings to an expert panel. During the field trip the students are divided into groups and they go to different parts of the country. Each group will do a field survey to find out the socio-demography, environmental, economic, nutritional and health problems in the village. In addition to the survey they also do a research project on any topic. The students also do social work, visit places of public health interest like the water treatment plant, sewage disposal, factory visits and others. Apart from technical skills in statistics and epidemiology, various other managerial skills like leadership, teamwork, communications and public relations are also learnt during the training. In conclusion this rural health training is an important aspect of the medical students training as it imparts several skills to them that are needed as a doctor.

  18. Secure Cloud-Based Solutions for Different eHealth Services in Spanish Rural Health Centers.

    Science.gov (United States)

    de la Torre-Díez, Isabel; Lopez-Coronado, Miguel; Garcia-Zapirain Soto, Begonya; Mendez-Zorrilla, Amaia

    2015-07-27

    The combination of eHealth applications and/or services with cloud technology provides health care staff—with sufficient mobility and accessibility for them—to be able to transparently check any data they may need without having to worry about its physical location. The main aim of this paper is to put forward secure cloud-based solutions for a range of eHealth services such as electronic health records (EHRs), telecardiology, teleconsultation, and telediagnosis. The scenario chosen for introducing the services is a set of four rural health centers located within the same Spanish region. iCanCloud software was used to perform simulations in the proposed scenario. We chose online traffic and the cost per unit in terms of time as the parameters for choosing the secure solution on the most optimum cloud for each service. We suggest that load balancers always be fitted for all solutions in communication together with several Internet service providers and that smartcards be used to maintain identity to an appropriate extent. The solutions offered via private cloud for EHRs, teleconsultation, and telediagnosis services require a volume of online traffic calculated at being able to reach 2 Gbps per consultation. This may entail an average cost of €500/month. The security solutions put forward for each eHealth service constitute an attempt to centralize all information on the cloud, thus offering greater accessibility to medical information in the case of EHRs alongside more reliable diagnoses and treatment for telecardiology, telediagnosis, and teleconsultation services. Therefore, better health care for the rural patient can be obtained at a reasonable cost.

  19. Educating advanced practice nurses in using social media in rural health care.

    Science.gov (United States)

    Rutledge, Carolyn M; Renaud, Michelle; Shepherd, Laurel; Bordelon, Michele; Haney, Tina; Gregory, Donna; Ayers, Paula

    2011-10-03

    Health care in the United States is facing a crisis in providing access to quality care for those in underserved and rural regions. Advanced practice nurses are at the forefront of addressing such issues, through modalities such as health care technology. Many nursing education programs are seeking strategies for better educating students on technology utilization. Health care technology includes electronic health records, telemedicine, and clinical decision support systems. However, little focus has been placed on the role of social media in health care. This paper describes an educational workshop using standardized patients and hands-on experiences to introduce advanced practice nurses in a Doctor of Nursing Practice program to the role of social media in addressing issues inherent in the delivery of rural health care. The students explore innovative approaches for utilizing social media for patient and caregiver support as well as identify online resources that assist providers in a rural setting.

  20. The Rural-Urban Divide: Health Services Utilization among Older Mexicans in Mexico

    Science.gov (United States)

    Salinas, Jennifer J.; Al Snih, Soham; Markides, Kyriakos; Ray, Laura A.; Angel, Ronald J.

    2010-01-01

    Context: Mexico. Purpose: Using the health care service utilization model as a framework, this paper will analyze the differences in health care service use among older Mexicans living in urban and rural areas in Mexico. Methods: The Mexican Health and Aging Survey (MHAS) data were used to test the applicability of Andersen's "model of health…

  1. Design and Usability Testing of an mHealth Application for Midwives in Rural Ghana

    Science.gov (United States)

    Velez, Olivia

    2011-01-01

    Midwives in Ghana provide the majority of rural primary and maternal healthcare services, but have limited access to data for decision making and knowledge work. Few mobile health (mHealth) applications have been designed for midwives. The study purpose was to design and test an mHealth application (mClinic) that can improve data access and reduce…

  2. Urban-rural health differences: primary care data and self reported data render different results.

    NARCIS (Netherlands)

    Kroneman, M.; Verheij, R.; Tacken, M.; Zee, J. van der

    2010-01-01

    Aim: Assessing the usefulness of GP electronic medical records for assessing the health of rural populations by comparing these data with data from health interview surveys. Data: Data from electronic medical records routinely recorded in general practices in 2000–2002. Data on self- reported health

  3. Urban-rural health differences: primary care data and self reported data render different results.

    NARCIS (Netherlands)

    Kroneman, M.; Verheij, R.; Tacken, M.A.J.B.; Zee, Jvan der

    2010-01-01

    AIM: Assessing the usefulness of GP electronic medical records for assessing the health of rural populations by comparing these data with data from health interview surveys. DATA: Data from electronic medical records routinely recorded in general practices in 2000-2002. Data on self-reported health

  4. Fair Starts for Children. An Assessment of Rural Poverty and Maternal and Infant Health.

    Science.gov (United States)

    Couto, Richard A.

    The Maternal and Infant Health Outreach Worker Program (MIHOW) of Vanderbilt University's Center for Health Services gathered data on family planning, prenatal care, pregnancy outcomes, breastfeeding, and preventive child health care from 60 women in 6 rural, low income communities in Tennessee, Kentucky, and West Virginia. The resulting baseline…

  5. Design and Usability Testing of an mHealth Application for Midwives in Rural Ghana

    Science.gov (United States)

    Velez, Olivia

    2011-01-01

    Midwives in Ghana provide the majority of rural primary and maternal healthcare services, but have limited access to data for decision making and knowledge work. Few mobile health (mHealth) applications have been designed for midwives. The study purpose was to design and test an mHealth application (mClinic) that can improve data access and reduce…

  6. Access to Specialty Health Care for Rural American Indians in Two States

    Science.gov (United States)

    Baldwin, Laura-Mae; Hollow, Walter B.; Casey, Susan; Hart, L. Gary; Larson, Eric H.; Moore, Kelly; Lewis, Ervin; Andrilla, C. Holly A.; Grossman, David C.

    2008-01-01

    Context: The Indian Health Service (IHS), whose per capita expenditure for American Indian and Alaska Native (AI/AN) health services is about half that of the US civilian population, is the only source of health care funding for many rural AI/ANs. Specialty services, largely funded through contracts with outside practitioners, may be limited by…

  7. Impact of rural residence and health system structure on quality of liver care.

    Directory of Open Access Journals (Sweden)

    Catherine Rongey

    Full Text Available BACKGROUND: Specialist physician concentration in urban areas can affect access and quality of care for rural patients. As effective drug treatment for hepatitis C (HCV becomes increasingly available, the extent to which rural patients needing HCV specialists face access or quality deficits is unknown. We sought to determine the influence of rural residency on access to HCV specialists and quality of liver care. METHODS: The study used a national cohort of 151,965 Veterans Health Administration (VHA patients with HCV starting in 2005 and followed to 2009. The VHA's constant national benefit structure reduces the impact of insurance as an explanation for observed disparities. Multivariate cox proportion regression models for each quality indicator were performed. RESULTS: Thirty percent of VHA patients with HCV reside in rural and highly rural areas. Compared to urban residents, highly rural (HR 0.70, CI 0.65-0.75 and rural (HR 0.96, CI 0.94-0.97 residents were significantly less likely to access HCV specialty care. The quality indicators were more mixed. While rural residents were less likely to receive HIV screening, there were no significant differences in hepatitis vaccinations, endoscopic variceal and hepatocellular carcinoma screening between the geographic subgroups. Of note, highly rural (HR 1.31, CI 1.14-1.50 and rural residents (HR 1.06, CI 1.02-1.10 were more likely to receive HCV therapy. Of those treated for HCV, a third received therapy from a non-specialist provider. CONCLUSION: Rural patients have less access to HCV specialists, but this does not necessarily translate to quality deficits. The VHA's efforts to improve specialty care access, rural patient behavior and decentralization of HCV therapy beyond specialty providers may explain this contradiction. Lessons learned within the VHA are critical for US healthcare systems restructuring into accountable care organizations that acquire features of integrated systems.

  8. Impact of Rural Residence and Health System Structure on Quality of Liver Care

    Science.gov (United States)

    Rongey, Catherine; Shen, Hui; Hamilton, Nathan; Backus, Lisa I.; Asch, Steve M.; Knight, Sara

    2013-01-01

    Background Specialist physician concentration in urban areas can affect access and quality of care for rural patients. As effective drug treatment for hepatitis C (HCV) becomes increasingly available, the extent to which rural patients needing HCV specialists face access or quality deficits is unknown. We sought to determine the influence of rural residency on access to HCV specialists and quality of liver care. Methods The study used a national cohort of 151,965 Veterans Health Administration (VHA) patients with HCV starting in 2005 and followed to 2009. The VHA’s constant national benefit structure reduces the impact of insurance as an explanation for observed disparities. Multivariate cox proportion regression models for each quality indicator were performed. Results Thirty percent of VHA patients with HCV reside in rural and highly rural areas. Compared to urban residents, highly rural (HR 0.70, CI 0.65-0.75) and rural (HR 0.96, CI 0.94-0.97) residents were significantly less likely to access HCV specialty care. The quality indicators were more mixed. While rural residents were less likely to receive HIV screening, there were no significant differences in hepatitis vaccinations, endoscopic variceal and hepatocellular carcinoma screening between the geographic subgroups. Of note, highly rural (HR 1.31, CI 1.14-1.50) and rural residents (HR 1.06, CI 1.02-1.10) were more likely to receive HCV therapy. Of those treated for HCV, a third received therapy from a non-specialist provider. Conclusion Rural patients have less access to HCV specialists, but this does not necessarily translate to quality deficits. The VHA's efforts to improve specialty care access, rural patient behavior and decentralization of HCV therapy beyond specialty providers may explain this contradiction. Lessons learned within the VHA are critical for US healthcare systems restructuring into accountable care organizations that acquire features of integrated systems. PMID:24386420

  9. Rurality and Self-Reported Health in Women with a History of Intimate Partner Violence

    Science.gov (United States)

    Hussain, Rafat; Loxton, Deborah; Khan, Asad

    2016-01-01

    Objective To investigate differences in self-reported health among Australian women with a history of intimate partner violence (IPV) in relation to rurality of residence. Methods Data were drawn from six survey waves of the Australian Longitudinal Study on Women’s Health 1973–78 birth cohort. Self-reported general and mental health scores derived from the SF-36 scale were compared for women with a history of IPV living in metropolitan, regional and rural areas. Multivariable generalised estimating equations were constructed adjusting for income hardship, number of children, education, social support, age and marital status. Results Women with a history of IPV living in regional and rural areas had no significant differences in self-reported general health scores compared to their metropolitan counterparts. Rural women affected by IPV had slightly better self-reported mental health than equivalent women living in metropolitan or regional areas. The socio-demographic factors with the strongest association with self-reported health were income, education, social support, and number of children. Conclusions Women in regional and rural areas were no more disadvantaged, in terms of self-reported general health or mental health, than IPV affected women living in major cities in Australia. PMID:27622559

  10. The changing landscape of health care financing and delivery: how are rural communities and providers responding?

    Science.gov (United States)

    Mueller, K J; Coburn, A; Cordes, S; Crittenden, R; Hart, J P; McBride, T; Myers, W

    1999-01-01

    Rural communities have not kept pace with the recent dramatic changes in health care financing and organization. However, the Medicare provisions in the Balanced Budget Act of 1997 will require rural providers to participate in the new systems. Case studies revealed the degree of readiness for change in six rural communities and charted their progress along a continuum, as reflected in three sets of activities: the development of networking; the creation of new strategies for managing patient care; and the adoption of new methods for contracting with health insurers. Some communities had constructed highly integrated systems, whereas others were just beginning to change their billing practices; a few were signing contracts for capitated care, in contrast to those that were resisting discounts in current fee structures. These six rural areas still have considerable ground to cover before their health care organization and financing reach the levels achieved by urban communities.

  11. Providing mental health services to older people living in rural communities.

    Science.gov (United States)

    Kaufman, Allan V; Scogin, Forrest R; Burgio, Louis D; Morthland, Martin P; Ford, Bryan K

    2007-01-01

    Rural dwelling elders who experience mental health problems often have difficulty finding help since rural communities often lack adequate mental health service providers. This paper reports on the initial phase of a 5-year, interdisciplinary clinical research study that is testing the effectiveness of providing a home delivered, therapeutic psychosocial intervention, aimed at improving the emotional wellbeing and the quality of life of medically frail elders who live in rural communities. In the early phases of this study, the clinical research team encountered a number of interesting and often unanticipated challenges as it attempted to recruit study participants and provide services to them. In this article, we examine these challenges and share what we have learned so far about providing mental health services to elderly persons living in rural environments.

  12. Globalisation, rural restructuring and health service delivery in Australia: policy failure and the role of social work?

    Science.gov (United States)

    Alston, Margaret

    2007-05-01

    The impacts of globalisation and rural restructuring on health service delivery in rural Australia have been significant. In the present paper, it is argued that declining health service access represents a failure of policy. Rural communities across the world are in a state of flux, and Australia is no different: rural communities are ageing at faster rates than urban communities and young people are out-migrating in large numbers. During the past 5 years, rural Australia has also experienced a severe and widespread drought that has exacerbated rural poverty, and impacted on the health and well-being of rural Australians. Australian governments have responded to globalising forces by introducing neoliberal policy initiatives favouring market solutions and championing the need for self-reliance among citizens. The result for rural Australia has been a withdrawal of services at a time of increased need. This paper addresses the social work response to these changes.

  13. Designing a Softwarized Network Deployed on a Fleet of Drones for Rural Zone Monitoring

    Directory of Open Access Journals (Sweden)

    Corrado Rametta

    2017-03-01

    Full Text Available In the last decade, the differences in the information communication technology (ICT infrastructures between urban and rural areas have registered a tremendous increase. ICT infrastructures could strongly help rural communities where many operations are time consuming, labor-intensive and expensive due to limited access and large distances to cover. One of the most attractive solutions, which is widely recognized as promising for filling this gap, is the use of drone fleets. In this context, this paper proposes a video monitoring platform as a service (VMPaaS for wide rural areas not covered by Internet access. The platform is realized with a Software-Defined Network (SDN/Network Functions Virtualization (NFV-based flying ad-hoc network (FANET, whose target is providing a flexible and dynamic connectivity backbone, and a set of drones equipped with high-resolution cameras, each transmitting a video stream of a portion of the considered area. After describing the architecture of the proposed platform, service chains to realize the video delivery service are described, and an analytical model is defined to evaluate the computational load of the platform nodes in such a way so as to allow the network orchestrator to decide the backbone drones where running the virtual functions, and the relative resources to be allocated. Numerical analysis is carried out in a case study.

  14. Health Needs of Ashram Schools in Rural Wardha

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    Amol R Dongre

    2011-04-01

    Full Text Available Objective: To assess the health needs for health promoting Ashram schools in rural Wardha. Methods: It was a cross sectional study undertaken in 10 Ashram schools, using qualitative (SWOT analysis, Transect walks and Semi-structured interviews of teachers and quantitative (Survey methods. Hemoglobin examination of all children was done by using WHO hemoglobin color scale. Anthropometric measurements such as height and weight of each child were obtained. Physical activity score for each child was calculated. The manual content analysis of qualitative data was done and the quantitative data was entered and analyzed using Epi_info (version 6.04d software package. Results: Out of 1287 children examined, 724 (56.3% were boys and 563 (43.7% were girls. About 576 (44.8%, 213 (16.6%, 760 (59.1% children had untrimmed nails, dirty clothes and unclean teeth respectively. More girls had (31.6% lice infestation than boys (18.2%. Eighty six (6.7%, 75 (5.8% and 110 (8.6% children had scabies, fungal infection and multiple boils on their skin respectively and 158 (12.3%, 136 (10.6% and 66 (18.3% children had dental caries, wax in ears and worm infestation respectively. Notably, 988 (76.8% children had iron deficiency anemia which was significantly more among girls (81.9% than boys (72.8%. About 506 (39.3% children consumed any tobacco product in last one month. About 746 (57.9% children were classified to have sedentary physical activity. Among 774 children (>12 years, 183 (23.6% and 34 (4.4% children felt lonely ‘sometime’ and ‘most of the times’ respectively. About 398 (94.3% boys and 342 (97.2% girls did not know the modes of transmission of HIV/AIDS. Conclusions: In conclusion, there was high prevalence of risk factors for both communicable and non-communicable diseases in Ashram school environment. This dictates the urgent need for teacher driven, needs based and school based intervention that can screen and identify potentially preventable health

  15. Economie agro-alimentaire : Analyse des modèles de consommation des zones rurales au Cameroun

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    Tedonkeng Pamo, E.

    1995-01-01

    Full Text Available Food Economy : Analysis of Food Consumption Pattern of the Rural Area of Cameroon. An outlook of the major steps of the Cameroon food consumption history reflecting the history of the food consumption in general is presented within the framework of food industry economy. On the basis of the agro-ecological zones of Cameroon, major staple food products and respective consumption pattern are analyzed. From this study it appears that nation wide there are areas where acute food deficiency occurs in spite of the presence or absence of the relative diversity in food production. Research on ways and means to improve these food consumption patterns, is matter of necessity and should have as basis food consumption characteristics and the culture of the different local populations.

  16. Implementing smart growth strategies in rural America: development patterns that support public health goals.

    Science.gov (United States)

    Dalbey, Matthew

    2008-01-01

    Recent studies on obesity rates show alarming increases across the entire population. Some of these studies indicate higher rates of obesity in rural populations than urban and suburban populations. Obesity in children in rural places also outpaces their suburban and urban counterparts. Although a number of factors account for these differences, public health professionals and researchers have begun to recognize that conventional development patterns and land use policies in rural areas are playing an important role in the trend. Smart growth alternatives to current rural development patterns also support broad public health goals. Rural communities across America face a number of challenges, yet many are using smart growth development strategies to turn the challenges into opportunities. These strategies are structured in a way that builds on broadly held values in rural communities, ones that build upon the traditional development pattern and support multiple community goals. Public health professionals, managers, and academics will benefit from this discussion because it will explain the strategies that rural decision makers, planners, and citizens are adopting to create places that support multiple community goals including a built environment that sustains and promotes active living.

  17. can volunteer community health workers in rural Uganda provide ...

    African Journals Online (AJOL)

    Introduction: Integrated community case management (iCCM) involves assessment and treatment of common ... proportions of children treated for fever, pneumonia, and diarrhoea in rural Uganda. ...... Clinical management of acute diarrhoea:.

  18. Institutional Delivery Service Utilization among Women from Rural Districts of Wolaita and Dawro Zones, Southern Ethiopia; a Community Based Cross-Sectional Study.

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    Mihiretu Alemayehu Arba

    Full Text Available The highest number of maternal deaths occur during labour, delivery and the first day after delivery highlighting the critical need for good quality care during this period. Therefore, for the strategies of institutional delivery to be effective, it is essential to understand the factors that influence individual and household factors to utilize skilled birth attendance and institutions for delivery. This study was aimed to assess factors affecting the utilization of institutional delivery service of women in rural districts of Wolaita and Dawro Zones.A community based cross-sectional study was done among mothers who gave birth within the past one year preceding the survey in Wolaita and Dawro Zones, from February 01 -April 30, 2015 by using a three stage sampling technique. Initially, 6 districts were selected randomly from the total of 17 eligible districts. Then, 2 kebele from each district was selected randomly cumulating a total of 12 clusters. Finally, study participants were selected from each cluster by using systematic sampling technique. Accordingly, 957 mothers were included in the survey. Data was collected by using a pretested interviewer administered structured questionnaire. The questionnaire was prepared by including socio-demographic variables and variables of maternal health service utilization factors. Data was entered using Epi-data version 1.4.4.0 and exported to SPSS version 20 for analysis. Bivariate and multiple logistic regressions were applied to identify candidate and predictor variables respectively.Only 38% of study participants delivered the index child at health facility. Husband's educational status, wealth index, average distance from nearest health facility, wanted pregnancy, agreement to follow post-natal care, problem faced during delivery, birth order, preference of health professional for ante-natal care and maternity care were predictors of institutional delivery.The use of institutional delivery service is

  19. Challenges to improving maternal health in rural Nepal.

    Science.gov (United States)

    Thapa, S

    1996-05-01

    In the remote village of Martadi, in Bajura district of western Nepal, the total fertility rate is 7. 20% of newborns die before they reach age 1. Temporary migration, mainly to India, is common due to the inability of the rugged and rocky terrain to supply enough food. The existence of temporary migration and a high frequency of remarriage suggest a high rate of sexually transmitted diseases. The relatively new hospital is very much under used (e.g., only 35 patients in 1995). The office in Kolti that supplies vaccines to Martadi has gone at least six months without receiving any new child immunization drugs, despite the presence of an air service. During and after delivery, no one, not even family members or traditional birth attendants, can touch a woman, who is confined to a cow-shed to deliver and care for her child and herself alone. Yet sick animals receive care. A new mother also is required to bathe herself, often requiring a walk of many hours. Women often identify access to water as their top priority. Pregnant or postpartum women are forbidden from eating green vegetables because of the belief that they cause diarrhea. Sanitation is better now in Martadi than in the past. Diarrhea and vomiting were once very prevalent. The international organization, CARE, along with the Ministry of Local Development operate the Remote Area Basic Needs Project, which revolves around community organization, agroforestry, rural infrastructure, and primary health care. The project has helped villagers construct low-cost toilets. It provides training in basic hygiene. Households have kitchen-gardens. Many families are now eating green vegetables regularly. Fruit trees are being introduced. Villagers recognize the value of child immunization. Some small-scale drinking water systems are operating. Villagers are trained in repair and management of these systems. About 33% of women aged 15-49 want no more children. A first-ever outreach program for female sterilization services

  20. Rural-to-Urban Migration and Changes in Health Among Young Adults in Thailand.

    Science.gov (United States)

    Nauman, Elizabeth; VanLandingham, Mark; Anglewicz, Philip; Patthavanit, Umaporn; Punpuing, Sureeporn

    2015-02-01

    We investigate the impacts of rural-to-urban migration on the health of young adult migrants. A key methodological challenge involves the potentially confounding effects of selection on the relationship between migration and health. Our study addresses this challenge in two ways. To control for potential effects of prior health status on post-migration health outcomes, we employ a longitudinal approach. To control for static unobserved characteristics that can affect migration propensity as well as health outcomes, we use fixed-effects analyses. Data were collected in 2005 and 2007 for a cohort of young adults in rural Kanchanaburi province, western Thailand. The migrant sample includes individuals who subsequently moved to urban destinations where they were reinterviewed in 2007. Return migrants were interviewed in rural Kanchanaburi in both years but moved to an urban area and returned in the meantime. A rural comparison group comprises respondents who remained in the origin villages. An urban comparison sample includes longer-term residents of the urban destination communities. Physical and mental health measures are based on the SF-36 health survey. Findings support the "healthy migrant hypothesis." Migrants are physically healthier than their nonmigrant counterparts both before and after moving to the city. We did not find an effect of migration on physical health. Rural-to-urban migrants who stayed at destination experienced a significant improvement in mental health status. Fixed-effects analyses indicate that rural-to-urban migration positively affects mental health. Return migrants do not fare as well as migrants who stayed at destination on both physical and mental health status--evidence of selective return migration.

  1. Rural Aging

    Science.gov (United States)

    ... Rural Health Topics & States Topics View more Rural Aging The nation's population is aging, and with that change comes increased healthcare needs. ... Disease Control and Prevention report, The State of Aging and Health in America 2013 , the population 65 ...

  2. Qualitative Assessment of Challenges in Tuberculosis Control in West Gojjam Zone, Northwest Ethiopia: Health Workers’ and Tuberculosis Control Program Coordinators’ Perspectives

    Directory of Open Access Journals (Sweden)

    Senedu B. Gebreegziabher

    2016-01-01

    Full Text Available Background. Weak health systems pose many barriers to effective tuberculosis (TB control. This study aimed at exploring health worker’s and TB control program coordinator’s perspectives on health systems challenges facing TB control in West Gojjam Zone, Amhara Region, Ethiopia. Methods. This was a qualitative descriptive study. Eight in-depth interviews with TB control program coordinators and two focus group discussions among 16 health workers were conducted. Purposive sampling was used to recruit study participants. Thematic analysis was used to identify and analyse main themes. Results. We found that intermittent interruptions of laboratory reagents and anti-TB drugs supplies, absence of trained and motivated health workers, poor TB data documentation, lack of adherence to TB treatment guideline, and lack of access to TB diagnostic tools at peripheral health institutions were challenges facing the TB control program performance in the study zone. Conclusions. Ensuring uninterrupted supply of anti-TB drugs and laboratory reagents to all health institutions is essential. Continuous refresher training of health workers on standard TB care and data handling and developing and implementing a sound retention strategy to attract and motivate health professionals to work in rural areas are necessary interventions to improve the TB control program performance in the study zone.

  3. [Health education for major parasitic diseases in rural community of China: current status and future development].

    Science.gov (United States)

    Zhang, Jing; Lin, Dan-dan

    2013-08-01

    Owing to human parasitic diseases being related to behavior, the health education as an important measure to prevent parasite infections through human behavior intervention, has played an important role in the process of parasitic disease prevention and control in rural area of China. This paper comments on the development history of the health education for parasitic disease prevention and control, current intervention modes and the effect of the health education for parasitic diseases in rural area. This paper also summarizes the role and impact of different modes of the health education for parasitic disease prevention and control and gives some suggestions to future development of the health education in rural area under current prevalent situation of parasitic diseases.

  4. Determinants of health and nutritional status of rural Nigerian women.

    Science.gov (United States)

    Ene-Obong, H N; Enugu, G I; Uwaegbute, A C

    2001-12-01

    This study was undertaken to determine the effects of socioeconomic and cultural factors on the health and nutritional status of 300 women of childbearing age in two rural farming communities in Enugu State, Nigeria. The women were engaged in farming, trading, and teaching. A cross-sectional survey was conducted using both qualitative and quantitative data-collection methods. The study involved focus-group discussions (FGDs), interviews using a questionnaire, measurement of food/nutrient intake, assessment of activity patterns, anthropometry, and observations of clinical signs of malnutrition. The better-educated women had higher incomes than those with little or no education. Poor education was mainly attributed to lack of monetary support by parents (34%), marriage while in school (27%), and sex discrimination (21%). The teachers had significantly (p iron, riboflavin and niacin requirements. More cases of chronic energy deficiency were observed among the farmers (16%) and traders (13%) than among the teachers (5%). Generally, the women worked long hours with reported working hours (6-7 hours) being lower than the observed working hours (11 hours) for the traders and teachers. Income had a significant (p iron (r = 0.362), riboflavin (r = 0.364), and vitamin C (r = 0.476). Workload was negatively correlated with protein intake (r = 0.346; p < 0.05). Meal frequencies for more than 70% of the farmers and petty traders and 42% of the teachers were dependent on the availability of food in the household. Food taboos had no effect on their nutrient intake, since only 5-11% of women adhered to taboos. Although most women gave their children and husbands preference in food distribution, not much difference was found in the amount of food consumed by these women. The ratio of wife's portion to husband's was 1:1.4 for the farmers, 1:1.3 for the traders, and 1:1.2 for the teachers. FGDs revealed that sex discrimination in education prevailed where resources were limited. The

  5. Saúde, trabalho e ambiente no meio rural brasileiro Health, work and environment at the Brazilian rural

    Directory of Open Access Journals (Sweden)

    Frederico Peres

    2009-12-01

    Full Text Available O presente artigo discute as implicações das mudanças no paradigma produtivo sobre a saúde e o ambiente no meio rural brasileiro. Para tanto, analisa dados de produção, demografia e economia, contrastando os determinantes, de ordem social, estrutural e econômica, com os reflexos na relação saúde, trabalho e ambiente, desvelando um quadro preocupante, que inclui: a os impactos ambientais de grandes cadeias produtivas como soja, milho, algodão e cana de açúcar; b a contaminação química de diversos compartimentos ambientais em razão do uso de agrotóxicos e fertilizantes na agricultura; c o uso de áreas naturais para o aumento de áreas destinadas à agricultura e pecuária; e d os reflexos destas ações sobre a saúde de um contingente expressivo de indivíduos, trabalhadores ou não, colocados cada vez mais em situação de extrema vulnerabilidade face aos riscos advindos dos diversos processos produtivos presentes no meio rural brasileiro. Assim, o presente artigo mostra que os macrodeterminantes (ou grandes forças motrizes acabam por configurar o retrato da saúde dos habitantes do Brasil Rural que, cotidianamente, enfrentam uma série de desafios para a garantia de uma qualidade de vida e de trabalho digna.This manuscript discusses the implications of the productive paradigm changes in health and environment of rural area of Brazil. It analyzes production, economy and demography data, facing social and structural determinants with health and environmental reflexes, revealing a serious panorama that includes: a environmental impacts associated to large productive chains, such as corn, soy-bean, cotton and sugar cane; b chemical contamination of diverse environment compartments due to pesticides and fertilizers used in agriculture; c the use of natural land in the expansion of agriculture and cattle farming activities; and d the reflexes of these actions on individuals, workers or not, that are more and more forced to deal

  6. Building relationships with physicians. Internal marketing efforts help strengthen organizational bonds at a rural health care clinic.

    Science.gov (United States)

    Peltier, J W; Boyt, T; Westfall, J E

    1997-01-01

    Physician turnover is costly for health care organizations, especially for rural organizations. One approach management can take to reduce turnover is to promote physician loyalty by treating them as an important customer segment. The authors develop an information--oriented framework for generating physician loyalty and illustrate how this framework has helped to eliminate physician turnover at a rural health care clinic. Rural health care organizations must develop a more internal marketing orientation in their approach to establishing strong relationship bonds with physicians.

  7. EDUCATION AND HEALTH: IMPORTANT FACTORS IN THE DEVELOPMENT OF RURAL

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    Camelia MĂNESCU

    2015-04-01

    Full Text Available Rural development and diversification of rural economy depend on the level of education, knowledge and qualification. Though improving and maintaining the proper level of basic infrastructure is an important element in the social and economic development of the rural area, it is professional training that represents the “engine” of good development. Education and training are essential for rural communities, but there are obvious discrepancies from the point of view of school infrastructure. Though we can say that the number of schools in the rural area is above the necessary one, education quality is low because, on one hand, of the poor educational infrastructure and, on the other hand, because of the level o training of the teachers. Most of the schools need to be renovated, to be refurnished, to be reequipped and to be supplied with teaching materials. Infrastructures and facilities proper to professional training and to primary education are important tools for the conversion of agricultural labour force into non-agricultural labour force.

  8. Biogas production: new trends for alternative energy sources in rural and Urban zones

    Energy Technology Data Exchange (ETDEWEB)

    Martins das Neves, L.C.; Vessoni Penna, T.C. [Department of Biochemical and Pharmaceutical Technology, School of Pharmaceutical Sciences, University of Sao Paulo (Brazil); Converti, A. [Department of Chemical and Process Engineering, University of Genoa (Italy)

    2009-08-15

    Biogas is a biofuel with a high energy value and basically consisting of methane, which can be used as a renewable energy source as a substitute for natural gas or liquefied petroleum gas. It can be produced by anaerobic digestion of agricultural organic waste or manure in rural areas, where it can be used to generate electric, thermal or mechanical energy. It can also be generated in landfills from the organic fraction of municipal solid wastes and used as an alternative energy source in urban areas. Industrialized and urbanized areas are afflicted by serious environmental problems associated with the generation of organic residues. Anaerobic microorganisms can degrade pollutants resulting in two kinds of products, i.e., digested sludge and biogas, which can be exploited as a soil fertilizer and a renewable energy source, respectively. The correct management of residual waste involves high costs, and inadequate treatment and storage can compromise its quality. Environmental agencies have been encouraging the dissemination of anaerobic digesters to produce biogas from organic residues and the use of the resulting sludge as fertilizer since it is able to destroy pathogenic agents and reduce the humidity level. This review aims to evaluate the production capability of biogas and its application as an alternative energy source in rural and urban areas. (Abstract Copyright [2009], Wiley Periodicals, Inc.)

  9. Editorial - Climate change impacts on rural poverty in low-elevation coastal zones, Edward B. Barbier

    Science.gov (United States)

    Elliott, Michael; Wolanski, Eric

    2015-11-01

    In the Invited Feature Article in this issue of Estuarine, Coastal and Shelf Science, we are extremely grateful to Edward Barbier for performing the major task of increasing our awareness of the hazards and risks faced by all communities on low lying coasts but especially the poor, rural communities (Barbier, 2015). Against a background of climate-induced change, we now have a good and increasing evidence of the way the natural estuarine, coastal and marine system will respond (Elliott et al, 2015). However, more importantly Barbier (2015) highlights the way in which poor, rural coastal communities will be affected and will need to respond or will need help from the developed world to respond. It is axiomatic that while those communities are having less impact than more developed countries on the causes of climate change they are more affected and so have to respond to its consequences, what have been called exogenic unmanaged pressures. Hence they need to rely on mechanisms, techniques, technologies and approaches to help them cope with such change (see also Wolanski and Elliott 2015).

  10. The integration of a telemental health service into rural primary medical care.

    Science.gov (United States)

    Davis, G L; Boulger, J G; Hovland, J C; Hoven, N T

    2007-07-01

    Mental health care shortages in rural areas have resulted in the majority of services being offered through primary medical care settings. The authors argue that a paradigm shift must occur so that those in need of mental health care have reasonable, timely access to these services. Changes proposed include integrating mental health services into primary medical care settings, moving away from the traditional view of mental health care services (one therapist, one hour, and one client), and increasing the consultative role of psychologists and other mental health care providers in primary medical care. Characteristics of mental health providers that facilitate effective integration into primary medical care are presented. The results of a needs assessment survey and an example of a telemental health project are described. This project involved brief consultations with patients and their physicians from a shared care model using a broadband internet telecommunications link between a rural clinic and mental health service providers in an urban area.

  11. Early implementation of WHO recommendations for the retention of health workers in remote and rural areas.

    Science.gov (United States)

    Buchan, James; Couper, Ian D; Tangcharoensathien, Viroj; Thepannya, Khampasong; Jaskiewicz, Wanda; Perfilieva, Galina; Dolea, Carmen

    2013-11-01

    The maldistribution of health workers between urban and rural areas is a policy concern in virtually all countries. It prevents equitable access to health services, can contribute to increased health-care costs and underutilization of health professional skills in urban areas, and is a barrier to universal health coverage. To address this long-standing concern, the World Health Organization (WHO) has issued global recommendations to improve the rural recruitment and retention of the health workforce. This paper presents experiences with local and regional adaptation and adoption of WHO recommendations. It highlights challenges and lessons learnt in implementation in two countries - the Lao People's Democratic Republic and South Africa - and provides a broader perspective in two regions - Asia and Europe. At country level, the use of the recommendations facilitated a more structured and focused policy dialogue, which resulted in the development and adoption of more relevant and evidence-based policies. At regional level, the recommendations sparked a more sustained effort for cross-country policy assessment and joint learning. There is a need for impact assessment and evaluation that focus on the links between the rural availability of health workers and universal health coverage. The effects of any health-financing reforms on incentive structures for health workers will also have to be assessed if the central role of more equitably distributed health workers in achieving universal health coverage is to be supported.

  12. 75 FR 29447 - Public Health Service Act, Rural Physician Training Grant Program, Definition of “Underserved...

    Science.gov (United States)

    2010-05-26

    ... 29447-29451] [FR Doc No: 2010-12557] DEPARTMENT OF HEALTH AND HUMAN SERVICES 42 CFR Part 5a RIN 0906-AA86 Public Health Service Act, Rural Physician Training Grant Program, Definition of ``Underserved... 749B of the Public Health Service Act. Sec. 5a.3 Definition of Underserved Rural Community....

  13. The meaning of health and well-being: voices from older rural women.

    Science.gov (United States)

    de la Rue, M; Coulson, I

    2003-01-01

    The impact of geographical location on the maintenance of older rural women's health and well-being has been largely unexamined in the research literature. Contextual explanations of environmental impact on health status have been traditionally been assigned to a narrow picture of rural life which emphasized occupational health at the expense of sociological aspects. There have been many research programs about ageing Australian people in urban areas but few concerning the older rural population. Few clues can be found as to how their needs and expectations may differ from those of their urban counterparts. The size of Australia's older population is increasing and steadily becoming feminised. Approximately 37% of these older women live outside capital cities in rural and remote areas. For those planning services for this group of older women, the influence of the rural and remote social and physical context on health and well-being must be understood and considered. Data were collected in 2001 for this qualitative study from the five old (78-88 years), widowed rural women participants who had lived most of their lives on farms, by in-depth interviewing regarding life history, and by using personal document strategies. The life history research approach guided data collection, while thematic analysis was employed to avoid examining isolated themes. Social constructionism and socio-environmental theory of gerontology provided the philosophical boundaries to the central research question. While each informant's life history was unique, it was found that the informants' health and well-being were profoundly influenced by the geographical location of living on the land. This small study, which should be extended by a larger study, may be seen as a beginning step in defining health promotional activities, policy development and service programs for older rural women that are both person-centered and sensitive to their unique lifestyle.

  14. Does Health Insurance Coverage Lead to Better Health and Educational Outcomes? Evidence from Rural China. NBER Working Paper No. 16417

    Science.gov (United States)

    Chen, Yuyu; Jin, Ginger Zhe

    2010-01-01

    Many governments advocate nationwide health insurance coverage but the effects of such a program are less known in developing countries. We use part of the 2006 China Agricultural Census (CAC) to examine whether the recent health insurance coverage in rural China has affected children mortality, pregnancy mortality, and the school enrollment of…

  15. Trust in health providers as a catalyst for malaria prevention: Heterogeneous impacts of health education in rural Ghana

    NARCIS (Netherlands)

    Hoop, T.J. de; Kempen, L.A.C.M. van

    2010-01-01

    Although knowledge about effectiveness of insecticide-treated bed nets (ITNs) is fairly widespread in Ghana, their use remains far from universal. We test and validate the hypothesis that health education of hospitals and health centers in rural Ghana is more effective for groups that display relati

  16. Extreme Heat and Health: Perspectives from Health Service Providers in Rural and Remote Communities in South Australia

    Directory of Open Access Journals (Sweden)

    Arthur Saniotis

    2013-10-01

    Full Text Available Among the challenges for rural communities and health services in Australia, climate change and increasing extreme heat are emerging as additional stressors. Effective public health responses to extreme heat require an understanding of the impact on health and well-being, and the risk or protective factors within communities. This study draws on lived experiences to explore these issues in eleven rural and remote communities across South Australia, framing these within a socio-ecological model. Semi-structured interviews with health service providers (n = 13, and a thematic analysis of these data, has identified particular challenges for rural communities and their health services during extreme heat. The findings draw attention to the social impacts of extreme heat in rural communities, the protective factors (independence, social support, education, community safety, and challenges for adaptation (vulnerabilities, infrastructure, community demographics, housing and local industries. With temperatures increasing across South Australia, there is a need for local planning and low-cost strategies to address heat-exacerbating factors in rural communities, to minimise the impact of extreme heat in the future.

  17. Primary health concept revisited: where do people seek health care in a rural area of Vietnam?

    Science.gov (United States)

    Khe, N D; Toan, N V; Xuan, L T T; Eriksson, B; Höjer, B; Diwan, V K

    2002-07-01

    The government of Vietnam is committed to promote and secure equity in access to health care for all citizens. The current rapid changes towards a market economy may challenge the government's wish for maintaining equity, especially for low income and vulnerable groups. The aim of this study was to investigate aspects of access and utilisation of health care of rural people. The study included a random sample of 1075 out of the 11,547 households in the Field Laboratory in Bavi district, northern Vietnam and a structured questionnaire was used. The results indicate that self-treatment is common practice and private providers are an important source of health services not only for those who are better off but also for poor households. The costs for health care are substantial for households, and lower income groups spent a significantly higher proportion of their income on health care than the rich did. The poor are deterred from seeking health care more often than the rich and for financial reason. As regards sources for payments, the poor relied much more on borrowing money to pay for their health care needs, while those who are better off relied mostly on household savings. A burden of high cost for treatment implies high risks for families to fall into a 'medical poverty trap'. Our findings suggest a need for developing risk-sharing schemes (co-payment, pre-payment and insurance), and appropriate allocation of scarce public resources. We suggest that the private health care sector needs both support and regulations to improve the quality and access to health care by the poor.

  18. An idealized rural coastal zone management integrating land and water use

    OpenAIRE

    Dagoon, N. J.

    1998-01-01

    Various countries have formulated special integrated coastal zone management (ICZM) strategies which seek to both manage development and conserve natural resources and integrate and coordinate the relevant people sectors and their functions and roles within the bounds of this rich realm. Concerns that may be addressed by ICZM include: 1) Natural resources degradation; 2) Pollution; 3) Land use conflicts; and, 4) Destruction of life and property by natural hazards. Some prevalent sources of en...

  19. Assessing potential spatial accessibility of health services in rural China: a case study of Donghai county

    OpenAIRE

    Hu, Ruishan; Dong, Suocheng; Zhao, Yonghong; Hu, Hao; Li, Zehong

    2013-01-01

    Introduction There is a great health services disparity between urban and rural areas in China. The percentage of people who are unable to access health services due to long travel times increases. This paper takes Donghai County as the study unit to analyse areas with physician shortages and characteristics of the potential spatial accessibility of health services. We analyse how the unequal health services resources distribution and the New Cooperative Medical Scheme affect the potential sp...

  20. Social and Physical Environments and Self-Rated Health in Urban and Rural Communities in Korea

    Directory of Open Access Journals (Sweden)

    Jung-A Lee

    2015-11-01

    Full Text Available This study evaluated the associations between social and physical environments and self-rated health (SRH for urban and rural Korean adults, using data from the Korean Community Health Survey (KCHS of 199,790 participants (115,454 urban and 84,336 rural. The main dependent variable was SRH, while the primary independent variables were social and physical characteristics. Urban residents reported better SRH than did rural residents. Five social environmental variables (trust of neighbors, residence in the area for over 20 years, exchanging help with neighbors, friend and fellowship activities, contact with relatives and neighbors over five times per month were more prevalent among rural residents. Satisfaction with physical environment was more common among rural residents, but satisfaction with traffic and healthcare facilities was more common among urban areas. After adjusting for relevant factors, positive associations between SRH and trust of neighbors, exchanging help with neighbors, participation in social activities or organizations, and physical environment existed in both rural and urban populations. Also, in both areas, there was no demonstrated association between SRH and years of residence or frequency of contact with relatives. Our findings suggest the existence of an association between social and physical factors and perceived health status among the general population of Korea.

  1. Rural-urban migration and mental and sexual health: a case study in Southwestern China.

    Science.gov (United States)

    Yang, Xiushi

    2014-01-01

    Massive rural-urban temporary migration has taken place amid China's rapid economic growth and development. Much has been written about the economic causes and consequences of this massive migration; less studied are the potential health and behavioral impacts of migration on migrants. Using data from a population-based sample survey conducted in southwestern China, this paper examines the potential impact of rural-urban migration and post-migration urban living on migrants' mental health and sexual risk behavior. The results suggest that regardless of places of origin and destination temporary migrants had on average poorer mental health and riskier sexual behavior than non-migrants. Compared to living in rural areas, living in urban areas does not make statistical difference in residents' mental health; it is only marginally associated with riskier sexual behavior. Rural-urban temporary migrants' mental health and health risk sexual behavior deserve more immediate research attention. Both selectivity of temporary migrants and migration-induced psycho-socio-behavioral changes may have contributed to migrants' poorer mental health and riskier sexual behavior. However, more theory-driven research with longitudinal design is needed before firm conclusions can be drawn about the underlying mechanisms that mediate or moderate the impact of temporary migration on migrants' mental health and sexual risk behavior.

  2. Posttraumatic Stress Disorder in Rural Primary Care: Improving Care for Mental Health Following Bioterrorism

    Science.gov (United States)

    Tsao, Jennie C. I.; Dobalian, Aram; Wiens, Brenda A.; Gylys, Julius A.; Evans, Garret D.

    2006-01-01

    Context: Recent bioterrorist attacks have highlighted the critical need for health care organizations to prepare for future threats. Yet, relatively little attention has been paid to the mental health needs of rural communities in the wake of such events. A critical aspect of bioterrorism is emphasis on generating fear and uncertainty, thereby…

  3. Social Capital and Health Outcomes among Older Adults in China: The Urban-Rural Dimension

    Science.gov (United States)

    Norstrand, Julie A.; Xu, Qingwen

    2012-01-01

    Purpose: This study examines different types of individual-level social capital (bonding, bridging, and linking) and their relationships with physical and emotional health among older Chinese living in urban and rural settings. Design and Methods: Using the 2005 China General Social Survey, physical and emotional health were regressed on social…

  4. A Longitudinal Analysis of Rural and Urban Veterans' Health-Related Quality of Life

    Science.gov (United States)

    Wallace, Amy E.; Lee, Richard; MacKenzie, Todd A.; West, Alan N.; Wright, Steven; Booth, Brenda M.; Hawthorne, Kara; Weeks, William B.

    2010-01-01

    Context: Cross-sectional studies have identified rural-urban disparities in veterans' health-related quality-of-life (HRQOL) scores. Purpose: To determine whether longitudinal analyses confirmed that these disparities in veterans' HRQOL scores persisted. Methods: We obtained data from the SF-12 portion of the veterans health administration's…

  5. Community Participation in Rural Ecuador's School Feeding Programme: A Health Promoting School Perspective

    Science.gov (United States)

    Torres, Irene; Simovska, Venka

    2017-01-01

    Purpose: The purpose of this paper is to contribute to the debate concerning community participation in school-based health education and health promotion, with regard to food and nutrition. Design/methodology/approach: Based on empirical data generated over the course of one year of fieldwork in three rural communities and schools in Ecuador, the…

  6. Classroom Goal Structures and HIV and Pregnancy Prevention Education in Rural High School Health Classrooms

    Science.gov (United States)

    Anderman, Eric M.; Cupp, Pamela K.; Lane, Derek R.; Zimmerman, Rick; Gray, DeLeon L.; O'Connell, Ann

    2011-01-01

    Over 5,000 adolescents enrolled in required rural high school health courses reported their perceptions of mastery and extrinsic goal structures in their health classrooms. Data were collected from all students at three time points (prior to HIV and pregnancy instruction, 3 months after instruction, and 1 year after instruction). Results indicated…

  7. Capacity building for health through community based participatory nutrition intervention research in rural communities

    Science.gov (United States)

    Building community capacity for health promotion in small rural communities is essential if health promotion research is to yield sustainable outcomes. Since its inception, capacity-building has been a stated goal of the Delta Nutrition Intervention Research initiative, a tri-state collaboration in ...

  8. Social Capital and Health Outcomes among Older Adults in China: The Urban-Rural Dimension

    Science.gov (United States)

    Norstrand, Julie A.; Xu, Qingwen

    2012-01-01

    Purpose: This study examines different types of individual-level social capital (bonding, bridging, and linking) and their relationships with physical and emotional health among older Chinese living in urban and rural settings. Design and Methods: Using the 2005 China General Social Survey, physical and emotional health were regressed on social…

  9. Consumer Health Information Provision in Rural Public Libraries: A Comparison of Two Library Systems

    Science.gov (United States)

    Flaherty, Mary Grace

    2013-01-01

    To better understand health information provision in the public library setting, two cooperative library systems that serve primarily rural populations in upstate New York were studied. The central library in one of those systems established a consumer health information center (CHIC) in 1999. In the other system, the central library does not have…

  10. Consumer Health Information Provision in Rural Public Libraries: A Comparison of Two Library Systems

    Science.gov (United States)

    Flaherty, Mary Grace

    2013-01-01

    To better understand health information provision in the public library setting, two cooperative library systems that serve primarily rural populations in upstate New York were studied. The central library in one of those systems established a consumer health information center (CHIC) in 1999. In the other system, the central library does not have…

  11. A Community Health Advisor Program to Reduce Cardiovascular Risk among Rural African-American Women

    Science.gov (United States)

    Cornell, C. E.; Littleton, M. A.; Greene, P. G.; Pulley, L.; Brownstein, J. N.; Sanderson, B. K.; Stalker, V. G.; Matson-Koffman, D.; Struempler, B.; Raczynski, J. M.

    2009-01-01

    The Uniontown, Alabama Community Health Project trained and facilitated Community Health Advisors (CHAs) in conducting a theory-based intervention designed to reduce the risk for cardiovascular disease (CVD) among rural African-American women. The multiphased project included formative evaluation and community organization, CHA recruitment and…

  12. Who wants to work in a rural health post? The role of intrinsic motivation, rural background and faith-based institutions in Ethiopia and Rwanda.

    Science.gov (United States)

    Serneels, Pieter; Montalvo, Jose G; Pettersson, Gunilla; Lievens, Tomas; Butera, Jean Damascene; Kidanu, Aklilu

    2010-05-01

    To understand the factors influencing health workers' choice to work in rural areas as a basis for designing policies to redress geographic imbalances in health worker distribution. A cohort survey of 412 nursing and medical students in Rwanda provided unique contingent valuation data. Using these data, we performed a regression analysis to examine the determinants of future health workers' willingness to work in rural areas as measured by rural reservation wages. These data were also combined with those from an identical survey in Ethiopia to enable a two-country analysis. Health workers with higher intrinsic motivation - measured as the importance attached to helping the poor - as well as those who had grown up in a rural area and Adventists who had participated in a local bonding scheme were all significantly more willing to work in a rural area. The main result for intrinsic motivation in Rwanda was strikingly similar to the result obtained for Ethiopia and Rwanda combined. Intrinsic motivation and rural origin play an important role in health workers' decisions to work in a rural area, in addition to economic incentives, while faith-based institutions can also influence the decision.

  13. Index of Access: a new innovative and dynamic tool for rural health service and workforce planning.

    Science.gov (United States)

    McGrail, Matthew R; Russell, Deborah J; Humphreys, John S

    2016-08-19

    Objective Improving access to primary health care (PHC) remains a key issue for rural residents and health service planners. This study aims to show that how access to PHC services is measured has important implications for rural health service and workforce planning.Methods A more sophisticated tool to measure access to PHC services is proposed, which can help health service planners overcome the shortcomings of existing measures and long-standing access barriers to PHC. Critically, the proposed Index of Access captures key components of access and uses a floating catchment approach to better define service areas and population accessibility levels. Moreover, as demonstrated through a case study, the Index of Access enables modelling of the effects of workforce supply variations.Results Hypothetical increases in supply are modelled for a range of regional centres, medium and small rural towns, with resulting changes of access scores valuable to informing health service and workforce planning decisions.Conclusions The availability and application of a specific 'fit-for-purpose' access measure enables a more accurate empirical basis for service planning and allocation of health resources. This measure has great potential for improved identification of PHC access inequities and guiding redistribution of PHC services to correct such inequities.What is known about the topic? Resource allocation and health service planning decisions for rural and remote health settings are currently based on either simple measures of access (e.g. provider-to-population ratios) or proxy measures of access (e.g. standard geographical classifications). Both approaches have substantial limitations for informing rural health service planning and decision making.What does this paper add? The adoption of a new improved tool to measure access to PHC services, the Index of Access, is proposed to assist health service and workforce planning. Its usefulness for health service planning is

  14. Situating mobile health: a qualitative study of mHealth expectations in the rural health district of Nouna, Burkina Faso.

    Science.gov (United States)

    Duclos, Vincent; Yé, Maurice; Moubassira, Kagoné; Sanou, Hamidou; Sawadogo, N Hélène; Bibeau, Gilles; Sié, Ali

    2017-07-12

    The implementation of mobile health (mHealth) projects in low- and middle-income countries raises high and well-documented expectations among development agencies, policymakers and researchers. By contrast, the expectations of direct and indirect mHealth users are not often examined. In preparation for a proposed intervention in the Nouna Health District, in rural Burkina Faso, this study investigates the expected benefits, challenges and limitations associated with mHealth, approaching these expectations as a form of situated knowledge, inseparable from local conditions, practices and experiences. The study was conducted within the Nouna Health District. We used a qualitative approach, and conducted individual semi-structured interviews and group interviews (n = 10). Participants included healthcare workers (n = 19), godmothers (n = 24), pregnant women (n = 19), women with children aged 12-24 months (n = 33), and women of childbearing age (n = 92). Thematic and content qualitative analyses were conducted. Participants expect mHealth to help retrieve patients lost to follow-up, improve maternal care monitoring, and build stronger relationships between pregnant women and primary health centres. Expected benefits are not reducible to a technological realisation (sending messages), but rather point towards a wider network of support. mHealth implementation is expected to present considerable challenges, including technological barriers, organisational challenges, gender issues, confidentiality concerns and unplanned aftereffects. mHealth is also expected to come with intrinsic limitations, to be found as obstacles to maternal care access with which pregnant women are confronted and on which mHealth is not expected to have any significant impact. mHealth expectations appear as situated knowledges, inseparable from local health-related experiences, practices and constraints. This problematises universalistic approaches to mHealth knowledge, while nevertheless hinting at

  15. Internal migration, mental health, and suicidal behaviors in young rural Chinese

    Science.gov (United States)

    Dai, Jing; Zhong, Bao-Liang; Xiang, Yu-Tao; Chiu, Helen F. K.; Chan, Sandra S. M.; Yu, Xin; Caine, Eric D.

    2015-01-01

    Purpose There is a dearth of data on the association of internal migration with mental health in young rural Chinese. This study aims to explore the associations between migrant status, mental health, and suicidal behaviors in young rural Chinese. Methods We recruited 1,646 rural subjects aged 16–34 years, of whom 756 were migrant workers and 890 non-migrants, from ten representative villages in rural Sichuan Province, the southwestern part of China. To assess subject's depressive symptoms and general psychological quality of life (psycho-QOL), the study protocol included the Centre for Epidemiological Studies Depression Scale, and psycho-QOL subscale of the World Health Organization's QOL Questionnaire-Brief Version, in addition to structured questions regarding one-year suicidal thoughts and behaviors (serious ideation, plan, and attempt), socio-demographic, social support, and physical health information. Results After adjustment for confounders, migrant workers had relative to non-migrant rural residents a decreased risk for depression (OR = 0.69, P = 0.026), but comparable risk for poor psycho-QOL (OR = 0.91, P = 0.557) and one-year suicidal behaviors (OR = 0.59–1.10, P = 0.19–0.90). Migrant status only accounted for 0.5, 2.8, 4.7, 9.8, and 12.6 % of the total explainable variance for suicide attempt, poor psycho-QOL, suicide plan, depression and serious suicide ideation, respectively. Conclusion Our findings suggested that among young rural Chinese there were no significant associations involving migrant status and poor psycho-QOL or one-year suicidal behaviors, while migrant status significantly correlated with a decreased risk of depression. The unique contribution of migrant status to mental health among young rural Chinese participants in this study was very small. PMID:25403568

  16. Internal migration, mental health, and suicidal behaviors in young rural Chinese.

    Science.gov (United States)

    Dai, Jing; Zhong, Bao-Liang; Xiang, Yu-Tao; Chiu, Helen F K; Chan, Sandra S M; Yu, Xin; Caine, Eric D

    2015-04-01

    There is a dearth of data on the association of internal migration with mental health in young rural Chinese. This study aims to explore the associations between migrant status, mental health, and suicidal behaviors in young rural Chinese. We recruited 1,646 rural subjects aged 16-34 years, of whom 756 were migrant workers and 890 non-migrants, from ten representative villages in rural Sichuan Province, the southwestern part of China. To assess subject's depressive symptoms and general psychological quality of life (psycho-QOL), the study protocol included the Centre for Epidemiological Studies Depression Scale, and psycho-QOL subscale of the World Health Organization's QOL Questionnaire-Brief Version, in addition to structured questions regarding one-year suicidal thoughts and behaviors (serious ideation, plan, and attempt), socio-demographic, social support, and physical health information. After adjustment for confounders, migrant workers had relative to non-migrant rural residents a decreased risk for depression (OR = 0.69, P = 0.026), but comparable risk for poor psycho-QOL (OR = 0.91, P = 0.557) and one-year suicidal behaviors (OR = 0.59-1.10, P = 0.19-0.90). Migrant status only accounted for 0.5, 2.8, 4.7, 9.8, and 12.6% of the total explainable variance for suicide attempt, poor psycho-QOL, suicide plan, depression and serious suicide ideation, respectively. Our findings suggested that among young rural Chinese there were no significant associations involving migrant status and poor psycho-QOL or one-year suicidal behaviors, while migrant status significantly correlated with a decreased risk of depression. The unique contribution of migrant status to mental health among young rural Chinese participants in this study was very small.

  17. Síndrome metabólica: estudo a partir de características demográficas, de estilo de vida e de controle da doença, em usuários hipertensos de Unidade Básica de Saúde de zona rural de cidade do interior paulista Metabolic Syndrome: a study of demographic characteristics, life style, and control of the disease in hypertensive patients at a Public Health Unit of a city in the rural zone in the State of São Paulo

    Directory of Open Access Journals (Sweden)

    Carlos Roberto Padovani

    2010-11-01

    , triglycerides, and HDL cholesterol. With the aim to identify factors associated with the evolution of hypertension to Metabolic Syndrome, demographic, lifestyle and disease control variables were investigated in a population of 95 hypertensive patients registered for treatment in a Primary Care Unit in a city in the rural zone of the state of Sao Paulo. The group was stratified into two segments as there are: i one composed of individuals presenting RF for coronary disease, either in an isolated form or associated with other factors and ii one composed of patients in which the joint occurrence of risk factors already formed the Metabolic Syndrome. The values of the variables related to pertinent aspects of lifestyle and disease control for both groups were compared according to Goodman’s test. In summary, the two groups distinguished themselves only by the variables related to physical activity, be it through mentioning physical activity answering the International Physical Activity Questionnaire (Ipaq be it through prevalence of obesity. Conclusively, the results obtained in this study aggregate evidence in the direction of concepts and practices of public policies in health.

  18. Health Seeking Behaviour among the Rural Dwellers in Ekiti State ...

    African Journals Online (AJOL)

    FIRST LADY

    disorder, disability and non-functioning of the body system. People tend to ... illness, age, religious background educational background, seventy of sickness ... reduction in maternal illness and deaths would greatly increase women's contribution to ... The outcome of these affects are: the rural dwellers are subjected to high.

  19. Developing sustainable models of rural health care: a community development approach.

    Science.gov (United States)

    Allan, J; Ball, P; Alston, M

    2007-01-01

    Globally, small rural communities frequently are demographically similar to their neighbours and are consistently found to have a number of problems linked to the international phenomenon of rural decline and urban drift. For example, it is widely noted that rural populations have poor health status and aging populations. In Australia, multiple state and national policies and programs have been instigated to redress this situation. Yet few rural residents would agree that their town is the same as an apparently similar sized one nearby or across the country. This article reports a project that investigated the way government policies, health and community services, population characteristics and local peculiarities combined for residents in two small rural towns in New South Wales. Interviews and focus groups with policy makers, health and community service workers and community members identified the felt, expressed, normative and comparative needs of residents in the case-study towns. Key findings include substantial variation in service provision between towns because of historical funding allocations, workforce composition, natural disasters and distance from the nearest regional centre. Health and community services were more likely to be provided because of available funding, rather than identified community needs. While some services, such as mental illness intervention and GPs, are clearly in demand in rural areas, in these examples, more health services were not needed. Rather, flexibility in the services provided and work practices, role diversity for health and community workers and community profiling would be more effective to target services. The impact of industry, employment and recreation on health status cannot be ignored in local development.

  20. Analysis of the Negative Impacts and Countermeasure of Clan Force on Rural Governance in Rural-urban Fringe Zone-based on the Investigation in Rural-urban Fringe Zones%宗族势力对城乡结合部乡村治理的负面影响及对策--基于对 S 省 W 村的调研

    Institute of Scientific and Technical Information of China (English)

    王正攀; 杨伟伟

    2015-01-01

    城镇化进程中,宗族势力已成为城乡结合部乡村治理过程中的重要阻力。如何消除宗族势力对城乡结合部乡村治理的负面影响,加强农村的基层民主建设,完善乡村治理结构,已成为社会管理的难点问题。基于对我国 S 省 W 村的实地调研,列举了宗族势力对城乡结合部乡村治理在负面影响方面的两大表现,分析了产生负面影响的原因,并提出了消除负面影响的对策建议。%In the process of urbanization,the clan forces have been an important resistance to the rural governance in ru-ral-urban fringe zones.It has been a serious problem to reduce the negative impacts,strengthen the construction of rural democracy at the grassroots level,and improve the rural governance structure.This paper expounds the two negative effects of the clan force on rural governance in rural-urban fringe zones and the reasons of the negative effects,and puts forwards the countermeasure and suggestions to reduce the negative effects in the end.

  1. Voices from the Gila: health care issues for rural elders in south-western New Mexico.

    Science.gov (United States)

    Averill, Jennifer B

    2002-12-01

    A goal of the Healthy People 2010 initiative is to reduce or eliminate health disparities in vulnerable populations, including populations from rural and minority ethnic backgrounds. Rural communities, including elderly populations, experience lower rates of personal income, educational attainment, health-insurance coverage, access to emergency and specialty care services, and reported health status than do urban communities. A need exists to address identified research priorities, such as the perceptions of rural elders, their family members, and health care providers. The purposes of this study were to explore the health care perceptions, needs, and definitions of health for multicultural rural elders in one county of south-western New Mexico, and to consider practice implications. Informed consent procedures followed the University of New Mexico Health Sciences Center Human Research Review Committee guidelines. Research methods. This critical ethnography incorporated ethnographic interviews, ethnographic participant observation, photography, review of pertinent documents, and analysis of contextual factors. The sample consisted of 22 participants. Definitions of health varied with socioeconomic status, encompassing avoidance of contact with the health care system, obtaining needed medications, remaining independent, a sense of spiritual belonging, eating wisely, and exercising moderately. Three major concerns emerged from the analysis: the escalating cost of prescription drugs, access-to-care issues, and social isolation. The primary limitation was the small sample size. Although the researcher's position as an outsider to local communities may also have affected the outcome, it provided fresh insight to regional problems. The study addressed national research priorities for a vulnerable group of rural elders. Nursing implications include the need for expanded knowledge and educational preparation regarding elder issues and community-level services, inclusion of

  2. Rural Health Inequities and the Role of Cooperative Extension

    Science.gov (United States)

    Andress, Lauri; Fitch, Cindy

    2016-01-01

    Health inequities affect communities through adverse health outcomes, lost productivity, and increased health care costs. They arise from unequal distribution of social determinants of health--the conditions in which people are born and live. Health outcomes, tied to behaviors and health care, also are rooted in location and social status.…

  3. [Mobile Health Units: An Analysis of Concepts and Implementation Requirements in Rural Regions.

    Science.gov (United States)

    Hämel, K; Kutzner, J; Vorderwülbecke, J

    2015-12-22

    Background: Access to health services in rural regions represents a challenge. The development of care models that respond to health service shortages and pay particular attention to the increasing health care needs of the elderly is an important concern. A model that has been implemented in other countries is that of mobile health units. But until now, there is no overview of their possible objectives, functions and implementation requirements. Method: This paper is based on a literature analysis and an internet research on mobile health units in rural regions. Results: Mobile health units aim to avoid regional undersupply and address particularly vulnerable population groups. In the literature, mobile health units are described with a focus on specific illnesses, as well as those that provide comprehensive, partly multi-professional primary care that is close to patients' homes. The implementation of mobile health units is demanding; the key challenges are (a) alignment to the needs of the regional population, (b) user-oriented access and promotion of awareness and acceptance of mobile health units by the local population, and (c) network building within existing care structures to ensure continuity of care for patients. To fulfill these requirements, a community-oriented program development and implementation is important. Conclusions: Mobile health units could represent an interesting model for the provision of health care in rural regions in Germany. International experiences are an important starting point and should be taken into account for the further development of models in Germany.

  4. Oral Health Promotion Intervention In Rural Contexts: Impact assessment. Córdoba, Argentina.

    Directory of Open Access Journals (Sweden)

    Lila Cornejo

    2014-03-01

    Full Text Available Introduction: The study was carried out in Cruz del Eje Department, Cordoba Province, Argentina. It was based on diagnosis of conceptions of health, concentration of fluoride in drinking water and accessibility to dental coverage in 71 rural schools. Additionally, parents and teachers’ conceptions of general and oral health, dental clinical status and sialochemistry of students from eight schools were considered. Objective: To evaluate a community intervention strategy for promoting oral health in rural contexts. Through the participation of the teacher as a mediator of healthy pattern, this strategy was developed. Methods: In order to elaborate oral health promoting strategies, educational workshops, epistolary communication and on site tutorials meetings were implemented. Specific health projects to be added to the Educational Institutional Programs, as a contextualized mediating strategy for promoting oral health were designed by teachers. The strategy was evaluated comparing dental caries increase (CI detected the previous year and the one following the implementation of the educational plans. Mac Nemar's test was applied, and p<0.05 was set to indicate statistical differences between both periods. Results: A 30.43% CI (p<0.0001 was observed the year before implementing the educational programs as well as a CI reduction to 17.39% (p=0.0002 a year after their application. Conclusion: The drop off in 57.14% of the CI in rural areas, confirms the intervention strategy of designed for this particular context.Keywords: community intervention, oral health promotion, rural communities.

  5. The tradeoff between centralized and decentralized health services: evidence from rural areas in Mexico.

    Science.gov (United States)

    Vargas Bustamante, Arturo

    2010-09-01

    This study investigates the effectiveness of centralized and decentralized health care providers in rural Mexico. It compares provider performance since both centralized and decentralized providers co-exist in rural areas of the country. The data are drawn from the 2003 household survey of Oportunidades, a comprehensive study of rural families from seven states in Mexico. The analyses compare out-of-pocket health care expenditures and utilization of preventive care among rural households with access to either centralized or decentralized health care providers. This study benefits from differences in timing of health care decentralization and from a quasi-random distribution of providers. Results show that overall centralized providers perform better. Households served by this organization report less regressive out-of-pocket health care expenditures (32% lower), and observe higher utilization of preventive services (3.6% more). Decentralized providers that were devolved to state governments in the early 1980s observe a slightly better performance than providers that were decentralized in the mid-1990s. These findings are robust to decentralization timing, heterogeneity in per capita government health expenditures, state and health infrastructure effects, and other confounders. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  6. Urban-rural mental health differences in Great Britain: findings from the National Morbidity Survey.

    Science.gov (United States)

    Paykel, E; Abbott, R; Jenkins, R; Brugha, T; Meltzer, H

    2003-01-01

    Studies of urban-rural differences in prevalence of non-psychotic mental disorder have not given consistent findings. Such differences have received relatively little study in Great Britain. Data from 9777 subjects in the Household Survey of the National Morbidity Survey of Great Britain were analysed for differences between urban, semi-rural, and rural areas. Psychiatric morbidity was assessed by scores on the Revised Clinical Interview Schedule (CIS-R), together with alcohol dependence, drug dependence, and receipt of treatment from general practitioners. Associations with other characteristics were examined by logistic regression. Urban subjects had higher rates than rural of CIS-R morbidity, alcohol dependence, and drug dependence, with semi-rural subjects intermediate. Urban subjects also tended to be members of more deprived social groups, with more adverse living circumstances and greater life stress--factors themselves associated with disorder. Urban-rural differences in alcohol and drug dependence were no longer significant after adjustment for these factors by logistic regression, and differences on CIS-R morbidity were considerably reduced. There were no differences in treatment. There are considerable British urban-rural differences in mental health, which may largely be attributable to more adverse urban social environments.

  7. Implementation research on community health workers’ provision of maternal and child health services in rural Liberia

    Science.gov (United States)

    Luckow, Peter W; Kenny, Avi; White, Emily; Ballard, Madeleine; Dorr, Lorenzo; Erlandson, Kirby; Grant, Benjamin; Johnson, Alice; Lorenzen, Breanna; Mukherjee, Subarna; Ly, E John; McDaniel, Abigail; Nowine, Netus; Sathananthan, Vidiya; Sechler, Gerald A; Kraemer, John D; Siedner, Mark J

    2017-01-01

    Abstract Objective To assess changes in the use of essential maternal and child health services in Konobo, Liberia, after implementation of an enhanced community health worker (CHW) programme. Methods The Liberian Ministry of Health partnered with Last Mile Health, a nongovernmental organization, to implement a pilot CHW programme with enhanced recruitment, training, supervision and compensation. To assess changes in maternal and child health-care use, we conducted repeated cross-sectional cluster surveys before (2012) and after (2015) programme implementation. Findings Between 2012 and 2015, 54 CHWs, seven peer supervisors and three clinical supervisors were trained to serve a population of 12 127 people in 44 communities. The regression-adjusted percentage of children receiving care from formal care providers increased by 60.1 (95% confidence interval, CI: 51.6 to 68.7) percentage points for diarrhoea, by 30.6 (95% CI: 20.5 to 40.7) for fever and by 51.2 (95% CI: 37.9 to 64.5) for acute respiratory infection. Facility-based delivery increased by 28.2 points (95% CI: 20.3 to 36.1). Facility-based delivery and formal sector care for acute respiratory infection and diarrhoea increased more in agricultural than gold-mining communities. Receipt of one-or-more antenatal care sessions at a health facility and postnatal care within 24 hours of delivery did not change significantly. Conclusion We identified significant increases in uptake of child and maternal health-care services from formal providers during the pilot CHW programme in remote rural Liberia. Clinic-based services, such as postnatal care, and services in specific settings, such as mining areas, require additional interventions to achieve optimal outcomes. PMID:28250511

  8. Oral health status of children and adults in urban and rural areas of Burkina Faso, Africa

    DEFF Research Database (Denmark)

    Varenne, Benoît; Petersen, Poul Erik; Ouattara, Seydou

    2004-01-01

    OBJECTIVES: To analyse the oral health status of children and adults in rural and urban areas of Burkina Faso; to provide epidemiological data for planning and evaluation of oral health care programmes. DESIGN: Cross-sectional survey including different ethnic and socio-economic groups. SAMPLE...... AND METHODS: Multistage cluster sampling of households in urban areas and random samples of participants selected based on the recent population census in rural areas. The final study population covered four age groups: 6 years (n = 424), 12 years (n = 505), 18 years (n = 492) and 35-44 years (n = 493......%), 12 years (57%), 18 years (58%), 35-44 years (49%). In addition, 10% of 35-44-year-olds had CPI score 4. Rural participants had more severe periodontal scores than did urban individuals. CONCLUSIONS: Health authorities should strengthen the implementation of community-based oral disease prevention...

  9. Medical connections: use of the internet and traditional sources of health information by rural Alabama households.

    Science.gov (United States)

    Hall, Laura M; Dunkelberger, John D; Wheat, John R

    2005-01-01

    Rural household adoption of the PC and Internet for accessing medical and healthcare information was investigated using survey data collected from 305 households randomly selected from non-metropolitan, rural counties across Alabama. The diffusion-adoption model for new technologies was employed to create five adoption stages relevant to this technology and its applications to communication of information in the health field. Descriptive household characteristics of age, education, income, and children revealed differences between adoption stages, with age and education having major impacts. Use of traditional sources of health information and the Internet were compared in relation to age and availability of medical services. Older, less educated households lagged behind in use of the Internet for health information. Medical professionals, doctors and pharmacists, were the most utilized information source by rural households; but those households connected to the Internet used on-line sources, even e-mail to communicate with their doctors.

  10. [Future built-up area zoning by applying the methodology for assessing the population health risk].

    Science.gov (United States)

    Bobkova, T E

    2009-01-01

    Using the methodology for assessing the population health risk provides proposals on the functional zoning of the reorganized area of a plastics-works. An area has been allocated for possible house-building.

  11. The Effects of Housing on Health and Health Risks in an Aging Population: A Qualitative Study in Rural Thailand

    Directory of Open Access Journals (Sweden)

    Ratana Somrongthong

    2014-01-01

    Full Text Available Background. Over the last decade, Thailand has experienced an aging population, especially in rural areas. Research finds a strong, positive relationship between good quality housing and health, and this paper assesses the impact and living experience of housing of older people in rural Thailand. Methods. This was a mixed-method study, using data from observations of the physical adequacy of housing, semistructured interviews with key informants, and archival information from health records for 13 households in rural Thailand. Results. There were four main themes, each of which led to health risks for the older people: “lighting and unsafe wires,” “house design and composition,” “maintenance of the house,” and “health care equipment.” The housing was not appropriately designed to accommodate health care equipment or to fully support individual daily activities of older people. Numerous accidents occurred as a direct result of inadequate housing and the majority of houses had insufficient and unsafe lighting, floor surfaces and furniture that created health risks, and toilets or beds that were at an unsuitable height for older people. Conclusion. This paper provides an improved and an important understanding of the housing situation among older people living in rural areas in Thailand.

  12. Model for collaboration: a rural medicine and academic health center teleradiology project

    Science.gov (United States)

    Van Slyke, Mark A.; Eggli, Douglas F.; Prior, Fred W.; Salmon, William; Pappas, Gregory; Vanatta, Fred; Goldfetter, Warren; Hashem, Said

    1996-05-01

    A pilot project was developed to explore the role of subspecialty radiology support to rural medicine sites over a long-distance network. A collaborative relationship between 2 rural radiology practices and an academic health was established. Project objectives included: (1) Does the subspecialty consultation significantly change diagnosis patterns at the rural site? (2) Is there value added as measured by improved clinical care or an overall decreased cost of care? (3) Can a collaborative model be economically self-supportive? (4) Does the collaborative model encourage and support education and collegial relationships? Two rural hospitals were selected based on the level of imaging technology and willingness to cooperate. Image capture and network technology was chosen to make the network process transparent to the users. DICOM standard interfaces were incorporated into existing CT and MRI scanners and a film digitizer. Nuclear medicine images were transferred and viewed using a proprietary vendor protocol. Relevant clinical data was managed by a custom designed PC based Lotus Notes application (Patient Study Tracking System: PaSTS) (Pennsylvania Blue Shield Institute). All data was transferred over a Frame Relay network and managed by the Pennsylvania Commonwealth sponsored PA Health Net. Images, other than nuclear medicine, were viewed on a GE Advantage viewing station using a pair of 2 X 2.5 K gray scale monitors. Patient text data was managed by the PaSTS PC and displayed on a separate 15' color monitor. A total of 476 radiology studies were networked into the AHC. Randomly chosen research studies comprised 82% of the case work. Consultative and primary read cases comprised 17% and 1% respectively. The exercise was judged effective by both rural sites. Significant findings and diagnoses were confirmed in 73% of cases with discrepant findings in only 4%. One site benefited by adopting more advanced imaging techniques increasing the sophistication of radiology

  13. A guide to understanding the variation in premiums in rural health insurance marketplaces.

    Science.gov (United States)

    Barker, Abigail R; McBride, Timothy D; Kemper, Leah M; Mueller, Keith

    2014-05-01

    Key Findings. (1) State-level decisions in implementing the Patient Protection and Affordable Care Act of 2010 (ACA) have led to significant state variation in the design of Health Insurance Marketplace (HIM) rating areas. In some designs, rural counties are grouped together, while in others, rural and urban counties have been deliberately mixed. (2) Urban counties have, on average, approximately one more firm participating in the marketplaces, representing about 11 more plan offerings, than rural counties have. (3) The highest-valued "platinum" plan types are less likely to be available in rural areas. Thus, the overall mix of plan types should be factored into the reporting of average premiums. (4) Levels of competition are likely to have a greater impact on the decisions of firms considering whether to operate in higher-cost areas or not, as those firms must determine how they can pass such costs on to consumers, conditional on the market share they are likely to control.

  14. EMERGENCE OF ENTIRELY NEW POISONING IN RURAL INDIA; AN UPCOMING HEALTH HAZARD TO THE COMMUNITY HEALTH.

    Directory of Open Access Journals (Sweden)

    A Kumar

    2012-10-01

    Full Text Available Acute agrochemical poisoning is a leading cause of mortality and morbidity in India. Pendimethalin (herbicide and Pancycuron (fungicide are frequently used worldwide and considered quite a remarkably safe one for humans. Their acute toxicity is not yet widely known. Here we are reporting cases of their acute poisoning in young. To the best of our knowledge not a single such case of their poisoning has been reported so far in india. Such poisoning by entirely new compounds is an emerging problem in the tropics. In this communication we are reporting such unusual and entirely new toxicities and trying to highlight the need of their early recognition and timely management in rural regions where health facilities are already at the stake.

  15. Does more education always lead to better health? Evidence from rural malaysia.

    Science.gov (United States)

    Leeves, Gareth; Soyiri, Ireneous

    2015-01-01

    Background. Education is usually associated with improvement in health; there is evidence that this may not be the case if education is not fully utilised at work. This study examines the relationship between education level, occupation, and health outcomes of individuals in rural Malaysia. Results. The study finds that the incidence of chronic diseases and high blood pressure are higher for tertiary educated individuals in agriculture and construction occupations. This brings these individuals into more frequent contact with the health system. These occupations are marked with generally lower levels of education and contain fewer individuals with higher levels of education. Conclusions. Education is not always associated with better health outcomes. In certain occupations, greater education seems related to increased chronic disease and contact with the health system, which is the case for workers in agriculture in rural Malaysia. Agriculture is the largest sector of employment in rural Malaysia but with relatively few educated individuals. For the maintenance and sustainability of productivity in this key rural industry, health monitoring and job enrichment policies should be encouraged by government agencies to be part of the agenda for employers in these sectors.

  16. Does More Education Always Lead to Better Health? Evidence from Rural Malaysia

    Directory of Open Access Journals (Sweden)

    Gareth Leeves

    2015-01-01

    Full Text Available Background. Education is usually associated with improvement in health; there is evidence that this may not be the case if education is not fully utilised at work. This study examines the relationship between education level, occupation, and health outcomes of individuals in rural Malaysia. Results. The study finds that the incidence of chronic diseases and high blood pressure are higher for tertiary educated individuals in agriculture and construction occupations. This brings these individuals into more frequent contact with the health system. These occupations are marked with generally lower levels of education and contain fewer individuals with higher levels of education. Conclusions. Education is not always associated with better health outcomes. In certain occupations, greater education seems related to increased chronic disease and contact with the health system, which is the case for workers in agriculture in rural Malaysia. Agriculture is the largest sector of employment in rural Malaysia but with relatively few educated individuals. For the maintenance and sustainability of productivity in this key rural industry, health monitoring and job enrichment policies should be encouraged by government agencies to be part of the agenda for employers in these sectors.

  17. An examination of the health information seeking experiences of women in rural Ontario, Canada

    Directory of Open Access Journals (Sweden)

    C.N. Wathen

    2006-01-01

    Full Text Available Introduction. Women are active information seekers, particularly in the context of managing health for themselves and their families. Rural living may present particular challenges and opportunities for women in their health information seeking. Method. Forty women living in a rural part of Ontario, Canada were interviewed using a semi-structured interview guide. They were asked about their health information seeking for both chronic and acute concerns. Analysis. Interview transcripts were organized using NVivo software (version 6 and analysed using a coding scheme iteratively developed by both authors. Results. Emerging themes included: the context of rural living, information and health literacy, the role of unanticipated information intermediaries in the search process, and the mis-match between assumptions made by 'the system' about sources of information, and women's lived realities. Conclusion. . There are unique challenges and enablers to health information seeking for women living in rural areas, including the role of formal, informal and ICT-based information intermediaries, the availability to women of required literacies for health information seeking and uptake. Research findings such as those presented in this paper can assist in better understanding both the contexts of information seeking, as well as the preferences and behaviour of those with information needs.

  18. Use of social media and internet to obtain health information by rural adolescent mothers.

    Science.gov (United States)

    Logsdon, M Cynthia; Mittelberg, Meghan; Myers, John

    2015-02-01

    Adolescent mothers residing in rural areas need accurate health information to care for themselves and their babies. The purpose of this study was to determine the use of social media and Internet by adolescent mothers residing in rural areas, particularly in regard to obtaining health information. Using a cross-sectional design, a convenience sample of adolescent mothers living in a rural county in a state located in the southern U.S. (n = 15), completed the Pew Internet Survey during home visits with nurses from a community health agency. All adolescent mothers accessed Internet using cell phones (93%) or computers (100%). Many adolescent mothers sent or received over 50 text messages per day. Thirty-three percent of adolescent mothers searched for health information on the Internet every few weeks; 27% received health information from Facebook. Communication of health information using the Internet and social media may be effective with adolescent mothers residing in rural areas. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Medication supply and management in rural Queensland: views of key informants in health service provision.

    Science.gov (United States)

    Tan, Amy Chen Wee; Emmerton, Lynne; Hattingh, Laetitia; Jarvis, Victoria

    2012-01-01

    Rural settings challenge health care providers to provide optimal medication services in a manner that is timely and of high quality. Extending the roles of rural health care providers is often necessary to improve access to medication services; however, there appears to be a lack of pharmacy-based involvement and support within the medication system. This article explores medication supply and management issues in rural settings, based on the governance perspectives of key informants on regulatory aspects, policy, and professional practice. The specific objectives were to (1) identify the key issues and existing facilitators and (2) explore the potential roles of pharmacy to improve medication supply and management services. Semi-structured interviews were conducted with representatives within regulatory or professional organizations. The participants were key informants who held leadership and/or managerial roles within their respective organizations and were recruited to provide insights from a governance perspective before data collection in the community. An interview guide, informed by the literature, assisted the flow of interviews, exploring topics, such as key issues, existing initiatives, and potential pharmacy-based facilitators, in relation to medication supply and management in rural settings. Issues identified that hindered the provision of optimal medication supply and management services in the rural areas centered on workforce, interprofessional communication, role structures, and funding opportunities. Legislative and electronic developments and support mechanisms aim to facilitate medication processes in rural areas. Potential initiatives to further enhance medication services and processes could explore extended roles for pharmacists and pharmacy support staff, as well as alternative service delivery models to enhance pharmacy workforce capacity. The study provided an overview of key issues with medication supply and management and highlighted

  20. Involvement of stakeholders in determining health priorities of adolescents in rural South Africa

    OpenAIRE

    Twine, Rhian; Kahn, Kathleen; Scholtz, Alexandra Scholtz; Norris, Shane A

    2016-01-01

    Background: When developing intervention research, it is important to explore issues from the community perspective. Interventions that promote adolescent health in South Africa are urgently needed, and Project Ntshembo (‘hope’) aims to improve the health of young women and their offspring in the Agincourt sub-district of rural northeast South Africa, actively using stakeholder involvement throughout the research process.Objective: This study aimed to determine adolescent health priorities ac...

  1. The efficacy of staff training on improving internal customer satisfaction in a rural health setting.

    Science.gov (United States)

    Hartley, R; Turner, R

    1995-09-01

    The NSW Health Department is 3 years into its customer satisfaction initiative. North West Health Service, one of the largest rural health districts, was among the first centres to embrace the customer satisfaction philosophy starting with compulsory training of all staff. This paper reports on changes in staff morale (internal satisfaction) as a result of that training. The data suggest that training per se has had minimal effect and argues for management development, particularly regarding leadership, rather than fiscal skills.

  2. Challenges and lessons learned in establishing a critical zone observatory in an intensively managed rural landscape of India

    Science.gov (United States)

    Paul, D.; Tripathi, S.; Harsha, K. S.; Adla, S.; Dash, S. K.; Chander, Y.; Mahajan, P.; Tripathi, S. N.; Sen, I. S.; Sinha, R.

    2016-12-01

    The study of critical earth system processes, particularly in densely populated regions in the developing world, entails the additional challenges of incorporating anthropogenic forcing and the economic constraints of low-cost technology. The criteria for site selection of Critical Zone Observatory (CZO) networks (crucial for the advancement of hydrological research in data scarce regions) generally give weightage to pristine, undisturbed regions to study isolated critical zone processes. This study details the factors involved and challenges faced in establishing a CZO in the Pandu River basin (Uttar Pradesh, India). This region is representative of the fertile Ganga River Basin which produces 50% of India's food grain annually and is critical for the food security of about 40% of the Indian population. Moreover, Uttar Pradesh has the highest absolute population and population density among all Indian states, amongst the lowest GDP/capita, an average landholding size of 0.76 ha with 92% of operational farm-holdings categorized as small or marginal. The significant proportion of Indians disgruntled with the state of public sector corruption may transform into scepticism towards government projects such as ours, thereby constraining our options for secure site selection. Within the framework of hypothesis-experiment-learning feedback loops, this paper chronicles iterative field trials and their outcomes in establishing an intensively managed rural landscape CZO. The work includes a conscious effort to combine the strengths of low-cost sensor, data logging and data-transfer technology and citizen science approaches through participatory data collection guided by scientific, socio-economic, cultural, political and administrative considerations.

  3. Discrimination, perceived social inequity, and mental health among rural-to-urban migrants in China.

    Science.gov (United States)

    Lin, Danhua; Li, Xiaoming; Wang, Bo; Hong, Yan; Fang, Xiaoyi; Qin, Xiong; Stanton, Bonita

    2011-04-01

    Status-based discrimination and inequity have been associated with the process of migration, especially with economics-driven internal migration. However, their association with mental health among economy-driven internal migrants in developing countries is rarely assessed. This study examines discriminatory experiences and perceived social inequity in relation to mental health status among rural-to-urban migrants in China. Cross-sectional data were collected from 1,006 rural-to-urban migrants in 2004-2005 in Beijing, China. Participants reported their perceptions and experiences of being discriminated in daily life in urban destination and perceived social inequity. Mental health was measured using the symptom checklist-90 (SCL-90). Multivariate analyses using general linear model were performed to test the effect of discriminatory experience and perceived social inequity on mental health. Experience of discrimination was positively associated with male gender, being married at least once, poorer health status, shorter duration of migration, and middle range of personal income. Likewise, perceived social inequity was associated with poorer health status, higher education attainment, and lower personal income. Multivariate analyses indicate that both experience of discrimination and perceived social inequity were strongly associated with mental health problems of rural-to-urban migrants. Experience of discrimination in daily life and perceived social inequity have a significant influence on mental health among rural-to-urban migrants. The findings underscore the needs to reduce public or societal discrimination against rural-to-urban migrants, to eliminate structural barriers (i.e., dual household registrations) for migrants to fully benefit from the urban economic development, and to create a positive atmosphere to improve migrant's psychological well-being.

  4. Outpatient prescription practices in rural township health centers in Sichuan Province, China

    Directory of Open Access Journals (Sweden)

    Jiang Qian

    2012-09-01

    Full Text Available Abstract Background Sichuan Province is an agricultural and economically developing province in western China. To understand practices of prescribing medications for outpatients in rural township health centers is important for the development of the rural medical and health services in this province and western China. Methods This is an observational study based on data from the 4th National Health Services Survey of China. A total of 3,059 prescriptions from 30 township health centers in Sichuan Province were collected and analyzed. Seven indicators were employed in the analyses to characterize the prescription practices. They are disease distribution, average cost per encounter, number of medications per encounter, percentage of encounters with antibiotics, percentage of encounters with glucocorticoids, percentage of encounters with combined glucocorticoids and antibiotics, and percentage of encounters with injections. Results The average medication cost per encounter was 16.30 Yuan ($2.59. About 60% of the prescriptions contained Chinese patent medicine (CPM, and almost all prescriptions (98.07% contained western medicine. 85.18% of the prescriptions contained antibiotics, of which, 24.98% contained two or more types of antibiotics; the percentage of prescriptions with glucocorticoids was 19.99%; the percentage of prescriptions with both glucocorticoids and antibiotics was 16.67%; 51.40% of the prescriptions included injections, of which, 39.90% included two or more injections. Conclusions The findings from this study demonstrated irrational medication uses of antibiotics, glucocorticoids and injections prescribed for outpatients in the rural township health centers in Sichuan Province. The reasons for irrational medication uses are not only solely due to the pursuit of maximizing benefits in the township health centers, but also more likely attributable to the lack of medical knowledge of rational medication uses among rural doctors and the

  5. Australian rural, remote and urban community nurses' health promotion role and function.

    Science.gov (United States)

    Roden, Janet; Jarvis, Lynda; Campbell-Crofts, Sandra; Whitehead, Dean

    2016-09-01

    Community nurses have often been 'touted' as potential major contributors to health promotion. Critical literature, however, often states that this has not been the case. Furthermore, most studies examining nurses' role and function have occurred mainly in hospital settings. This is a sequential mixed-methods study of two groups of community nurses from a Sydney urban area (n = 100) and from rural and remote areas (n = 49) within New South Wales, Australia. A piloted questionnaire survey was developed based on the five action areas of the Ottawa Charter for Health Promotion. Following this, 10 qualitative interviews were conducted for both groups, plus a focus group to support or refute survey results. Findings showed that rural and remote nurses had more positive attitudes towards health promotion and its clinical implementation. Survey and interview data confirmed that urban community nurses had a narrower focus on caring for individuals rather than groups, agreeing that time constraints impacted on their limited health promotion role. There was agreement about lack of resources (material and people) to update health promotion knowledge and skills. Rural and remote nurses were more likely to have limited educational opportunities. All nurses undertook more development of personal skills (DPS, health education) than any other action area. The findings highlight the need for more education and resources for community nurses to assist their understanding of health promotion concepts. It is hoped that community nurse leaders will collectively become more effective health promoters and contribute to healthy reform in primary health care sectors.

  6. The impact of innovation funding on a rural health nursing service: the Reporoa experience.

    Science.gov (United States)

    Connor, Margaret; Nelson, Katherine; Maisey, Jane

    2009-07-01

    Health Reporoa Inc. offers a first contact rural nursing service to the village of Reporoa and surrounding districts. From 2003 to 2006 it became a project site through selection for the Ministry of Health (MoH) primary health care nursing innovation funding. Health Reporoa Inc. successfully achieved its project goals and gained an ongoing contract from Lakes District Health Board to consolidate and further expand its services at the close of the funding period. This paper examines the impact of the innovation funding during the project period and in the two years that followed. The major impact came through an expansion of the accessible free health service to the local population; advancing nursing practice; increased connection to the nursing profession and wider health community, and enhanced affirmation of the nursing contribution. The rural nursing service model developed at Health Reporoa, through the benefit of innovation funding, can now act as a blueprint for other rural health services, particularly those in high deprivation areas.

  7. Rural-Urban Differences in Suicide Rates for Current Patients of a Public Mental Health Service in Australia

    Science.gov (United States)

    Sankaranarayanan, Anoop; Carter, Gregory; Lewin, Terry

    2010-01-01

    Rural versus urban rates of suicide in current patients of a large area mental health service in Australia were compared. Suicide deaths were identified from compulsory root cause analyses of deaths, 2003-2007. Age-standardized rates of suicide were calculated for rural versus urban mental health service and compared using variance of…

  8. DOES DIFFERENT STAGES OF MEDICAL EDUCATION WILL BRING CHANGES IN ATTITUDE TOWARDS RURAL HEALTH SERVICES?

    Directory of Open Access Journals (Sweden)

    Sandeep

    2015-01-01

    Full Text Available OBJECTIVE: To know attitude for rural health service in students of different stages of medical education like undergraduate (third year MBBS students , internship doing student and post graduates students. MATERIALS & METHOD : The present cross sectional study was conducted at Governement Medical C ollege , Nagpur in month of august to November 2014 in predesigned and pretested proform. The proforma includes information about parents regarding socioeconomic status their occupation literacy status a nd also information regarding willingness to work in rural health services and different reasons for not giving health services to rural areas like political unstable area , no entertainments , no future , not having better leaving conditions , no proper educa tion for their kids etc . Informed consent was taken prior to inclusion into the study . Three different medical educating students i.e 69 % (99 third MBBS students , 54% (Interns 87 students and 47% (61 postgraduates students. RESULTS: Undergraduate stude nt and in interns female students are more than male students and they are71 (72 % and 50(57% respectively. Most of the study participants are residing in urban areas i.e. 63 (63.6% undergraduates , 58(66.7% interns and 49(80.3% students in postgraduat es are having urban is the place of residence. 54(76% female students from undergraduates and 32 (64% female students from interns and 15(68.1% female students from postgraduates are willing to serve for rural health. female undergraduates students (88. 7%accepted rural area is unstable to work when compared with male undergraduates (42.9% and this difference found to be statistically significant (p=0.001.Majority of female undergraduates(69% accepted that there is no personal safety in rural areas as compared with male undergraduates(17.9%.This difference also found to be significant (p=0.001.Isolation and remoteness of the location of health facility was accepted by most of the female

  9. Improving reproductive health knowledge in rural China--a web-based strategy.

    Science.gov (United States)

    Tang, Songyuan; Tian, Lichuan; Cao, Wei Wei; Zhang, Kaining; Detels, Roger; Li, Virginia C

    2009-01-01

    In China, one of the major problems in upgrading rural health services is the difficulty of communicating between the rural and urban areas. Enabling local agencies to access the Internet in resource-poor areas can provide an efficient means of diffusing current training and information and will have far-reaching policy implications. To test the feasibility of using the Internet to deliver needed health information to the countryside, the UCLA School of Public Health and the Institute of Health Studies of Kunming Medical College (IHS-KMC) collaborated in an experimental website project to improve the quality of reproductive health services to promote women's health in three rural counties of Yunnan. The project involved the county government and the Bureau of Public Health, the Bureau of Family Planning; the Bureau of Education, Women's Federation, and the Maternal and Child Health Station targeting village health workers and teachers; women's cadres. Three counties, matched on socioeconomic status, participated in the study and were randomized to receive three programs. Nanhua County received computer skill training and logistic support including a planning workshop for information diffusion. Mouding County received computers only. Dayao, the control county, did not receive the full program until the conclusion of the project. The study demonstrated that the use of a website to disseminate health information in remote rural areas is not only feasible but that it also will be enthusiastically adopted by local health workers and interested parties. Moreover, the knowledge was diffused from the primary population of village doctors, family planning workers, women's cadres, and teachers to the secondary population of villagers and students.

  10. Outness, Stigma, and Primary Health Care Utilization among Rural LGBT Populations.

    Science.gov (United States)

    Whitehead, J; Shaver, John; Stephenson, Rob

    2016-01-01

    Prior studies have noted significant health disadvantages experienced by LGBT (lesbian, gay, bisexual, and transgender) populations in the US. While several studies have identified that fears or experiences of stigma and disclosure of sexual orientation and/or gender identity to health care providers are significant barriers to health care utilization for LGBT people, these studies have concentrated almost exclusively on urban samples. Little is known about the impact of stigma specifically for rural LGBT populations, who may have less access to quality, LGBT-sensitive care than LGBT people in urban centers. LBGT individuals residing in rural areas of the United States were recruited online to participate in a survey examining the relationship between stigma, disclosure and "outness," and utilization of primary care services. Data were collected and analyzed regarding LGBT individuals' demographics, health care access, health risk factors, health status, outness to social contacts and primary care provider, and anticipated, internalized, and enacted stigmas. Higher scores on stigma scales were associated with lower utilization of health services for the transgender & non-binary group, while higher levels of disclosure of sexual orientation were associated with greater utilization of health services for cisgender men. The results demonstrate the role of stigma in shaping access to primary health care among rural LGBT people and point to the need for interventions focused towards decreasing stigma in health care settings or increasing patients' disclosure of orientation or gender identity to providers. Such interventions have the potential to increase utilization of primary and preventive health care services by LGBT people in rural areas.

  11. Outness, Stigma, and Primary Health Care Utilization among Rural LGBT Populations.

    Directory of Open Access Journals (Sweden)

    J Whitehead

    Full Text Available Prior studies have noted significant health disadvantages experienced by LGBT (lesbian, gay, bisexual, and transgender populations in the US. While several studies have identified that fears or experiences of stigma and disclosure of sexual orientation and/or gender identity to health care providers are significant barriers to health care utilization for LGBT people, these studies have concentrated almost exclusively on urban samples. Little is known about the impact of stigma specifically for rural LGBT populations, who may have less access to quality, LGBT-sensitive care than LGBT people in urban centers.LBGT individuals residing in rural areas of the United States were recruited online to participate in a survey examining the relationship between stigma, disclosure and "outness," and utilization of primary care services. Data were collected and analyzed regarding LGBT individuals' demographics, health care access, health risk factors, health status, outness to social contacts and primary care provider, and anticipated, internalized, and enacted stigmas.Higher scores on stigma scales were associated with lower utilization of health services for the transgender & non-binary group, while higher levels of disclosure of sexual orientation were associated with greater utilization of health services for cisgender men.The results demonstrate the role of stigma in shaping access to primary health care among rural LGBT people and point to the need for interventions focused towards decreasing stigma in health care settings or increasing patients' disclosure of orientation or gender identity to providers. Such interventions have the potential to increase utilization of primary and preventive health care services by LGBT people in rural areas.

  12. Biosécurité et productivité du tilapia du Nil Oreochromis niloticus (Linnaeus, 1958 élevé en zone rurale ivoirienne

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    Kone, M.

    2012-01-01

    Full Text Available Biosecurity and Productivity of Nile Tilapia Oreochromis niloticus (Linnaeus, 1958 Bred in Ivoirian's Rural Zone. Fingerlings of tilapia Oreochromis niloticus were bred in three types of fish farming of rural zone in Ivory Coast to determine impacts of the compliance of biosecurity measures on zootechnical parameters of these bred fishes. Fish farming were shared out in three types of farming based on the value of biosecurity measures compliance, which were 5%, 55%, and 83%. No significant differences were observed between mean values of physic and chemical parameters of ponds water from three types of fish farming. Concerning mean values of zootechnical parameters, the fish breeding with 83% of rate compliance of biosecurity measures had registered better values of zoo technical performance with significant differences compared with others types of fish farming.

  13. Illegal private clinics: ideal health services choices among rural-urban migrants in China?

    Science.gov (United States)

    Li, Yan

    2014-01-01

    The main purpose of this article is to explore the important issues and the role of illegal private clinics in health services access among rural-urban migrants in China. The function that illegal private clinics substantially play on the health among rural-urban migrants in China is rarely discussed in studies. A study on a migrant community in Beijing shows the disadvantaged status of health services choices and the constraints for access to health services among migrants. It argues that the existence of illegal private clinics provides a channel to migrants for medical services in the city and reflects the difficulties and high cost of providing medical services to migrants in urban public hospitals. Occasionally the illegal private clinics can cause danger to the health of migrants.

  14. Health inequalities among rural and urban population of Eastern Poland in the context of sustainable development.

    Science.gov (United States)

    Pantyley, Viktoriya

    2017-09-21

    The primary goals of the study were a critical analysis of the concepts associated with health from the perspective of sustainable development, and empirical analysis of health and health- related issues among the rural and urban residents of Eastern Poland in the context of the sustainable development of the region. The study was based on the following research methods: a systemic approach, selection and analysis of the literature and statistical data, developing a special questionnaire concerning socio-economic and health inequalities among the population in the studied area, field research with an interview questionnaire conducted on randomly-selected respondents (N=1,103) in randomly selected areas of the Lubelskie, Podkarpackie, Podlaskie and eastern part of Mazowieckie Provinces (with the division between provincial capital cities - county capital cities - other cities - rural areas). The results of statistical surveys in the studied area with the use of chi-square test and contingence quotients indicated a correlation between the state of health and the following independent variables: age, life quality, social position and financial situation (C-Pearson's coefficient over 0,300); a statistically significant yet weak correlation was recorded for gender, household size, place of residence and amount of free time. The conducted analysis proved the existence of a huge gap between state of health of the population in urban and rural areas. In order to eliminate unfavourable differences in the state iof health among the residents of Eastern Poland, and provide equal sustainable development in urban and rural areas of the examined areas, special preventive programmes aimed at the residents of peripheral, marginalized rural areas should be implemented. In these programmes, attention should be paid to preventive measures, early diagnosis of basic civilization and social diseases, and better accessibility to medical services for the residents.

  15. Medicaid managed care for mental health services: the survival of safety net institutions in rural settings.

    Science.gov (United States)

    Willging, Cathleen E; Waitzkin, Howard; Nicdao, Ethel

    2008-09-01

    Few accounts document the rural context of mental health safety net institutions (SNIs), especially as they respond to changing public policies. Embedded in wider processes of welfare state restructuring, privatization has transformed state Medicaid systems nationwide. We carried out an ethnographic study in two rural, culturally distinct regions of New Mexico to assess the effects of Medicaid managed care (MMC) and the implications for future reform. After 160 interviews and participant observation at SNIs, we analyzed data through iterative coding procedures. SNIs responded to MMC by nonparticipation, partnering, downsizing, and tapping into alternative funding sources. Numerous barriers impaired access under MMC: service fragmentation, transportation, lack of cultural and linguistic competency, Medicaid enrollment, stigma, and immigration status. By privatizing Medicaid and contracting with for-profit managed care organizations, the state placed additional responsibilities on "disciplined" providers and clients. Managed care models might compromise the rural mental health safety net unless the serious gaps and limitations are addressed in existing services and funding.

  16. Health and environmental implications of rural female entrepreneurship practices in osun state Nigeria.

    Science.gov (United States)

    Akinbami, Catherine A O; Momodu, Abiodun S

    2013-09-01

    In rural Nigeria, food processing is mostly engaged in by women and children. Most of these processes are done using outdated technologies that make use of traditional woodstoves. This article presents the health and environmental implications of the rural female entrepreneurs involved in food processing and proffer means of bettering the lot of these women to handle these hazards. A partially structured questionnaire and focus group discussion was used to capture data from respondents. The study revealed that about 73 % of women involved in direct production of garri and palm oil processing could be at risk of early death or disability-adjusted life years from the mentioned diseases. The article concludes that the rural female entrepreneur needs to be better positioned to handle these hazards, for her health, that of her children, as well as for the environment.

  17. Caring for the country: fatigue, sleep and mental health in Australian rural paramedic shiftworkers.

    Science.gov (United States)

    Courtney, James A; Francis, Andrew J P; Paxton, Susan J

    2013-02-01

    This study investigated sleep quality, fatigue, mental health and physical activity in rural paramedic shiftworkers. Although limited, previous studies have associated high fatigue levels and poorer health in this sector with shiftwork rostering and occupational demands. A modified version of the Standard Shiftwork Index was completed by 150 paramedics (117 male and 31 females) from rural Victoria. Single sample t tests found significantly higher levels of fatigue, depression, anxiety, and stress, and significantly poorer sleep quality than reference samples. Paramedics also reported less physical activity than community samples. By regression analysis, sleep quality explained the greatest amount of variance in fatigue scores, followed by depression and age. No gender differences in levels of depression or fatigue were found. Consistent with an earlier study of metropolitan paramedics based on the same methodology, findings suggest rural ambulance paramedic shiftworkers are at particular risk for increased levels of fatigue and depression (regardless of age or gender) and poor quality sleep. Organisational intervention was suggested.

  18. (In Segurança alimentar em familias de pré-escolares de uma zona rural do Ceará (In Seguridad alimenticia en familias de preescolares de una zona rural del Ceará Food (insecurity in families of preschool children in a rural zone of Ceará

    Directory of Open Access Journals (Sweden)

    Julliana dos Santos Aires

    2012-01-01

    Full Text Available OBJETIVOS: Detectar a prevalência da (in segurança alimentar entre as famílias residentes na zona rural de Maranguape e verificar a associação entre as variáveis socioeconômicas e o grau de (in segurança alimentar. MÉTODOS: Estudo descritivo, com abordagem quantitativa, realizado no Centro de Saúde da Família (CSF na zona rural de Maranguape-Ceará em setembro de 2009. A amostra constituiu-se de 200 famílias com crianças pré-escolares atendidas no CSF, sendo aplicada a Escala Brasileira de Insegurança Alimentar (EBIA. RESULTADOS: Das famílias, 12% apresentaram segurança alimentar e 88% insegurança alimentar. Constatou-se associação estatisticamente significante entre a prevalência da (in segurança alimentar e a escolaridade do responsável (pOBJETIVOS: Detectar la prevalencia de la (in seguridad alimenticia entre las familias residentes en la zona rural de Maranguape y verificar la asociación entre las variables socioeconómicas y el grado de (in seguridad alimenticia. MÉTODOS: Estudio descriptivo, con abordaje cuantitativo, realizado en el Centro de Salud de la Familia (CSF en la zona rural de Maranguape-Ceará en setiembre del 2009. La muestra se constituyó de 200 familias con niños preescolares atendidos en el CSF, siendo aplicada la Escala Brasileña de Inseguridad Alimenticia (EBIA. RESULTADOS: De las familias, el 12% presentaron seguridad alimenticia y el 88% inseguridad alimenticia. Se constató asociación estadísticamente significativa entre la prevalencia de la (in seguridad alimenticia y la escolaridad del responsable (pOBJECTIVES: To determine the prevalence of food (insecurity among housteholds in a rural zone of Maranguape, and to verify the association between socioeconomic variables and the degree of food (insecurity. METHODS: A descriptive study with a quantitative approach, conducted in the Centro de Saúde da Família (CSF , Center of Family Health, in a rural zone in Maranguape - Ceará in September

  19. Process documentation of health education interventions for school children and adolescent girls in rural India.

    Science.gov (United States)

    Dongre, Amol R; Deshmukh, Pradeep R; Garg, Bishan S

    2009-05-01

    To undertake process documentation (PD) of two health education interventions for tribal school children (6-14 years) and adolescent girls (12-19 years) in rural central India. The present participatory process documentation exercise was undertaken at Kasturba Rural Health Training Center, (KRHTC), Anji, which is a field practice area of the Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sewagram. The various steps identified for process documentation were decided after reviewing the monthly and annual reports of KRHTC, training reports, published research papers, flipbooks and daily diaries of health educators. In order to get the health educators' perceptions, a free listing and pile sort exercise on the domain of 'perceived advantages of the present approach' was undertaken, followed by a semi-structured Focus Group Discussion (FGD) with the educators. A two-dimensional scaling and hierarchical cluster analysis was completed with the pile sort data to get the collective picture of perceived advantages. The health education interventions were need-based, focusing on a target audience. The approach was community-based and has the potential to stimulate an action-experience-learning cycle of health educators and community members by stimulating their creative potential. The health educators found locally-developed handmade flipbooks with relevant messages and culturally sensitive pictures to be facilitating factors. The present study provided process documentation of two health education interventions which could be useful to both governmental and non-governmental organizations working in resource poor rural settings of developing countries.

  20. An Approach to Developing Local Climate Change Environmental Public Health Indicators in a Rural District

    Science.gov (United States)

    2017-01-01

    Climate change represents a significant and growing threat to population health. Rural areas face unique challenges, such as high rates of vulnerable populations; economic uncertainty due to their reliance on industries that are vulnerable to climate change; less resilient infrastructure; and lower levels of access to community and emergency services than urban areas. This article fills a gap in public health practice by developing climate and health environmental public health indicators for a local public health department in a rural area. We adapted the National Environmental Public Health Tracking Network's framework for climate and health indicators to a seven-county health department in Western Kentucky. Using a three-step review process, we identified primary climate-related environmental public health hazards for the region (extreme heat, drought, and flooding) and a suite of related exposure, health outcome, population vulnerability, and environmental vulnerability indicators. Indicators that performed more poorly at the county level than at the state and national level were defined as “high vulnerability.” Six to eight high vulnerability indicators were identified for each county. The local health department plans to use the results to enhance three key areas of existing services: epidemiology, public health preparedness, and community health assessment. PMID:28352286

  1. Rural health care in Vietnam and China: conflict between market reforms and social need.

    Science.gov (United States)

    Huong, Dang Boi; Phuong, Nguyen Khanh; Bales, Sarah; Jiaying, Chen; Lucas, Henry; Segall, Malcolm

    2007-01-01

    China and Vietnam have adopted market reforms in the health sector in the context of market economic reforms. Vietnam has developed a large private health sector, while in China commercialization has occurred mainly in the formal public sector, where user fees are now the main source of facility finance. As a result, the integrity of China's planned health service has been disrupted, especially in poor rural areas. In Vietnam the government has been an important financer of public health facilities and the pre-reform health service is largely intact, although user fees finance an increasing share of facility expenditure. Over-servicing of patients to generate revenue occurs in both countries, but more seriously in China. In both countries government health expenditure has declined as a share of total health expenditure and total government expenditure, while out-of-pocket health spending has become the main form of health finance. This has particularly affected the rural poor, deterring them from accessing health care. Assistance for the poor to meet public-sector user fees is more beneficial and widespread in Vietnam than China. China is now criticizing the degree of commercialization of its health system and considers its health reforms "basically unsuccessful." Market reforms that stimulate growth in the economy are not appropriate to reform of social sectors such as health.

  2. Forging partnerships between rural women with chronic conditions and their health care providers.

    Science.gov (United States)

    Cudney, Shirley; Weinert, Clarann; Kinion, Elizabeth

    2011-03-01

    Successful adaptation to chronic illness is enhanced by active client-health care provider partnerships. The purposes of this article are to (a) examine the health care partnership needs of western rural women with chronic illness who participated in a computer-based support and education project, (b) describe how the role of the women in the partnership can be maximized by the use of a personal health record and improving health literacy, and (c) discuss ways health care providers can enhance their role in the partnership by careful listening and creating environments conducive to forging productive client-provider partnerships.

  3. Frequency of intimate partner violence and rural women's mental health in four Indian states.

    Science.gov (United States)

    Stephenson, Rob; Winter, Amy; Hindin, Michelle

    2013-09-01

    This study examines the association between self-reported frequency of verbal, physical, and sexual intimate partner violence (IPV) and mental health among 6,303 rural married women (age 15-49), in four Indian states: Bihar, Jharkhand, Maharashtra, and Tamil Nadu. Data are taken from the 2002-2003 National Family Health Survey-2 Follow-Up Survey. The results indicate that experiencing physical, verbal, or sexual IPV is associated with an increased risk of adverse mental health outcomes. Our results provide support for the importance of screening for IPV in mental health settings, especially in resource-poor settings where both IPV and mental health are often overlooked.

  4. Cognitive Appraisals of Specialty Mental Health Services and Their Relation to Mental Health Service Utilization in the Rural Population

    Science.gov (United States)

    Deen, Tisha L.; Bridges, Ana J.; McGahan, Tara C.; Andrews, Arthur R., III

    2012-01-01

    Purpose: Rural individuals utilize specialty mental health services (eg, psychiatrists, psychologists, counselors, and social workers) at lower rates than their urban counterparts. This study explores whether cognitive appraisals (ie, individual perceptions of need for services, outcome expectancies, and value of a positive therapeutic outcome) of…

  5. Relationships among sense of coherence, resources, and mental health in urban and rural residents in Japan

    Directory of Open Access Journals (Sweden)

    Tsuno Yoko Sumikawa

    2012-12-01

    Full Text Available Abstract Background The salutogenic model states that coping resources are defined within sociocultural and historical contexts and that various social and historical factors influence the availability of such resources. Though previous studies have suggested the need for an interregional comparison of psychological and social resources, few studies have undertaken such an investigation. The aim of this study is to investigate the associations among coping resources, sense of coherence (SOC, and health status in a comparison of urban and rural residents. Methods General residents (aged 30–69 years in two areas were targeted for the current study. Through a random sampling selection, 1,000 residents from each area were picked, and an anonymous questionnaire was mailed to each resident. Ultimately, 269 and 363 valid responses from the urban and rural areas, respectively, were analyzed. SOC, both social and psychological resources, and mental health were assessed. To examine relationships between SOC and resources associated with mental health, mental health was defined as a dependent variable. Hierarchical multiple regression was conducted with variables entered from sociodemographic characteristics, social and psychological resources, and SOC. Results Regarding regional characteristics, social capital and participation in community activities were significantly greater in the rural area than in the urban area. Urban residents reported significantly higher self-esteem and optimism than rural residents. SOC showed the most significant association with mental health in both areas. Mental health was significantly associated with physical activity limitations and life stressors in both areas. However, the associations were weakened when social and psychological resources and SOC were added, which demonstrated their buffering effect on the negative influence of life stressors on health. When SOC was added, the association of self-esteem with mental

  6. Access to and use of sexual and reproductive health services provided by midwives among rural immigrant women in Spain: midwives’ perspectives

    Directory of Open Access Journals (Sweden)

    Laura Otero-Garcia

    2013-11-01

    Full Text Available Background: There insufficient information regarding access and participation of immigrant women in Spain in sexual and reproductive health programs. Recent studies show their lower participation rate in gynecological cancer screening programs; however, little is known about the participation in other sexual and reproductive health programs by immigrant women living in rural areas with high population dispersion. Objectives: The objective of this study is to explore the perceptions of midwives who provide these services regarding immigrant women's access and participation in sexual and reproductive health programs offered in a rural area. Design: A qualitative study was performed, within a larger ethnographic study about rural primary care, with data collection based on in-depth interviews and field notes. Participants were the midwives in primary care serving 13 rural basic health zones (BHZ of Segovia, a region of Spain with high population dispersion. An interview script was designed to collect information about midwives’ perceptions on immigrant women's access to and use of the healthcare services that they provide. Interviews were recorded and transcribed with participant informed consent. Data were analyzed based on the qualitative content analysis approach and triangulation of results with fieldwork notes. Results: Midwives perceive that immigrants in general, and immigrant women in particular, underuse family planning services. This underutilization is associated with cultural differences and gender inequality. They also believe that the number of voluntary pregnancy interruptions among immigrant women is elevated and identify childbearing and childrearing-related tasks and the language barrier as obstacles to immigrant women accessing the available prenatal and postnatal healthcare services. Conclusions: Immigrant women's underutilization of midwifery services may be linked to the greater number of unintended pregnancies, pregnancy

  7. Does the design and implementation of proven innovations for delivering basic primary health care services in rural communities fit the urban setting: the case of Ghana’s Community-based Health Planning and Services (CHPS)

    Science.gov (United States)

    2014-01-01

    Background Rapid urban population growth is of global concern as it is accompanied with several new health challenges. The urban poor who reside in informal settlements are more vulnerable to these health challenges. Lack of formal government public health facilities for the provision of health care is also a common phenomenon among communities inhabited by the urban poor. To help ameliorate this situation, an innovative urban primary health system was introduced in urban Ghana, based on the milestones model developed with the rural Community-Based Health Planning and Services (CHPS) system. This paper provides an overview of innovative experiences adapted while addressing these urban health issues, including the process of deriving constructive lessons needed to inform discourse on the design and implementation of the sustainable Community-Based Health Planning and Services (CHPS) model as a response to urban health challenges in Southern Ghana. Methods This research was conducted during the six-month pilot of the urban CHPS programme in two selected areas acting as the intervention and control arms of the design. Daily routine data were collected based on milestones initially delineated for the rural CHPS model in the control communities whilst in the intervention communities, some modifications were made to the rural milestones. Results The findings from the implementation activities revealed that many of the best practices derived from the rural CHPS experiment could not be transplanted to poor urban settlements due to the unique organizational structures and epidemiological characteristics found in the urban context. For example, constructing Community Health Compounds and residential facilities within zones, a central component to the rural CHPS strategy, proved inappropriate for the urban sector. Night and weekend home visit schedules were initiated to better accommodate urban residents and increase coverage. The breadth of the disease burden of the urban

  8. Does the design and implementation of proven innovations for delivering basic primary health care services in rural communities fit the urban setting: the case of Ghana's Community-based Health Planning and Services (CHPS).

    Science.gov (United States)

    Adongo, Philip Baba; Phillips, James F; Aikins, Moses; Arhin, Doris Afua; Schmitt, Margaret; Nwameme, Adanna U; Tabong, Philip Teg-Nefaah; Binka, Fred N

    2014-04-01

    Rapid urban population growth is of global concern as it is accompanied with several new health challenges. The urban poor who reside in informal settlements are more vulnerable to these health challenges. Lack of formal government public health facilities for the provision of health care is also a common phenomenon among communities inhabited by the urban poor. To help ameliorate this situation, an innovative urban primary health system was introduced in urban Ghana, based on the milestones model developed with the rural Community-Based Health Planning and Services (CHPS) system. This paper provides an overview of innovative experiences adapted while addressing these urban health issues, including the process of deriving constructive lessons needed to inform discourse on the design and implementation of the sustainable Community-Based Health Planning and Services (CHPS) model as a response to urban health challenges in Southern Ghana. This research was conducted during the six-month pilot of the urban CHPS programme in two selected areas acting as the intervention and control arms of the design. Daily routine data were collected based on milestones initially delineated for the rural CHPS model in the control communities whilst in the intervention communities, some modifications were made to the rural milestones. The findings from the implementation activities revealed that many of the best practices derived from the rural CHPS experiment could not be transplanted to poor urban settlements due to the unique organizational structures and epidemiological characteristics found in the urban context. For example, constructing Community Health Compounds and residential facilities within zones, a central component to the rural CHPS strategy, proved inappropriate for the urban sector. Night and weekend home visit schedules were initiated to better accommodate urban residents and increase coverage. The breadth of the disease burden of the urban residents also requires a

  9. Rural primary care practices and meaningful use of electronic health records: the role of Regional Extension Centers.

    Science.gov (United States)

    Casey, Michelle M; Moscovice, Ira; McCullough, Jeffrey

    2014-01-01

    To examine the role of Regional Extension Centers (RECs) in helping rural physician practices adopt electronic health records (EHRs) and achieve meaningful use. Using data from the Office of the National Coordinator for Health Information Technology, we conducted a county-level regression analysis using ordinary least squares to better understand rural-urban differences in REC participation, EHR implementation, and meaningful use, controlling for counties' economic conditions. We prepared case studies of 2 RECs that are serving a large number of rural practices, based on interviews with key individuals at the RECs, their partner organizations, and rural primary care practices that received assistance from the RECs. RECs are largely achieving their objective of targeting providers in communities that face barriers to EHRs. REC participants are disproportionately rural and more likely to come from high poverty and low employment communities. The case study RECs had long-standing relationships with rural providers, as well as extensive staff expertise in quality improvement and EHR implementation, and employed a variety of strategies to successfully assist rural providers. Rural providers report that REC assistance was invaluable in helping them implement EHRs and achieve meaningful use status. Modifying the criteria for Medicare and Medicaid EHR incentives could help additional rural providers pay for EHRs. REC federal funding is scheduled to end in 2014, but practices that have not yet adopted EHRs may need significant, ongoing assistance to receive meaningful use. © 2013 National Rural Health Association.

  10. Public health and agrarian liberal politics in Spain: the Rural Health Bureau (1910-1918

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    Rodríguez-Ocaña, Esteban

    2010-12-01

    Full Text Available This paper reviews the meaning of the Rural Health Bureau (1910-1918 for the history of Spanish public health, thanks to a wealth of previously unknown sources found through a systematic search through medical journals of the time and the Bulletin of the national department of Agriculture. The Bureau was dependent of the Ministry of Development, in the same way as the competences on animal health. It aimed to provide a public health rationale for a plan of agrarian infrastructures, a goal resolved into a huge task of surveillance on hookworm disease, malaria, water supplies and diet. Thus it becomes a perfect paradigm of the Spanish Liberal tradition of promoting information instead than actual changes into society, as well as a needed complement to the hydraulic policy sponsored by Rafael Gasset.

    Abordo el significado en la historia de la Salud pública española de la Inspección de Sanidad del Campo (1910-1918 partiendo de fuentes escasamente conocidas producto de una búsqueda sistemática en las revistas médicas de la época y en el Boletín de Agricultura técnica y económica, órgano de la Dirección general de Agricultura. La Inspección dependió del Ministerio de Fomento, al igual que la higiene veterinaria, y su objetivo era proporcionar bases higiénicas para un plan de infraestructuras agrarias, lo que se tradujo en una ingente tarea de vigilancia epidemiológica sobre anquilostomiasis, paludismo, aguas y alimentación. En este sentido resulta un perfecto epítome de la tradición informativa liberal, así como un complemento de la política hidráulica impulsada por Rafael Gasset.

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

    Science.gov (United States)

    Alhassan, Robert Kaba; Nketiah-Amponsah, Edward

    2016-12-01

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

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

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    J. Kim*

    2013-12-01

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

  13. 76 FR 25696 - National Advisory Committee on Rural Health and Human Services; Notice of Meeting

    Science.gov (United States)

    2011-05-05

    ...-Snell at the Office of Rural Health Policy (ORHP) via Telephone at (301) 443-0835 or by e-mail at ddemasse-snell@hrsa.gov . The committee meeting agenda will be posted on ORHP's Web site http://www...

  14. Gender Differences in Views about Cognitive Health and Healthy Lifestyle Behaviors among Rural Older Adults

    Science.gov (United States)

    Wu, Bei; Goins, R. Turner; Laditka, James N.; Ignatenko, Valerie; Goedereis, Eric

    2009-01-01

    Purpose: Research suggests that men and women often differ in knowledge and beliefs about causes and treatments of a variety of diseases. This study examines gender differences in views about cognitive health and behaviors that have been associated with its maintenance, focusing on older adults living in rural areas. Design and Methods: We…

  15. Urban-rural health differences and the availability of green space.

    NARCIS (Netherlands)

    Verheij, R.A.; Maas, J.; Groenewegen, P.P.

    2008-01-01

    It is argued that urban—rural health differences, which are found in many studies, may be at least partially associated with the availability of green space. Until recently there was only limited evidence from experimental research for this relationship, but recent large-scale epidemiological work

  16. The Role of Physician Assistants in Rural Health Care: A Systematic Review of the Literature

    Science.gov (United States)

    Henry, Lisa R.; Hooker, Roderick S.; Yates, Kathryn L.

    2011-01-01

    Purpose: A literature review was performed to assess the role of physician assistants (PAs) in rural health care. Four categories were examined: scope of practice, physician perceptions, community perceptions, and retention/recruitment. Methods: A search of the literature from 1974 to 2008 was undertaken by probing the electronic bibliographic…

  17. Improvement of Rural Children's Asthma Self-Management by Lay Health Educators

    Science.gov (United States)

    Horner, Sharon D.; Fouladi, Rachel T.

    2008-01-01

    Background: The purpose of the present analysis is to examine changes in rural children's asthma self-management after they received lay health educator (LHE)-delivered classes. Methods: Elementary schools were randomly assigned to the treatment or attention-control condition and their participating students received either asthma education or…

  18. Are nurses the answer to the health needs of rural South Africa ...

    African Journals Online (AJOL)

    Are nurses the answer to the health needs of rural South Africa? ... South African Family Practice ... Extending the role of the nurse in the village clinic from prevention and care to diagnosis and treatment is a solution that has been tried in ...

  19. Twenty-five years of serving the health care needs of rural North Carolina.

    Science.gov (United States)

    Walker, Franklin

    2015-01-01

    The Community Practitioner Program seeks to improve access to quality health care for North Carolina's most vulnerable people by providing educational loan repayment grants to primary care physicians, physician assistants, and nurse practitioners in return for their service in rural and underserved communities.

  20. Usefulness of a Survey on Underage Drinking in a Rural American Indian Community Health Clinic

    Science.gov (United States)

    Gilder, David A.; Luna, Juan A.; Roberts, Jennifer; Calac, Daniel; Grube, Joel W.; Moore, Roland S.; Ehlers, Cindy L.

    2013-01-01

    This study examined the usefulness of a survey on underage drinking in a rural American Indian community health clinic. One hundred ninety-seven youth (90 male, 107 female; age range 8-20 years) were recruited from clinic waiting rooms and through community outreach. The study revealed that the usefulness of the survey was twofold: Survey results…

  1. Rural health prepayment schemes in China: towards a more active role for government.

    Science.gov (United States)

    Bloom, G; Shenglan, T

    1999-04-01

    A large majority of China's rural population were members of health prepayment schemes in the 1970's. Most of these schemes collapsed during the transition to a market economy. Some localities subsequently reestablished schemes. In early 1997 a new government policy identified health prepayment as a major potential source of rural health finance. This paper draws on the experience of existing schemes to explore how government can support implementation of this policy. The decision to support the establishment of health prepayment schemes is part of the government's effort to establish new sources of finance for social services. It believes that individuals are more likely to accept voluntary contributions to a prepayment scheme than tax increases. The voluntary nature of the contributions limits the possibilities for risk-sharing and redistribution between rich and poor. This underlines the need for the government to fund a substantial share of health expenditure out of general revenues, particularly in poor localities. The paper notes that many successful prepayment schemes depend on close supervision by local political leaders. It argues that the national programme will have to translate these measures into a regulatory system which defines the responsibilities of scheme management bodies and local governments. A number of prepayment schemes have collapsed because members did not feel they got value for money. Local health bureaux will have to cooperate with prepayment schemes to ensure that health facilities provide good quality services at a reasonable cost. Users' representatives can also monitor performance. The paper concludes that government needs to clarify the relationship between health prepayment schemes and other actors in rural localities in order to increase the chance that schemes will become a major source rural health finance.

  2. A Cross-sectional Study of Health-related Behaviors in Rural Eastern China

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective This study examined the status of health-related behaviors among rural residents and the factors influencing the practice of such behaviors. Methods One thousand and ninety subjects aged 15 years or over in a rural community, Anhui Province, China were surveyed. A questionnaire was used to collect information on the health knowledge, attitude and behavior of the subjects. Information on health behavior included smoking, drinking, dietary habits, regular exercises, sleeping pattern and oral health behavior. Results The prevalence of smoking and drinking in the male subjects was 46.5% and 46.9%, respectively. There was a positive significant association between smoking and drinking. Only 8.3% of all subjects ate three regular meals a day regularly. Among subjects who ate two meals a day, 89.7% did not have breakfast. Only 1.7% of subjects took part in regular exercise. About 85% of subjects slept 6 to 8 h per day. Only 38.4 % of the respondents had the habit of hand washing before eating and after using the lavatory. 79.3% of the subjects brushed their teeth every day, and among them, only 10.6 percent brushed their teeth twice a day.Further analyses showed that 64.8% of subjects had 3-5 items of positive health behaviors out of 8 items and only 16.9% had six or more items. Logistical regression analyses suggested that better health behavior was affected by sex, age, years of education, income and health knowledge.Conclusion The status of health behaviors among rural residents was generally poor. It is thus urgent to reinforce health education in rural communities in China.

  3. Sustainable primary health care services in rural and remote areas: innovation and evidence.

    Science.gov (United States)

    Wakerman, John; Humphreys, John S

    2011-06-01

    To highlight how evidence from studies of innovative rural and remote models of service provision can inform global health system reform in order to develop appropriate, accessible and sustainable primary health care (PHC) services to 'difficult-to-service' communities. The paper synthesises evidence from remote and rural PHC health service innovations in Australia. There is a strong history of PHC innovation in Australia. Successful health service models are 'contextualised' to address diverse conditions. They also require systemic solutions, which address a range of interlinked factors such as governance, leadership and management, adequate funding, infrastructure, service linkages and workforce. An effective systemic approach relies on alignment of changes at the health service level with those in the external policy environment. Ideally, every level of government or health authority needs to agree on policy and funding arrangements for optimal service development. A systematic approach in addressing these health system requirements is also important. Service providers, funders and consumers need to know what type and level of services they can reasonably expect in different community contexts, but there are gaps in agreed indicators and benchmarks for PHC services. In order to be able to comprehensively monitor and evaluate services, as well as benchmarks, we need adequate national information systems. Despite the gaps in our knowledge, we do have a significant amount of information about what works, where and why. At a time of global PHC reform, applying this knowledge will contribute significantly to the development of appropriate, sustainable PHC services and improving access. © 2011 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

  4. 42 CFR 485.603 - Rural health network.

    Science.gov (United States)

    2010-10-01

    ... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CONDITIONS OF PARTICIPATION: SPECIALIZED PROVIDERS Conditions of... services. (b) The members of the organization have entered into agreements regarding— (1) Patient...

  5. Depression in rural adolescents: relationships with gender and availability of mental health services.

    Science.gov (United States)

    Black, Georgina; Roberts, Rachel M; Li-Leng, Tan

    2012-01-01

    There is growing evidence in the literature which indicates that the prevalence of depression is similar in both non-metropolitan and metropolitan areas. However, it is generally perceived that factors associated with compromised mental health in rural residents include deprivation and lack of access to healthcare services. This study examines the relationship between depression and possible determinants of mental health among rural adolescents. The determinants identified were degree of remoteness, gender, socioeconomic status and the perception of rural community characteristics. Rural community characteristics examined were long waiting lists and lack of mental health professionals. Respondents were 531 South Australian adolescents (55.7% female) aged 13 to 18 years, living outside the Adelaide (state capital) metropolitan area. Respondents completed a questionnaire including: demographic questions; the Kutcher Adolescent Depression Scale (KADS); and questions regarding individual perceptions of community characteristics. The data were obtained by self-report, degree of remoteness was measured using the Accessibility and Remoteness Index of Australia Plus, and socio-economic status was determined from the Australian Bureau of Statistics (ABS) Socio-Economic Index of Relative Socio-Economic Advantage and Disadvantage (SEIFA). The rate of depression obtained from this sample of rural adolescents is concerning; 18% screened positive for depression on the KADS, 41% reported low mood much of the time or more often, and 20% experienced occasional or more frequent self-harm or suicidal thoughts, plans or actions. Depression was related to gender, with more females (23%) screening positive for depression than males (11.8%). Prevalence of depression was unrelated to degree of remoteness or the socioeconomic status of the participants. This finding is not consistent with other research that identifies socioeconomic status as a psychosocial determinant of mental health. It

  6. THE HEALTH STATUS OF A RURAL IRANIAN COMMUNITY IN THE CASPIAN LITTORAL AREA IN 1976

    Directory of Open Access Journals (Sweden)

    Ali A.Alemi

    1978-08-01

    Full Text Available The health status of the rural community under the study is measured in terms of vital statistics, and living conditions in relation to demographic data. The findings reveal that this rural population can be considered a very unhealthy one. For instance, the infant mortality rate is 98.4 per 1000 live births, and 80.0 per cent of the total population were found to be infected by one or more parasitic diseases. Allocation of resources has been recommended to raise the standard of living, in order to bring about a better hygienic environment. Accessibility of health services through expansion of primary health care, and in this sphere the use of health auxiliaries should yet again receive special consideration.

  7. How far can systematic reviews inform policy development for "wicked" rural health service problems?

    Science.gov (United States)

    Humphreys, John S; Kuipers, Pim; Wakerman, John; Wells, Robert; Jones, Judith A; Kinsman, Leigh D

    2009-11-01

    Policy makers and researchers increasingly look to systematic reviews as a means of connecting research and evidence more effectively with policy. Based on Australian research into rural and remote primary health care services, we note some concerns regarding the suitability of systematic review methods when applied to such settings. It suggests that rural and other health services are highly complex and researching them is akin to dealing with "wicked" problems. It proposes that the notion of "wicked" problems may inform our understanding of the issues and our choice of appropriate methods to inform health service policy. Key issues including the complexity of health services, methodological limitations of traditional reviews, the nature of materials under review, and the importance of the service context are highlighted. These indicate the need for broader approaches to capturing relevant evidence. Sustained, collaborative synthesis in which complexity, ambiguity and context is acknowledged is proposed as a way of addressing the wicked nature of these issues.

  8. Developmental Origins of Health and Disease (DOHaD): Implications for health and nutritional issues among rural children in China.

    Science.gov (United States)

    Feng, Aihua; Wang, Lijie; Chen, Xiang; Liu, Xiaoyan; Li, Ling; Wang, Baozhen; Luo, Huiwen; Mo, Xiuting; Tobe, Ruoyan Gai

    2015-04-01

    In China, with fast economic growth, health and nutrition status among the rural population has shown significant improvement in the past decades. On the other hand, burden of non-communicable diseases and prevalence of related risk factors such as overweight and obesity has also increased. Among rural children, the double burden of malnutrition and emerging overweight and obesity has been neglected so far. According to the theory of Developmental Origin of Health and Diseases (DOHaD), malnutrition, including both undernutrition (stunting and wasting) and over-nutrition (overweight and obesity) during childhood is closely related to worsened health outcomes during adulthood. Such a neglected problem is attributable to a complicated synergy of social and environmental factors such as parental migration, financial situation of the household, child-rearing knowledge and practices of the primary caregivers, and has implications for public health. Based on literature review of lessons from the field, intervention to address malnutrition among rural children should be a comprehensive package, with consideration of their developmental environment and geographical and socioeconomic diversity. The scientific evidence on DOHaD indicates the probability and necessity of prevention of adult disease by promotion of maternal and child health and reducing malnutrition by provision of high-quality complementary foods, promotion of a well-balanced dietary pattern, and promotion of health literacy in the public would bring a potential benefit to reduce potential risk of diseases.

  9. Barefoot Doctors and the "Health Care Revolution" in Rural China: A Study Centered on Shandong Province.

    Science.gov (United States)

    Xu, Sanchun; Hu, Danian

    2017-09-01

    Barefoot doctors were rural medical personnel trained en masse, whose emergence and development had a particular political, economic, social, and cultural background. Like the rural cooperative medical care system, the barefoot doctor was a well-known phenomenon in the Cultural Revolution. Complicated regional differences and a lack of reliable sources create much difficulty for the study of barefoot doctors and result in differing opinions of their status and importance. Some scholars greatly admire barefoot doctors, whereas others harshly criticize them. This paper explores the rise and development of barefoot doctors based on a case study of Shandong province. I argue that the promotion of barefoot doctors was a consequence of the medical education revolution and an implementation of the Cultural Revolution in rural public health care, which significantly influenced medical services and development in rural areas. First, barefoot doctors played a significant role in accomplishing the first rural health care revolution by providing primary health care to peasants and eliminating endemic and infectious illnesses. Second, barefoot doctors were the agents who integrated Western and Chinese medicines under the direction of the state. As an essential part of the rural cooperative medical system, barefoot doctor personnel grew in number with the system's implementation. After the Cultural Revolution ended, the cooperative medical system began to disintegrate-a process that accelerated in the 1980s until the system's collapse in the wake of the de-collectivization. As a result, the number of barefoot doctors also ran down steadily. In 1985, "barefoot doctor" as a job title was officially removed from Chinese medical profession, demonstrating that its practice was non-universal and unsustainable. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Childhood Health Status and Adulthood Cardiovascular Disease Morbidity in Rural China: Are They Related?

    Directory of Open Access Journals (Sweden)

    Qing Wang

    2016-06-01

    Full Text Available Cardiovascular diseases (CVDs are among the top health problems of the Chinese population. Although mounting evidence suggests that early childhood health status has an enduring effect on late life chronic morbidity, no study so far has analyzed the issue in China. Using nationally representative data from the 2013 China Health and Retirement Longitudinal Study (CHARLS, a Probit model and Two-Stage Residual Inclusion estimation estimator were applied to analyze the relationship between childhood health status and adulthood cardiovascular disease in rural China. Good childhood health was associated with reduced risk of adult CVDs. Given the long-term effects of childhood health on adulthood health later on, health policy and programs to improve the health status and well-being of Chinese populations over the entire life cycle, especially in persons’ early life, are expected to be effective and successful.

  11. A Study of Rural Elderly’s Health Information Needs and Seeking Behavior

    Directory of Open Access Journals (Sweden)

    Wei-Chun Liao

    2012-06-01

    Full Text Available Survey method was used and 92 valid questionnaires were collected for the analyses. The results showed that the majority of the rural elder people expressed the need for and attention to health information. ‘‘health service information’’ and ‘‘prevention health care information’’ were the most needed and important. Family, friends and television were the main channels for accessing health information. However, fewer respondents actively sought health information. When health problems occurred, they tended to seek direct medical treatment. This study also found that men were more attentive and active in seeking health information. Respondents over 75 years old rarely concerned about their health information need. People with more education were also more aware of their health information needs and more attentive to information disseminated via mass media. [Article content in Chinese

  12. Classroom Goal Structures and HIV/Pregnancy Prevention Education in Rural High School Health Classrooms

    OpenAIRE

    Anderman, Eric M.; CUPP, PAMELA K.; Lane, Derek R.; Zimmerman, Rick; Gray, DeLeon L.; O'Connell, Ann

    2011-01-01

    Over 5,000 adolescents enrolled in required rural high school health courses reported their perceptions of mastery and extrinsic goal structures in their health classrooms. Data were collected from all students at three time points (prior to HIV/pregnancy instruction, three months after instruction, and one year after instruction). Results indicated that classroom goal structures were related to both proximal and distal knowledge, attitudes, intentions, and efficacy beliefs. Results in partic...

  13. Physical and Mental Health Problems of the Elderly in a Rural Community of Sepang, Selangor

    OpenAIRE

    2004-01-01

    The prevalence of aging population is increasing not only in developed countries, but also in developing countries like Malaysia. The aim of this study was: (1) to determine the prevalence of physical and mental health problems, and (2) to determine the association of these health problems with socio demographic factors among the elderly in a rural community in Sepang, Selangor. A cross sectional study design was used. Five out of nine villages were selected via random sampling. The elderly i...

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

    Directory of Open Access Journals (Sweden)

    Chen Chi-Liang

    2008-03-01

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

  15. Assessment of pharmacists' delivery of public health services in rural and urban areas in Iowa and North Dakota.

    Science.gov (United States)

    Scott, David M; Strand, Mark; Undem, Teri; Anderson, Gabrielle; Clarens, Andrea; Liu, Xiyuan

    2016-01-01

    The profession of pharmacy is expanding its involvement in public health, but few studies have examined pharmacists' delivery of public health services. To assess Iowa and North Dakota pharmacists' practices, frequency of public health service delivery, level of involvement in achieving the essential services of public health, and barriers to expansion of public health services in rural and urban areas. This study implemented an on-line survey sent to all pharmacists currently practicing pharmacy in Iowa and North Dakota. Overall, 602 valid responses were analyzed, 297 in rural areas and 305 in urban areas. Three practice settings (chain stores [169, 28.2%], independent community pharmacies [162, 27.0%], and hospital pharmacies [156, 26.0%]) comprised 81.2% of the sample. Both chain and independent community pharmacists were more commonly located in rural areas than in urban areas (Pindependents) in rural areas reported more frequent delivery than did pharmacists in urban areas (P pharmacy provides, partner with the community to identify and help solve health problems, and conduct needs assessments to identify health risks in my community. Rural pharmacists more frequently deliver public health services than urban in both Iowa and North Dakota. These findings should be interpreted to be primarily due to differences in the role of the rural pharmacist and the quest for certain opportunities that rural pharmacists are seeking.

  16. Role of ASHA in improvement of maternal health status in northern India: an urban rural comparison

    Directory of Open Access Journals (Sweden)

    P Padda

    2013-12-01

    Full Text Available Background: In spite of extensive network of health care facilities areas of concern in the state of Punjab are alarming rate of children suffering from anemia, high prevalence of anemia among women, particularly pregnant ones, low consumption of IFA tablets and poor post natal care, proportion of children exclusively breastfed is very low, delay in initiation of breastfeeding and use of supplementary foods. To combat this NRHM was launched and ASHA is the most important link between the community and health care. Objectives: to evaluate the role of ASHA workers in rural areas of district Faridkot using the maternal health indicators by making urban rural comparison. Methods: A house to house survey was conducted in selected urban and rural areas of Malwa region of Punjab to select the cohorts of pregnant females. These pregnant females were registered and followed till 42 days after delivery. All the information regarding ante natal, natal and post natal care of the pregnant female was recorded on the self-structured and pretested questionnaire and an urban rural comparison was made to evaluate the role of ASHA. Results: Out of 2841 pregnant women of urban area, 900 (31.7% had an abortion whereas out of 5088 of pregnant women of rural area 1063 (20.9% ended in an abortion. The females whose pregnancy ended in an abortion were not included in the study. Therefore, 1941 and 4025 pregnant women formed the sample for the analysis to avoid bias. 92.6% of pregnant women living in urban area had an institutional delivery and 7.4% delivered at home. The pregnant women of urban had a higher still birth rate (40.8 per 1000 live births than pregnant women of rural (11.1 per 1000 live births. Sex ratio of the newborns was also more skewed in urban (866 females per 1000 males than rural area (995 females per 1000 males. Conclusion: This can be concluded from the present study that the maternal and child health services delivery definitely improves after

  17. A Survey of Rural Hospitals’ Perspectives on Health Information Technology Outsourcing

    Science.gov (United States)

    Johnson, Nicholas; Murphy, Alison; McNeese, Nathan; Reddy, Madhu; Purao, Sandeep

    2013-01-01

    A survey of rural hospitals was conducted in the spring of 2012 to better understand their perspectives on health information technology (HIT) outsourcing and the role that hospital-to-hospital HIT partnerships (HHPs) can play as an outsourcing mechanism. The survey sought to understand how HHPs might be leveraged for HIT implementation, as well as the challenges with forming them. The results suggest that HHPs have the potential to address rural hospitals’ slow rate of HIT adoption, but there are also challenges to creating these partnerships. These issues, as well as avenues for further research, are then discussed. PMID:24551373

  18. A survey of rural hospitals' perspectives on health information technology outsourcing.

    Science.gov (United States)

    Johnson, Nicholas; Murphy, Alison; McNeese, Nathan; Reddy, Madhu; Purao, Sandeep

    2013-01-01

    A survey of rural hospitals was conducted in the spring of 2012 to better understand their perspectives on health information technology (HIT) outsourcing and the role that hospital-to-hospital HIT partnerships (HHPs) can play as an outsourcing mechanism. The survey sought to understand how HHPs might be leveraged for HIT implementation, as well as the challenges with forming them. The results suggest that HHPs have the potential to address rural hospitals' slow rate of HIT adoption, but there are also challenges to creating these partnerships. These issues, as well as avenues for further research, are then discussed.

  19. Rural New Zealand health professionals' perceived barriers to greater use of the internet for learning.

    Science.gov (United States)

    Janes, Ron; Arroll, Bruce; Buetow, Stephen; Coster, Gregor; McCormick, Ross; Hague, Iain

    2005-01-01

    The purpose of this research was to investigate rural North Island (New Zealand) health professionals' attitudes and perceived barriers to using the internet for ongoing professional learning. A cross-sectional postal survey of all rural North Island GPs, practice nurses and pharmacists was conducted in mid-2003. The questionnaire contained both quantitative and qualitative questions. The transcripts from two open questions requiring written answers were analysed for emergent themes, which are reported here. The first open question asked: 'Do you have any comments on the questionnaire, learning, computers or the Internet?' The second open question asked those who had taken a distance-learning course using the internet to list positive and negative aspects of their course, and suggest improvements. Out of 735 rural North Island health professionals surveyed, 430 returned useable questionnaires (a response rate of 59%). Of these, 137 answered the question asking for comments on learning, computers and the internet. Twenty-eight individuals who had completed a distance-learning course using the internet, provided written responses to the second question. Multiple barriers to greater use of the internet were identified. They included lack of access to computers, poor availability of broadband (fast) internet access, lack of IT skills/knowledge, lack of time, concerns about IT costs and database security, difficulty finding quality information, lack of time, energy or motivation to learn new skills, competing priorities (eg family), and a preference for learning modalities which include more social interaction. Individuals also stated that rural health professionals needed to engage the technology, because it provided rapid, flexible access from home or work to a significant health information resource, and would save money and travelling time to urban-based education. In mid-2003, there were multiple barriers to rural North Island health professionals making greater

  20. Culturally-Tailored Education Programs to Address Health Literacy Deficits and Pervasive Health Disparities among Hispanics in Rural Shelbyville, Kentucky.

    Science.gov (United States)

    Ramos, Irma N; Ramos, Kenneth S; Boerner, Aisa; He, Qiang; Tavera-Garcia, Marco A

    2013-11-16

    This investigation was conducted to evaluate the impact of culturally-tailored education on health knowledge among Hispanic residents of rural, Shelbyville, KY. The program identified specific pathways to address health literacy deficits and disparities identified through a community-wide health assessment completed in 2010. A total of 43 Hispanic males who shared deficiencies in community-wide health infrastructure were enrolled in the program. The curriculum included an introductory session followed by five, subject-specific, sessions offered on a weekly basis from February to April 2011. Pre/post-test assessments showed marked improvement in knowledge base for all participants after each session, most notably related to cardiovascular disease, diabetes and metabolic syndrome. The group reconvened in January 2012 for follow-up instruction on cardiovascular disease and diabetes, as well as global assessment of knowledge retention over a nine-month period. Comparisons of pre/post testing in cardiovascular disease and diabetes, as well as global health-related knowledge showed significant gains for all parameters. Health education programs that embrace perceptions of the community of their own health, and that integrate knowledge into culturally-sensitive education, significantly improved health knowledge among Hispanic residents in rural Kentucky. Such gains may translate into sustainable improvements in health literacy and help reduce health disparities.

  1. Role of AYUSH workforce, therapeutics, and principles in health care delivery with special reference to National Rural Health Mission.

    Science.gov (United States)

    Samal, Janmejaya

    2015-01-01

    Decades back AYUSH systems of medicine were limited to their own field with few exceptions in some states as health in India is a state issue. This took a reverse turn after the initiation of National Rural Health Mission (NRHM) in 2005 which brought the concept of "Mainstreaming of AYUSH and Revitalization of Local Health Traditions" utilizing the untapped AYUSH workforces, therapeutics and principles for the management of community health problems. As on 31/03/2012 AYUSH facilities were co-located in 468 District Hospitals, 2483 Community Health Centers and 8520 Primary Health Centers in the country. Several therapeutics are currently in use and few drugs have been included in the ASHA drug kit to treat common ailments in the community. At the same time Government of India has recognized few principles and therapeutics of Ayurveda as modalities of intervention to some of the community health problems. These include Ksharasutra (medicine coated thread) therapy for ano-rectal surgeries and Rasayana Chikitsa (rejuvenative therapy) for senile degenerative disorders etc. Similarly respective principles and therapeutics can also be utilized from other systems of AYUSH such as Yoga and Naturopathy, Unani, Siddha and Homoeopathy. Akin to Ayurveda these principles and therapeutics can also help in managing community health problems if appropriately implemented. This paper is a review on the role of AYUSH, as a system, in the delivery of health care in India with special reference to National Rural Health Mission.

  2. Health insurance and child mortality in rural Burkina Faso.

    Science.gov (United States)

    Schoeps, Anja; Lietz, Henrike; Sié, Ali; Savadogo, Germain; De Allegri, Manuela; Müller, Olaf; Sauerborn, Rainer; Becher, Heiko; Souares, Aurélia

    2015-01-01

    Micro health insurance schemes have been implemented across developing countries as a means of facilitating access to modern medical care, with the ultimate aim of improving health. This effect, however, has not been explored sufficiently. We investigated the effect of enrolment into community-based health insurance on mortality in children under 5 years of age in a health and demographic surveillance system in Nouna, Burkina Faso. We analysed the effect of health insurance enrolment on child mortality with a Cox regression model. We adjusted for variables that we found to be related to the enrolment in health insurance in a preceding analysis. Based on the analysis of 33,500 children, the risk of mortality was 46% lower in children enrolled in health insurance as compared to the non-enrolled children (HR=0.54, 95% CI 0.43-0.68) after adjustment for possible confounders. We identified socioeconomic status, father's education, distance to the health facility, year of birth, and insurance status of the mother at time of birth as the major determinants of health insurance enrolment. The strong effect of health insurance enrolment on child mortality may be explained by increased utilisation of health services by enrolled children; however, other non-observed factors cannot be excluded. Because malaria is a main cause of death in the study area, early consultation of health services in case of infection could prevent many deaths. Concerning the magnitude of the effect, implementation of health insurance could be a major driving factor of reduction in child mortality in the developing world.

  3. Health insurance and child mortality in rural Burkina Faso

    Directory of Open Access Journals (Sweden)

    Anja Schoeps

    2015-04-01

    Full Text Available Background: Micro health insurance schemes have been implemented across developing countries as a means of facilitating access to modern medical care, with the ultimate aim of improving health. This effect, however, has not been explored sufficiently. Objective: We investigated the effect of enrolment into community-based health insurance on mortality in children under 5 years of age in a health and demographic surveillance system in Nouna, Burkina Faso. Design: We analysed the effect of health insurance enrolment on child mortality with a Cox regression model. We adjusted for variables that we found to be related to the enrolment in health insurance in a preceding analysis. Results: Based on the analysis of 33,500 children, the risk of mortality was 46% lower in children enrolled in health insurance as compared to the non-enrolled children (HR=0.54, 95% CI 0.43–0.68 after adjustment for possible confounders. We identified socioeconomic status, father's education, distance to the health facility, year of birth, and insurance status of the mother at time of birth as the major determinants of health insurance enrolment. Conclusions: The strong effect of health insurance enrolment on child mortality may be explained by increased utilisation of health services by enrolled children; however, other non-observed factors cannot be excluded. Because malaria is a main cause of death in the study area, early consultation of health services in case of infection could prevent many deaths. Concerning the magnitude of the effect, implementation of health insurance could be a major driving factor of reduction in child mortality in the developing world.

  4. Spatiotemporal discordance in five common measures of rurality for US counties and applications for health disparities research in older adults

    Directory of Open Access Journals (Sweden)

    Steven A. Cohen

    2015-11-01

    Full Text Available Introduction: Rural populations face numerous barriers to health, including poorer health care infrastructure, access to care, and other sociodemographic factors largely associated with rurality. Multiple measures of rurality used in the biomedical and public health literature can help assess rural-urban health disparities and may impact the observed associations between rurality and health. Furthermore, understanding what makes a place truly rural versus urban may vary from region to region in the United States.Purpose: The objectives of this study are to compare and contrast five common measures of rurality and determine how well-correlated these measures are at the national, regional, and divisional level, as well as to assess patterns in the correlations between the prevalence of obesity in the population aged 60+ and each of the five measures of rurality at the regional and divisional level.Methods: Five measures of rurality were abstracted from the US Census and US Department of Agriculture (USDA to characterize US counties. Obesity data in the population aged 60+ were abstracted from the Behavioral Risk Factor Surveillance System (BRFSS. Spearman’s rank correlations were used to quantify the associations among the five rurality measurements at the national, regional, and divisional level, as defined by the US Census Bureau. Geographic information systems were used to visually illustrate temporal, spatial, and regional variability. Results: Overall, Spearman’s rank correlations among the five measures ranged from 0.521 (percent urban-Urban Influence Code to 0.917 (Rural-Urban Continuum Code-Urban Influence Code. Notable discrepancies existed in these associations by Census region and by division. The associations between measures of rurality and obesity in the 60+ population varied by rurality measure used and by region. Conclusion: This study is among the first to systematically assess the spatial, temporal, and regional differences

  5. Robust E-Health Communication Architecture for Rural Communities in Developing Countries

    Directory of Open Access Journals (Sweden)

    F. E. Idachaba

    2012-06-01

    Full Text Available The lack of access to quality healthcare and the lack of sufficient manpower, especially doctors, in rural areas is a major healthcare challenge faced by dwellers in rural communities in most developing countries. The intervention of governments, which range from the introduction of training programs aimed at producing health workers from schools of health technology and nursing to the recalling and deployment of retired nurses to rural areas, has still not been able to generate the desired improvement in healthcare delivery, as outbreaks of epidemics are still being reported in such areas. This work presents an E-Health architecture which utilizes low cost sensors and communication devices to link the doctors in the urban areas with the patients in rural areas enabling doctors-patients interaction. The system enables accurate and timely diagnosis of the patients and facilitates proper treatment plans. It also incorporates an epidemic alert which enables the tracking of diseases and the early detection and control of epidemics.

  6. Rural male health workers in Western Jamaica: Knowledge, attitudes and practices toward prostate cancer screening

    Directory of Open Access Journals (Sweden)

    Paul Andrew Bourne

    2010-01-01

    Full Text Available Background: Statistics have shown that since 1988, a significant percentage of males are unwilling to seek medical care. The question is if they had the knowledge, worked in the health system and were educated, would this be any different? Aim: The current study aims to fill this void in the literature by examining the perception of rural male health workers (from the Western Region about prostate examination, and why they are reluctant to inquire about the probability of having, or the likelihood of not having prostate cancer. Materials and Methods: The study utilized primary cross-sectional data that was collected during February and March 2008 from 170 males (ages 29 years and older, health-care workers who were employed in particular rural health institutions in Jamaica (i.e. Western Regional Health Authority. SPSS was used to analyze the data. Results: When the respondents were asked “Have you ever heard about the screening procedure for prostate?” 71.2% indicated yes, but only 27.1% had got their prostate checked by a health practitioner. When respondents were asked to state what influenced their choice of not doing a digital rectal examination, 20.6% indicated comfort level; 9.4% stated the gender of the health practitioner, 5.3% mentioned fear and others did not respond. Of those who had the examination 2 years ago, 96.5% did not state the choice of method. Conclusion: The current study is limited in terms of its generalizability to rural males or rural males in Western Jamaica, but it does provide an insight into the difficulty of men in breaking away from culture.

  7. Self-reported morbidity and health service utilization in rural Tamil Nadu, India.

    Science.gov (United States)

    Dodd, Warren; King, Nia; Humphries, Sally; Little, Matthew; Dewey, Cate

    2016-07-01

    In Tamil Nadu, India, improvements have been made toward developing a high-quality, universally accessible healthcare system. However, some rural residents continue to confront significant barriers to obtaining healthcare. The primary objective of this study was to investigate self-reported morbidity, health literacy, and healthcare preferences, utilization, and experiences in order to identify priority areas for government health policies and programs. Drawing on 66 semi-structured interviews and 300 household surveys (including 1693 individuals), administered in 26 rural villages in Tamil Nadu's Krishnagiri district, we found that the prevalence of self-reported major health conditions was 22.3%. There was a large burden of non-communicable and chronic diseases, and the most common major morbidities were: connective tissue problems (7.6%), nervous system and sense organ diseases (5.0%), and circulatory and respiratory diseases (2.5%). Increased age and decreased education level were associated with higher odds of reporting most diseases. Low health literacy levels resulted in individuals seeking care only once pain interfered with daily activities. As such, individuals' health-seeking behaviour depended on which strategy was believed to result in the fastest return to work using the fewest resources. Although government facilities were the most common healthcare access point, they were mistrusted; 48.8% and 19.2% of respondents perceived inappropriate treatment protocols and corruption, respectively, at public facilities. Conversely, 93.3% of respondents reported high treatment cost as the main barrier to accessing private facilities. Our results highlight that addressing the chronic and non-communicable disease burdens amongst rural populations in this context will require health policies and village-level programs that address the low health literacy and the issues of rural healthcare accessibility and acceptability.

  8. In the choice between health and money, health comes first: an analysis of happiness among rural Chilean elderly

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    German Lobos

    2016-01-01

    Full Text Available Abstract: We studied the relationship between happiness and individual socio-demographic context and health and dietary variables by interviewing 389 elderly individuals (age 60-90 years living in rural areas in the Maule Region of Central Chile. The Lyubomirsky & Lepper (1999 subjective happiness scale was used. Ordinal logistic regression models were estimated. The discrete dependent variable was level of happiness. The following variables were significantly associated with happiness: (1 individual socio-demographic variables like age and satisfaction with the economic situation; (2 health variables like independence in activities of daily living, common activities, and self-rated health; and (3 dietary variables such as life satisfaction related to food and the frequency with which the elders shared dinner with others. The study results suggest more efficient efforts at healthy eating for the elderly in rural areas.

  9. In the choice between health and money, health comes first: an analysis of happiness among rural Chilean elderly.

    Science.gov (United States)

    Lobos, German; Lapo, Maria Del Carmen; Schnettler, Berta

    2016-01-01

    We studied the relationship between happiness and individual socio-demographic context and health and dietary variables by interviewing 389 elderly individuals (age 60-90 years) living in rural areas in the Maule Region of Central Chile. The Lyubomirsky & Lepper (1999) subjective happiness scale was used. Ordinal logistic regression models were estimated. The discrete dependent variable was level of happiness. The following variables were significantly associated with happiness: (1) individual socio-demographic variables like age and satisfaction with the economic situation; (2) health variables like independence in activities of daily living, common activities, and self-rated health; and (3) dietary variables such as life satisfaction related to food and the frequency with which the elders shared dinner with others. The study results suggest more efficient efforts at healthy eating for the elderly in rural areas.

  10. Addressing Health Workforce Distribution Concerns: A Discrete Choice Experiment to Develop Rural Retention Strategies in Cameroon

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    Paul Jacob Robyn

    2015-03-01

    Full Text Available Background Nearly every nation in the world faces shortages of health workers in remote areas. Cameroon is no exception to this. The Ministry of Public Health (MoPH is currently considering several rural retention strategies to motivate qualified health personnel to practice in remote rural areas. Methods To better calibrate these mechanisms and to develop evidence-based retention strategies that are attractive and motivating to health workers, a Discrete Choice Experiment (DCE was conducted to examine what job attributes are most attractive and important to health workers when considering postings in remote areas. The study was carried out between July and August 2012 among 351 medical students, nursing students and health workers in Cameroon. Mixed logit models were used to analyze the data. Results Among medical and nursing students a rural retention bonus of 75% of base salary (aOR= 8.27, 95% CI: 5.28-12.96, P< 0.001 and improved health facility infrastructure (aOR= 3.54, 95% CI: 2.73-4.58 respectively were the attributes with the largest effect sizes. Among medical doctors and nurse aides, a rural retention bonus of 75% of base salary was the attribute with the largest effect size (medical doctors aOR= 5.60, 95% CI: 4.12-7.61, P< 0.001; nurse aides aOR= 4.29, 95% CI: 3.11-5.93, P< 0.001. On the other hand, improved health facility infrastructure (aOR= 3.56, 95% CI: 2.75-4.60, P< 0.001, was the attribute with the largest effect size among the state registered nurses surveyed. Willingness-to-Pay (WTP estimates were generated for each health worker cadre for all the attributes. Preference impact measurements were also estimated to identify combination of incentives that health workers would find most attractive. Conclusion Based on these findings, the study recommends the introduction of a system of substantial monetary bonuses for rural service along with ensuring adequate and functional equipment and uninterrupted supplies. By focusing on

  11. Fear and loathing in New England: examining the health-care perspectives of homeless people in rural areas.

    Science.gov (United States)

    Whitley, Rob

    2013-01-01

    Little anthropological research has been conducted on the health care perspectives of homeless people in rural areas. The aim of the present study is to elicit health-care beliefs, and examine overall health experience among a sample of current or recently homeless people in rural New Hampshire. Thirteen qualitative interviews were conducted, 11 with single men. Interviews were audio-recorded and transcribed, and analyzed using thematic analysis. Despite a massive burden of disease and illness, almost all participants reported an abiding aversion to doctors, hospitals and professional health care. Participants reported numerous negative encounters with doctors and health care professionals, often of a demeaning and disparaging nature. Participants noted that these encounters resulted in frequent cases of misdiagnosis and iatrogenesis. In contrast, participants spoke more fondly of other social and voluntary services, for example homeless organizations. Like other rural New Englanders, participants made their own individual efforts to maintain and promote health, for example by pursuing hobbies or prayer. The findings are contextualized within literature suggesting that these perspectives are generally shared by other poor rural people. Consistent with this literature, the findings suggest that homelessness in rural areas is often temporary and episodic. As such, this paper brings into question the distinctiveness and overall utility of the concept: 'the rural homeless'. The key determinant of negative attitudes to health care may not be recent homelessness. It may be entrenched socio-economic marginalization, and the resultant social stigma, that are shared amongst the rural poor, regardless of their current housing status.

  12. Prevalence of Hypertension and its optimal management issues in Rural India: An unmet health care need

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    Prashanth HR

    2015-03-01

    Full Text Available Cardiovascular diseases are the number one cause of death globally. They account for approximately 17 million deaths in the world each year (1.Of these deaths, complications of high blood pressure account for more than nine million, including about half of all deaths from heart disease and stroke(2.The number of adults with hypertension in 2025 was predicted to increase by about 60% to a total of 1•56 billion (1•54–1•58 billion(3. In India too, overall morbidity and mortality from non-communicable diseases (NCDs is rising rapidly which will have severe impact on the already frail economy (4. Many studies done in different settings in India have shown that the prevalence of hypertension ranges from as high as 20-50 percent in both rural and urban population (Table 1 (5. Contradictory to the earlier reports that the prevalence of hypertension is low in rural areas, the recent studies have shown that the rural-urban differences have largely disappeared and the hypertension and other risk factors for cardiovascular diseases are only equal or slightly greater in the rural population (6. A recent study done by the authors in a rural population in Tamilnadu found that 27.2% of adults between 18 to 60 years have hypertension (7. Also the studies show that more than 50% of the men and women above 60 years old are hypertensive in rural South India (8. This observation has major repercussion on India’s health system and health expenditure in the context of improved life expectancy and a significant increase in the proportion of people living in the age group of 60 years and above in India.

  13. Variations in Colorectal Cancer Screening of Medicare Beneficiaries Served by Rural Health Clinics

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    Thomas T. H. Wan

    2015-07-01

    Full Text Available This study aims (1 to examine the trends and patterns of colorectal cancer screening (CCS of Medicare beneficiaries in rural areas by state and year (before and after Affordable Care Act [ACA] enactment and (2 to investigate the contextual, organizational, and aggregated patient characteristics influencing variations in care received by patients of rural health clinics (RHCs. The following 2 hypotheses were formulated: (1 CCS rates are higher in the post-ACA period than in the pre-ACA period, irrespective of the factors rurality, poverty, dually eligible status, and the organizational characteristics of RHCs and (2 the contextual and organizational factors of RHCs exert more influence on the variation in CCS rates of RHC patients than do aggregated personal factors. We used administrative data on CCS rates (2007 through 2012 for rural Medicare beneficiaries. Autoregressive growth curve modeling of the CCS rates was performed. A generalized estimating equation of selected predictors was analyzed. Of the 9 predictors, 5 were statistically significant: The ACA and the percentage of female patients had a positive effect on the CCS rate, whereas regional location, years of RHC certification, and average age of patients had a negative effect on the CCS rate. The predictors accounted for 40.2% of the total variance in CCS. Results show that in rural areas of 9 states, the enactment of ACA improved CCS rates, contextual, organizational, and patient characteristics being considered. Improvement in preventive care will be expected, as the ACA is implemented in the United States.

  14. Attitude about mental illness of health care providers and community leaders in rural Haryana, North India

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    Harshal Ramesh Salve

    2014-12-01

    Full Text Available Background: Attitude about mental illness determines health seeking of the people. Success of National Mental Health Programme (NMHP is dependent on attitude about mental illness of various stakeholders in the programme. Material & Methods: A community based cross-sectional study was carried out in Ballabgarh block of Faridabad district in Haryana. We aimed to study attitude about mental illness of various stakeholders of health care providers (HCP, community leaders in rural area of Haryana, north India. Study area consisting of five Primary Health Centers (PHCs serving 2,12,000 rural population. All HCP working at PHCs, Accredited Social Health Activist (ASHA and community leaders in study area were approached for participation. Hindi version of Opinion about Mental illness Scale for Chinese Community (OMICC was used to study attitude. Results: In total, 467 participants were participated in the study. Of which, HCP, ASHAs and community leaders were 81 (17.4%, 145 (31.0% and 241 (51.6% respectively. Community members reported socially restrictive, pessimistic and stereotyping attitude towards mentally ill person. ASHA and HCP reported stereotyping attitude about person with mental illness. None of the stakeholders reported stigmatizing attitude. Conclusion: Training programme focusing on spectrum of mental illness for HCP and ASHA working in rural area under NMHP programme is needed. Awareness generation of community leaders about bio-medical concept of mental illness is cornerstone of NMHP success in India.

  15. Fuel for Life: Domestic Cooking Fuels and Women’s Health in Rural China

    Directory of Open Access Journals (Sweden)

    Peng Nie

    2016-08-01

    Full Text Available Background: There is evidence that household air pollution is associated with poor health in China, and that this form of air pollution may even be more of a health concern in China than the much-publicized outdoor air pollution. However, there is little empirical evidence on the relationship between household air pollution and health in China based on nationally representative and longitudinal data. This study examines the association between the type of domestic cooking fuel and the health of women aged ≥16 in rural China. Methods: Using longitudinal and biomarker data from the China Family Panel Studies (n = 12,901 and the China Health and Nutrition Survey (n = 15,539, we investigate the impact of three major domestic cooking fuels (wood/straw, coal, liquefied petroleum gas (LPG on health status using both cross-sectional and panel approaches. Results: Compared to women whose households cook with dirty fuels like wood/straw, women whose households cook with cleaner fuels like LPG have a significantly lower probability of chronic or acute diseases and are more likely to report better health. Cooking with domestic coal instead of wood or straw is also associated with elevated levels of having certain risks (such as systolic blood pressure related to cardiovascular diseases. Conclusions: Our study provides evidence that using cleaner fuels like LPG is associated with better health among women in rural China, suggesting that the shift from dirty fuels to cleaner choices may be associated with improved health outcomes.

  16. Assessing the technical efficiency of health posts in rural Guatemala: a data envelopment analysis.

    Science.gov (United States)

    Hernández, Alison R; San Sebastián, Miguel

    2014-01-01

    Strengthening health service delivery to the rural poor is an important means of redressing inequities. Meso-level managers can help enhance efficiency in the utilization of existing resources through the application of practical tools to analyze routinely collected data reflecting inputs and outputs. This study aimed to assess the efficiency and change in productivity of health posts over two years in a rural department of Guatemala. Data envelopment analysis was used to measure health posts' technical efficiency and productivity change for 2008 and 2009. Input/output data were collected from the regional health office of Alta Verapaz for 34 health posts from the 19 districts comprising the health region. Technical efficiency varied widely across health posts, with mean scores of 0.78 (SD=0.24) and 0.75 (SD=0.21) in 2008 and 2009, respectively. Overall, productivity increased by 4%, though 47% of health posts experienced a decline in productivity. Results were combined on a bivariate plot to identify health posts at the high and low extremes of efficiency, which should be followed up to determine how and why their production processes are operating differently. Assessing efficiency using the data that are available at the meso-level can serve as a first step in strengthening performance. Further work is required to support managers in the routine application of efficiency analysis and putting the results to use in guiding efforts to improve service delivery and increase utilization.

  17. The influence of the rural health security schemes on health utilization and household impoverishment in rural China: data from a household survey of western and central China

    Directory of Open Access Journals (Sweden)

    Zhang Hong

    2010-02-01

    Full Text Available Abstract Background The New Rural Cooperative Medical Scheme (NRCMS, voluntary health insurance and the Medical Financial Assistance (MFA, financial relief program were established in 2003 for rural China. The aim of this study was to document their coverage, assess their effectiveness on access to in-patient care and protection against financial catastrophe and household impoverishment due to health spending, and identify the factors predicting impoverishment with and without these schemes. Methods A cross-sectional household survey was conducted in 2008 in Hebei and Shaanxi provinces and the Inner Mongolia Autonomous Region using a multi-stage sampling technique. Information on personal demographic characteristics, chronic illness status, health care use, household expenditure, and household health spending were collected by interview. Results NRCMS covered 90.8% of the studied individuals and among the designated poor, 7.6% had their premiums paid by MFA. Of those referred for hospitalization in the year prior to the interview, 34.3% failed to comply, mostly (80.2% owing to financial constraints. There was no significant difference in the unmet need for admission between the insured with NRCMS and the uninsured. Before reimbursement, the incidence of catastrophic health payment (household health spending more than 40% of household's capacity to pay and medical impoverishment (household per capita income falling below the poverty line due to medical expense was 14.3% and 8.2%, respectively. NRCMS prevented 9.9% of the households from financial catastrophe and 7.7% from impoverishment, whereas MFA kept just one household from impoverishment and had no effect on financial catastrophe. Household per capita expenditure and household chronic disease proportion (proportion of members of a household with chronic illness were the most important determinants of the unmet need for admission, risk of being impoverished and the chance of not being saved

  18. Prevention of unintended pregnancy and HIV/STIs among Latinos in rural communities: perspectives of health care providers.

    Science.gov (United States)

    Branch, Meredith; Harvey, S Marie; Zukoski, Ann P; Warren, Jocelyn

    2010-08-01

    Latino women in the United States are disproportionately at risk for unintended pregnancy, HIV, and sexually transmitted infections (STIs). We conducted nine focus groups with health care practitioners who provide reproductive health care to Latinos in rural areas of the Northwest. From the practitioner perspective, we explored barriers and facilitators to the acquisition and use of contraceptives and to the prevention of HIV/STIs among rural Latinos. Suggestions for improving reproductive health care included Spanish-language resources/materials and convenient contraceptive methods. Findings provide context to the complex issues related to unintended pregnancy and disease prevention among Latinos residing in rural communities.

  19. Distance, rurality and the need for care: access to health services in South West England

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    Martin David

    2004-09-01

    Full Text Available Abstract Background This paper explores the geographical accessibility of health services in urban and rural areas of the South West of England, comparing two measures of geographical access and characterising the areas most remote from hospitals. Straight-line distance and drive-time to the nearest general practice (GP and acute hospital (DGH were calculated for postcodes and aggregated to 1991 Census wards. The correlation between the two measures was used to identify wards where straight-line distance was not an accurate predictor of drive-time. Wards over 25 km from a DGH were classified as 'remote', and characterised in terms of rurality, deprivation, age structure and health status of the population. Results The access measures were highly correlated (r2>0.93. The greatest differences were found in coastal and rural wards of the far South West. Median straight-line distance to GPs was 1 km (IQR = 0.6–2 km and to DGHs, 12 km (IQR = 5–19 km. Deprivation and rates of premature limiting long term illness were raised in areas most distant from hospitals, but there was no evidence of higher premature mortality rates. Half of the wards remote from a DGH were not classed as rural by the Office for National Statistics. Almost a quarter of households in the wards furthest from hospitals had no car, and the proportion of households with access to two or more cars fell in the most remote areas. Conclusion Drive-time is a more accurate measure of access for peripheral and rural areas. Geographical access to health services, especially GPs, is good, but remoteness affects both rural and urban areas: studies concentrating purely on rural areas may underestimate geographical barriers to accessing health care. A sizeable minority of households still had no car in 1991, and few had more than one car, particularly in areas very close to and very distant from hospitals. Better measures of geographical access, which integrate public and private transport

  20. Risk distribution across multiple health insurance funds in rural Tanzania

    DEFF Research Database (Denmark)

    Chomi, Eunice Nahyuha; Mujinja, Phares Gamba; Enemark, Ulrika

    2014-01-01

    cross-subsidisation across the funds. This paper analyses whether the risk distribution varies across the Community Health Fund (CHF) and National Health Insurance Fund (NHIF) in two districts in Tanzania. Specifically we aim to 1) identify risk factors associated with increased utilisation of health......INTRODUCTION: Multiple insurance funds serving different population groups may compromise equity due to differential revenue raising capacity and an unequal distribution of high risk members among the funds. This occurs when the funds exist without mechanisms in place to promote income and risk...... services and 2) compare the distribution of identified risk factors among the CHF, NHIF and non-member households. METHODS: Data was collected from a survey of 695 households. A multivariate logisitic regression model was used to identify risk factors for increased health care utilisation. Chi-square tests...

  1. Communication of reproductive health information to the rural girl ...

    African Journals Online (AJOL)

    ... by communicators. Keywords: Sexual and reproductive health, adolescents, communication. ... national Conference on Population and Development. (ICPD) which called for ... ber of socioeconomic factors impede her decisions on sexual and .... behaviors and the consequences of engaging in risky sex- ual behaviors.

  2. Nutritional and health status primary schoolchildren in rural Uganda ...

    African Journals Online (AJOL)

    ... for health status was done following the formal ether concentration technique for ... Prevalence rates for iodine deficiency, anaemia, iron deficiency and vitamin A ... iron deficiency (measured as serum Ferritin) and VAD (measured as serum ...

  3. A spatial decision support tool for estimating population catchments to aid rural and remote health service allocation planning.

    Science.gov (United States)

    Schuurman, Nadine; Randall, Ellen; Berube, Myriam

    2011-12-01

    There is mounting pressure on healthcare planners to manage and contain costs. In rural regions, there is a particular need to rationalize health service allocation to ensure the best possible coverage for a dispersed population. Rural health administrators need to be able to quantify the population affected by their allocation decisions and, therefore, need the capacity to incorporate spatial analyses into their decision-making process. Spatial decision support systems (SDSS) can provide this capability. In this article, we combine geographical information systems (GIS) with a web-based graphical user interface (webGUI) in a SDSS tool that enables rural decision-makers charged with service allocation, to estimate population catchments around specific health services in rural and remote areas. Using this tool, health-care planners can model multiple scenarios to determine the optimal location for health services, as well as the number of people served in each instance.

  4. Compositional, Contextual, and Collective Community Factors in Mental Health and Well-Being in Australian Rural Communities

    Science.gov (United States)

    Collins, Jessica; Ward, Bernadette M.; Snow, Pamela; Kippen, Sandra; Judd, Fiona

    2016-01-01

    There are disproportionately higher and inconsistently distributed rates of recorded suicides in rural areas. Patterns of rural suicide are well documented, but they remain poorly understood. Geographic variations in physical and mental health can be understood through the combination of compositional, contextual, and collective factors pertaining to particular places. The aim of this study was to explore the role of “place” contributing to suicide rates in rural communities. Seventeen mental health professionals participated in semi-structured in-depth interviews. Principles of grounded theory were used to guide the analysis. Compositional themes were demographics and perceived mental health issues; contextual themes were physical environment, employment, housing, and mental health services; and collective themes were town identity, community values, social cohesion, perceptions of safety, and attitudes to mental illness. It is proposed that connectedness may be the underlying mechanism by which compositional, contextual, and collective factors influence mental health and well-being in rural communities. PMID:26848083

  5. Perinatal and Infant Health Among Rural and Urban American Indians/Alaska Natives

    Science.gov (United States)

    Baldwin, Laura-Mae; Grossman, David C.; Casey, Susan; Hollow, Walter; Sugarman, Jonathan R.; Freeman, William L.; Hart, L. Gary

    2002-01-01

    Objectives. We sought to provide a national profile of rural and urban American Indian/Alaska Native (AI/AN) maternal and infant health. Methods. In this cross-sectional study of all 1989–1991 singleton AI/AN births to US residents, we compared receipt of an inadequate pattern of prenatal care, low birthweight (< 2500 g), infant mortality, and cause of death for US rural and urban AI/AN and non-AI/AN populations. Results. Receipt of an inadequate pattern of prenatal care was significantly higher for rural than for urban mothers of AI/AN infants (18.1% vs 14.4%, P ≤ .001); rates for both groups were over twice that for Whites (6.8%). AI/AN postneonatal death rates (rural = 6.7 per 1000; urban = 5.4 per 1000) were more than twice that of Whites (2.6 per 1000). Conclusions. Preventable disparities between AI/ANs and Whites in maternal and infant health status persist. PMID:12197982

  6. Workplace stress, job satisfaction, job performance, and turnover intention of health care workers in rural Taiwan.

    Science.gov (United States)

    Chao, Ming-Che; Jou, Rong-Chang; Liao, Cing-Chu; Kuo, Chung-Wei

    2015-03-01

    Workplace stress (WS) has been found to affect job satisfaction (JS), performance, and turnover intentions (TIs) in developed countries, but there is little evidence from other countries and especially rural areas. In rural Taiwan, especially, there is an insufficient health care workforce, and the situation is getting worse. To demonstrate the relationship, we used a cross-sectional structured questionnaire, and data from 344 licensed professionals in 1 rural regional hospital were analyzed using the structural equation model. The results showed that WS had a positive effect on both TI and job performance (JP) but a negative effect on satisfaction. JS did improve performance. For the staff with an external locus of control, stress affected JP and satisfaction significantly. For the staff with lower perceived job characteristics, JS affected performance significantly. The strategies to decrease stress relating to work load, role conflict, family factors, and working environment should be focused and implemented urgently to lower the turnover rate of health care workers in rural Taiwan.

  7. Engaging youth in rural Uganda in articulating health priorities through Photovoice.

    Science.gov (United States)

    Esau, Daniel; Ho, Pak To; Blair, Geoffrey K; Duffy, Damian; O'Hara, Nathan N; Kapoor, Videsh; Ajiko, Margaret

    2016-04-07

    Youth living in rural Uganda represent over 20% of the country's population. Despite the size of this demographic, there is a paucity of data on their health priorities. Engaging people in understanding their own health status has been proven to be an effective mechanism for health promotion. The objective of this study was to use Photovoice, a community-based, participatory action research methodology, to understand the current health priorities of youth living in rural Uganda. Thirty-two students between the ages of 13 and 17 were recruited from four schools within the region of Soroti, Uganda. Participants were given a disposable camera and were asked to photograph situations that contributed or detracted from their health status. The cameras were then returned to the investigators and each photo taken by the participant was reviewed with the investigators during a semi-structured interview. Codes were applied to the photographs and organized into overarching themes. Each participant chose one to two photos that were most representative of their health priorities for a secondary analysis. Participants provided 499 photos that met the eligibility criteria. The most common themes presented in the photographs were 'hygiene' (n= 73, 12.4%), 'nutrition' (n= 69, 11.7%), and 'cleanliness' (n= 48, 8%). 'Hygiene' (n= 6, 14.6%) and 'exercise' (n= 6, 14.6%) were the most common priorities articulated in the representative photographs. Photovoice proved to be an effective method to assess and express the health concerns of youth in rural Uganda. Study participants were able to articulate their health concerns and priorities through photographs and reflect on opportunities for health promotion through subsequent interviews. © The Author(s) 2015.

  8. Shortage of doctors in rural health centers: Empirical evidence from Gujarat

    Directory of Open Access Journals (Sweden)

    Somen Saha

    2012-07-01

    Full Text Available Background: Shortage of medical graduates and post graduates in the government sector, especially in rural areas is a major problem in India. Rural and remote areas of Gujarat are facing shortages of MBBS graduates and post graduates. About 25 percent of posts in the health and family welfare department are vacant. The worst affected is the class I positions where over 40 per cent posts were vacant. This study is an attempt to identify the motivating and de-motivating factors, in joining government service, among the medical graduates and post graduates in Dahod district of Gujarat. Methods: Questionnaires were prepared for two groups of doctors: those who are in government services; those who left the government services. The questionnaire included both item wise response and likert scale questions. 36 in-service medical professional and 19 private doctors participated in the study. Results: 44% of in service professionals from urban areas are working in urban areas, while 56% of them are working in rural areas. On the contrary, only 15% of the in-service professionals from rural areas are working in an urban area, with majority of them (84% are posted in a rural area. In services doctors believe that job security is more in government sector as compare to private sector. Variables like work environment, accountability, career development, social recognition and remuneration is less than satisfactory in government service. Conclusion: The decision to practice in rural areas is the result of complex interaction between a number of factors including individual background, service infrastructure, human resource practices including opportunity for career growth, remuneration, and autonomy. The study provide strong indication that promoting students from rural background to pursue medical education through reservation or scholarship may go a long way in addressing shortage of medical professional in rural areas. Following motivational factors can

  9. Acceptability of, and willingness to pay for, community health insurance in rural India.

    Science.gov (United States)

    Jain, Ankit; Swetha, Selva; Johar, Zeena; Raghavan, Ramesh

    2014-09-01

    To understand the acceptability of, and willingness to pay for, community health insurance coverage among residents of rural India. We conducted a mixed methods study of 33 respondents located in 8 villages in southern India. Interview domains focused on health-seeking behaviors of the family for primary healthcare, household expenditures on primary healthcare, interest in pre-paid health insurance, and willingness to pay for such a product. Most respondents reported that they would seek care only when symptoms were manifest; only 6 respondents recognized the importance of preventative services. None reported impoverishment due to health expenditures. Few viewed health insurance as necessary either because they did not wish to be early adopters, because they had alternate sources of financial support, or because of concerns with the design of insurance coverage or the provider. Those who were interested reported being willing to pay Rs. 1500 ($27) as the modal annual insurance premium. Penetration of community health insurance programs in rural India will require education of the consumer base, careful attention to premium rate setting, and deeper understanding of social networks that may act as financial substitutes for health insurance. Copyright © 2013 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  10. Cultural health beliefs in a rural family practice: a Malaysian perspective.

    Science.gov (United States)

    Ariff, Kamil M; Beng, Khoo S

    2006-02-01

    Understanding the sociocultural dimension of a patient's health beliefs is critical to a successful clinical encounter. Malaysia with its multi-ethnic population of Malay, Chinese and Indian still uses many forms of traditional health care in spite of a remarkably modern rural health service. The objective of this paper is discuss traditional health care in the context of some of the cultural aspects of health beliefs, perceptions and practices in the different ethnic groups of the author's rural family practices. This helps to promote communication and cooperation between doctors and patients, improves clinical diagnosis and management, avoids cultural blind spots and unnecessary medical testing and leads to better adherence to treatment by patients. Includes traditional practices of 'hot and cold', notions of Yin-Yang and Ayurveda, cultural healing, alternative medicine, cultural perception of body structures and cultural practices in the context of women's health. Modern and traditional medical systems are potentially complementary rather than antagonistic. Ethnic and cultural considerations can be integrated further into the modern health delivery system to improve care and health outcomes.

  11. Classroom Goal Structures and HIV/Pregnancy Prevention Education in Rural High School Health Classrooms.

    Science.gov (United States)

    Anderman, Eric M; Cupp, Pamela K; Lane, Derek R; Zimmerman, Rick; Gray, DeLeon L; O'Connell, Ann

    2011-12-01

    Over 5,000 adolescents enrolled in required rural high school health courses reported their perceptions of mastery and extrinsic goal structures in their health classrooms. Data were collected from all students at three time points (prior to HIV/pregnancy instruction, three months after instruction, and one year after instruction). Results indicated that classroom goal structures were related to both proximal and distal knowledge, attitudes, intentions, and efficacy beliefs. Results in particular indicate that the perception of a mastery goal structure in health education classrooms fosters knowledge, improved attitudes, enhanced efficacy beliefs, and lower intentions to have sexual intercourse.

  12. Effects of husbands' migration on mental health and gender role ideology of rural Mexican women.

    Science.gov (United States)

    Wilkerson, Jared A; Yamawaki, Niwako; Downs, Samuel D

    2009-07-01

    Our purpose for this study was to investigate the roles of migration in rural Mexican migrant-sending communities. Specifically, we examined the effects of changing gender role ideology on the mental health of wives whose spouses migrated to the United States. The sending group scored significantly higher in egalitarian gender role ideology but lower in general mental health than the nonsending group. We found through mediation analysis that the difference in gender role ideology mediated the difference in mental health between the two groups. Results are contrary to some psychological and feminist literature advocating benefits of masculine or androgynous ideology.

  13. Social and Cultural Factors Affecting Maternal Health in Rural Gambia: An Exploratory Qualitative Study

    Science.gov (United States)

    Lowe, Mat; Chen, Duan-Rung; Huang, Song-Lih

    2016-01-01

    Background The high rate of maternal mortality reported in The Gambia is influenced by many factors, such as difficulties in accessing quality healthcare and facilities. In addition, socio-cultural practices in rural areas may limit the resources available to pregnant women, resulting in adverse health consequences. The aim of this study is to depict the gender dynamics in a rural Gambian context by exploring the social and cultural factors affecting maternal health. Methods and Findings Five focus group discussions that included 50 participants (aged 15–30 years, with at least one child) and six in-depth interviews with traditional birth attendants were conducted to explore perceptions of maternal health issues among rural women. The discussion was facilitated by guides focusing on issues such as how the women perceived their own physical health during pregnancy, difficulties in keeping themselves healthy, and health-related problems during pregnancy and delivery. The data resulting from the discussion was transcribed verbatim and investigated using a qualitative thematic analysis. In general, rural Gambian women did not enjoy privileges in their households when they were pregnant. The duties expected of them required pregnant women to endure heavy workloads, with limited opportunities for sick leave and almost nonexistent resources to access prenatal care. The division of labor between men and women in the household was such that women often engaged in non-remunerable field work with few economic resources, and their household duties during pregnancy were not alleviated by either their husbands or the other members of polygamous households. At the time of delivery, the decision to receive care by trained personnel was often beyond the women’s control, resulting in birth-related complications. Conclusions Our findings suggest that despite women’s multiple roles in the household, their positions are quite unfavorable. The high maternal morbidity and mortality

  14. Implementation of Remote Health Monitoring in Medical Rural Clinics for Web Telemedicine System

    Directory of Open Access Journals (Sweden)

    Hafez Fouad

    2014-11-01

    Full Text Available The problem with limited numbers of physicians, nurses, and other healthcare providers is expected to exacerbate. Health care must be as efficient as possible. This situation provides an opportunity for the application of telehealth clinics. It is time for organizations providing health care to objectively consider telehealth clinics. Information and communication technologies (ICTs have great potential to address some of the challenges faced by both developed and developing countries in providing accessible, cost-effective, high-quality health care services. Telemedical clinics use ICTs to overcome geographical barriers, and increase access to healthcare services. This is particularly beneficial for rural and underserved communities in developing countries – groups that traditionally suffer from lack of access to health care. In this work we propose an equipped system with new technology to provide wide range of services in Telemedical clinics which facilitates the provision of medical aids from a distance. It is an effective solution for providing specialty healthcare in the form of improved access and reduced cost to the rural patients and the reduced professional isolation of the rural doctors. Telemedical clinics can enable ordinary doctors to perform extra-ordinary tasks.

  15. Assessing the potential of rural and urban private facilities in implementing child health interventions in Mukono district, central Uganda

    DEFF Research Database (Denmark)

    Rutebemberwa, Elizeus; Buregyeya, Esther; Lal, Sham;

    2016-01-01

    clinicians, less likely to have people with tertiary education (OR 0.34; 95 % CI 0.17-0.66) and less likely to have zinc tablets (OR 0.38; 95 % CI 0.19-0.78). In both urban and rural areas, there was low usage of stock cards and patient registers. About half of the facilities in both rural and urban areas...... keeping, essential drugs for the treatment of malaria, pneumonia and diarrhoea; the sex, level of education, professional and in-service training of the persons found attending to patients in these facilities. A comparison was made between urban and rural facilities. Univariate and bivariate analysis...... attended to at least one sick child in the week prior to the interview. CONCLUSION: There were big gaps between rural and urban private facilities with rural ones having less trained personnel and less zinc tablets' availability. In both rural and urban areas, record keeping was low. Child health...

  16. A compulsory experiential and inter-professional rural health subject for undergraduate students.

    Science.gov (United States)

    Liaw, Siaw-Teng; McGrath, Barry; Jones, Graeme; Russell, Ursula; Bourke, Lisa; Hsu-Hage, Bridget

    2005-01-01

    The Australian University Departments of Rural Health (UDRH) program aims to improve the rural workforce through improving rural experiences of undergraduates, graduates and health professionals. The 10 UDRHs vary in the way they implement the UDRH Program. This article describes the development of a compulsory, experiential and inter-professional rural health subject in a medical curriculum by the UDRH at the University of Melbourne, Victoria, Australia. The key concepts, underpinning theory, processes, logistics and resources required to develop and implement the subject among a network of small towns and Indigenous communities are examined. METHODS used included formative evaluation using a participatory research approach, including the examination of internal discussion papers, minutes of meetings and planning workshops, financial records and feedback from students, staff and preceptors. Students, staff and preceptors generally accept the value of the rural health module in professional training. However, they stress the need for explicit learning objectives, relevant content and engaging delivery. Students expressed some concern about the compulsory nature of the subject. Significant issues are capacity, quality, sustainability and managing expectations of government and communities. Capacity includes the availability of appropriate placements and preceptors who have the capacity and capability to teach or to be supported to teach. The availability of appropriate and affordable accommodation is important, as are the cost and safety of travel to and from placements. Sustainability of 'placements' and 'placement fatigue' must be managed with a combination of resources and preceptor training and support. Quality of placements is important and highlights a paradox in that, while academically rigorous teaching, research and clinical programs for students and preceptors are important for quality, they are mostly perceived as additional burdens by health service

  17. A technical framework for costing health workforce retention schemes in remote and rural areas

    Directory of Open Access Journals (Sweden)

    Stormont Laura

    2011-04-01

    Full Text Available Abstract Background Increasing the availability of health workers in remote and rural areas through improved health workforce recruitment and retention is crucial to population health. However, information about the costs of such policy interventions often appears incomplete, fragmented or missing, despite its importance for the sound selection, planning, implementation and evaluation of these policies. This lack of a systematic approach to costing poses a serious challenge for strong health policy decisions. Methods This paper proposes a framework for carrying out a costing analysis of interventions to increase the availability of health workers in rural and remote areas with the aim to help policy decision makers. It also underlines the importance of identifying key sources of financing and of assessing financial sustainability. The paper reviews the evidence on costing interventions to improve health workforce recruitment and retention in remote and rural areas, provides guidance to undertake a costing evaluation of such interventions and investigates the role and importance of costing to inform the broader assessment of how to improve health workforce planning and management. Results We show that while the debate on the effectiveness of policies and strategies to improve health workforce retention is gaining impetus and attention, there is still a significant lack of knowledge and evidence about the associated costs. To address the concerns stemming from this situation, key elements of a framework to undertake a cost analysis are proposed and discussed. Conclusions These key elements should help policy makers gain insight into the costs of policy interventions, to clearly identify and understand their financing sources and mechanisms, and to ensure their sustainability.

  18. Health insurance benefit design and healthcare utilization in northern rural China.

    Directory of Open Access Journals (Sweden)

    Hong Wang

    Full Text Available BACKGROUND: Poverty due to illness has become a substantial social problem in rural China since the collapse of the rural Cooperative Medical System in the early 1980s. Although the Chinese government introduced the New Rural Cooperative Medical Schemes (NRCMS in 2003, the associations between different health insurance benefit package designs and healthcare utilization remain largely unknown. Accordingly, we sought to examine the impact of health insurance benefit design on health care utilization. METHODS AND FINDINGS: We conducted a cross-sectional study using data from a household survey of 15,698 members of 4,209 randomly-selected households in 7 provinces, which were representative of the provinces along the north side of the Yellow River. Interviews were conducted face-to-face and in Mandarin. Our analytic sample included 9,762 respondents from 2,642 households. In each household, respondents indicated the type of health insurance benefit that the household had (coverage for inpatient care only or coverage for both inpatient and outpatient care and the number of outpatient visits in the 30 days preceding the interview and the number of hospitalizations in the 365 days preceding the household interview. People who had both outpatient and inpatient coverage compared with inpatient coverage only had significantly more village-level outpatient visits, township-level outpatient visits, and total outpatient visits. Furthermore, the increased utilization of township and village-level outpatient care was experienced disproportionately by people who were poorer, whereas the increased inpatient utilization overall and at the county level was experienced disproportionately by people who were richer. CONCLUSION: The evidence from this study indicates that the design of health insurance benefits is an important policy tool that can affect the health services utilization and socioeconomic equity in service use at different levels. Without careful

  19. 77 FR 23222 - Foreign-Trade Zone 59, Temporary/Interim Manufacturing Authority, Novartis Consumer Health, Inc...

    Science.gov (United States)

    2012-04-18

    ... Foreign-Trade Zones Board Foreign-Trade Zone 59, Temporary/Interim Manufacturing Authority, Novartis Consumer Health, Inc., (Pharmaceutical Product Manufacturing); Notice of Approval On January 12, 2012, the... Foreign Trade Zone, Inc., grantee of FTZ 59, requesting temporary/interim manufacturing (T/IM) authority...

  20. Prevalence of Burnout Syndrome and Associated Factors Among Rural Health Workers (Behvarzes) in South Khorasan.

    Science.gov (United States)

    Bijari, Bita; Abassi, Ali

    2016-10-01

    Essential primary health care is delivered through the public health center PHC network by public health workers (Behvarzs). Health workers are exposed to different types of stresses while working. The aim of this study is to determine the prevalence of burnout and associated factors among rural health workers in the health centers of Birjand University of Medical Sciences. All rural health workers of health centers under the coverage of the Birjand University of Medical Sciences selected through census sampling participated in this cross-sectional study. The Maslach Burnout Inventory, GHQ-12 questionnaire, and demographic questionnaire were completed by the participants. Data were analyzed by SPSS 15 using descriptive statistics, chi-square (χ(2)), t-test, and ANOVA test. A total of 423 health workers participated in this study, and their mean age was 39 ± 8.4 years. Among the participants, 34.5% had moderate to severe levels of burnout. About 31.4% of the subjects had abnormal scores in emotional exhaustion, 16.8% in depersonalization, and 47% in the personal accomplishment subscales. The rate of abnormal mental health among the participants was 36.68%. The prevalence of mental disorders was 24.5% in subjects with low burnout or without burnout against 60.4% of subjects with moderate or severe burnout (P = 0.001). Age, education level, number of children, and years of employment were found to have a significant association with the burnout level of the participants (P Burnout was prevalent among health workers. Based on the high level of burnout among health workers, reducing job ambiguity/conflict, participating in planning new programs, and improving interaction with health authorities may help them to overcome their job-related pressure and to give a more desirable performance.

  1. Why medical students do not like to join rural health service? An exploratory study in India.

    Science.gov (United States)

    Nallala, Srinivas; Swain, Subhashisa; Das, Sanju; Kasam, Shravan K; Pati, Sanghamitra

    2015-01-01

    Inadequate, inequitable distribution of the medical workforce remains a challenge across the globe, and India is no exception. Odisha, a state in India faces a major shortage of doctors particularly in rural and remote areas. In order to address this challenge, it is essential to understand medical students' career plans, specialization preferences, choices of job location and sector, and views on working in rural and remote areas. This study explored the immediate and long-term career plans of final year medical students, their intended practice locations and underlying reasons for the choices. A cross-sectional survey was conducted in all the medical colleges (three government and three private) in the state of Odisha. Through the systematic sampling method, data were gathered from 390 final year students. A semi-structured questionnaire was administered to the students and data were analyzed using SPSS version 20. Of the 390 students, 290 (74.35%) were from a government college. The most preferred immediate career goal was postgraduation studies (45.9% of students in government medical schools and 54% in private). About 17% of government students and 9% of private students showed willingness to work in rural areas, in the long run. Nearly 44.5% mentioned opportunities for career growth, followed by the possibilities for higher education (26.8%) as major the factors for preferring an urban posting. Similarly, higher pay scales, better working conditions were major factors for preferring the private sector. Most of the students maintained that good housing, better salaries, and adequate facilities at the workplace would attract more students toward rural service. Since public funded medical students are not motivated to serve in rural settings, increasing the number of places or establishing new medical institutions may not be an effective solution to the issue. Approaches such as extended clinical apprenticeship in rural health facilities, long-term community

  2. Why medical students do not like to join rural health service? An exploratory study in India

    Directory of Open Access Journals (Sweden)

    Srinivas Nallala

    2015-01-01

    apprenticeship in rural health facilities, long-term community engagement during medical studentship could be considered.

  3. In the choice between health and money, health comes first: an analysis of happiness among rural Chilean elderly

    OpenAIRE

    German Lobos; Maria del Carmen Lapo; Berta Schnettler

    2016-01-01

    Abstract: We studied the relationship between happiness and individual socio-demographic context and health and dietary variables by interviewing 389 elderly individuals (age 60-90 years) living in rural areas in the Maule Region of Central Chile. The Lyubomirsky & Lepper (1999) subjective happiness scale was used. Ordinal logistic regression models were estimated. The discrete dependent variable was level of happiness. The following variables were significantly associated with happiness: (1)...

  4. Assessment of pharmacists’ delivery of public health services in rural and urban areas in Iowa and North Dakota

    Directory of Open Access Journals (Sweden)

    Scott DM

    2016-12-01

    Full Text Available Background: The profession of pharmacy is expanding its involvement in public health, but few studies have examined pharmacists’ delivery of public health services. Objective: To assess Iowa and North Dakota pharmacists’ practices, frequency of public health service delivery, level of involvement in achieving the essential services of public health, and barriers to expansion of public health services in rural and urban areas. Methods: This study implemented an on-line survey sent to all pharmacists currently practicing pharmacy in Iowa and North Dakota. Results: Overall, 602 valid responses were analyzed, 297 in rural areas and 305 in urban areas. Three practice settings (chain stores [169, 28.2%], independent community pharmacies [162, 27.0%], and hospital pharmacies [156, 26.0%] comprised 81.2% of the sample. Both chain and independent community pharmacists were more commonly located in rural areas than in urban areas (P<0.05. For some public health services, pharmacists in rural areas reported higher frequency of delivery than did pharmacists in urban areas (P < .05 that included: medication therapy management, immunizations, tobacco counseling, and medication take-back programs. For some essential services, pharmacists (particularly independents in rural areas reported more frequent delivery than did pharmacists in urban areas (P < .05, these included: evaluate the services the pharmacy provides, partner with the community to identify and help solve health problems, and conduct needs assessments to identify health risks in my community. Conclusion: Rural pharmacists more frequently deliver public health services than urban in both Iowa and North Dakota. These findings should be interpreted to be primarily due to differences in the role of the rural pharmacist and the quest for certain opportunities that rural pharmacists are seeking.

  5. Factors affecting maternal health care services utilization in rural ...

    African Journals Online (AJOL)

    admin

    Indonesia, Kenya, Nigeria, Pakistan, Sudan, and the. United Republic of ... these poor health outcomes among women and children was the ... and anemia. The 2007 .... likely to use ANC services compared to women whose ... indicators of utilization of this service. .... prophylaxis, iron and folic acid tablets and helping.

  6. Maternity waiting homes in Rural Health Centers of Ethiop: The ...

    African Journals Online (AJOL)

    kim

    services provided by the MWHs as perceived and reflected by pregnant .... conference (66%), and other community events (37%). In-depth ... Information regarding maternal health is almost absent … they ... recreation. The presence of a clean and green facility .... communities and establish sustainable revenue generation.

  7. Mixed methods study of management of health conditions in rural low-income families: implications for health care policy in the USA.

    Science.gov (United States)

    Simmons, L A; Huddleston-Casas, C A; Morgan, K A; Feldman, D

    2012-01-01

    The purpose of this mixed methods study was to examine the health issues and health management strategies utilized by rural low-income women and their families to inform the design, implementation, and evaluation of health reform in rural areas of the USA. METHODS; Quantitative data was analyzed from 271 rural, low-income women and their families and qualitative data from a sub-sample of 44. Specifically explored were the: (1) types and perceived severity of health conditions rural, low-income individuals report; (2) perceived value and utilization of a usual source of care; and (3) strategies these individuals employ to manage their health. Rural American families manage multiple healthcare needs with limited resources; 42.1% reported 1-4 chronic conditions in the family, 31.4% reported 5-8 conditions, and 17.7% reported 9 or more conditions. The majority of participants (79.0%) reported having a doctor or other healthcare professional that they usually see; 61.3% reported their partners had a usual provider, and 91.7% reported their children had a usual provider. Analysis of the qualitative data revealed two main themes regarding management of health conditions: (1) lack of engagement in managing overall health; and (2) ineffective utilization of health care. Rural low-income individuals in the US may benefit from new policies that promote patient-centered, personalized care. However, any policy change must be carefully designed to consider the ways in which rural American families manage their health in order to improve individual health status and reduce rural health disparities.

  8. [Childhood diarrhea in rural Nicaragua: beliefs and traditional health practices].

    Science.gov (United States)

    Gorter, A C; Sánchez, G; Pauw, J; Pérez, R M; Sandiford, P; Smith, G D

    1995-11-01

    In Nicaragua, the principal cause of infant mortality is diarrhea, which is responsible for 40% of these deaths annually. This statistic reflects the low usage of health services and oral rehydration therapy (ORT). In an effort to improve the situation, several studies were carried out in Villa Carlos Fonseca municipio. This report describes two of those studies, one ethnographic and the other epidemiologic (conducted in 1989 and 1990, respectively), to find out beliefs and traditional health practices and their influence on the way in which mothers responded to their children's diarrheal illness. The ethnographic study involved interviewing 70 mothers with an average age of 28 years who had children under 2 years of age. The children represented two groups: one at high risk for diarrhea and the other at low risk. The objectives were to learn the traditional names for diarrhea, the perception of risk, and the treatments that were used. The epidemiologic study included 391 mothers over 14 years of age with one or more children under age 5 years, of whom 215 had had diarrhea in the two weeks preceding the survey. The objectives were to describe local beliefs and health practices and to determine the incidence of diarrheas according to the diagnosis made by the mothers. At least 12 types of diarrhea were identified, for which terms such as "empacho" and "sol de vista" were used. In most cases, the mothers had more confidence in folkloric treatments that they themselves or the traditional healers (curanderos) applied than in the services offered at health centers. This attitude limited their use of health services and ORT, although it was observed that in certain cases traditional treatments were used in combination with those of western medicine. There was a direct but nonsignificant correlation between the level of schooling of the mothers and the frequency with which they visited the health center. The authors suggest the effects of massages, herbal baths, and other

  9. "Lungisa"-weaving relationships and social space to restore health in rural KwaZulu Natal.

    Science.gov (United States)

    Wickström, Anette

    2014-06-01

    Many Zulu people who live in big cities in South Africa return to their rural homestead when they fall ill. Although the health care offered in rural areas is not efficient, people wish to connect to their family and ancestors. My aim is to explore acts of lungisa ("to put in order") and what they say about health, agency, and the circumstances under which people live. Returning home means weaving oneself firmly within a web of relationships that are located in material things and places. Healing involves imperfect strategies used to better connect bodies, relationships, and places. I theorize the acts of returning using Adriana Cavarero's concept of weaving together and argue that people produce space and relationships over time to exert some control over a life lived under political and economic circumstances that have created separation. Six months of ethnographic fieldwork make up the material for my analysis.

  10. Approaches to dog health education programs in Australian rural and remote Indigenous communities: four case studies.

    Science.gov (United States)

    Constable, S E; Dixon, R M; Dixon, R J; Toribio, J-A

    2013-09-01

    Dog health in rural and remote Australian Indigenous communities is below urban averages in numerous respects. Many Indigenous communities have called for knowledge sharing in this area. However, dog health education programs are in their infancy, and lack data on effective practices. Without this core knowledge, health promotion efforts cannot progress effectively. This paper discusses a strategy that draws from successful approaches in human health and indigenous education, such as dadirri, and culturally respectful community engagement and development. Negotiating an appropriate education program is explored in its practical application through four case studies. Though each case was unique, the comparison of the four illustrated the importance of listening (community consultation), developing and maintaining relationships, community involvement and employment. The most successful case studies were those that could fully implement all four areas. Outcomes included improved local dog health capacity, local employment and engagement with the program and significantly improved dog health.

  11. Identifying factors for job motivation of rural health workers in North Viet Nam.

    Science.gov (United States)

    Dieleman, Marjolein; Cuong, Pham Viet; Anh, Le Vu; Martineau, Tim

    2003-11-05

    BACKGROUND: In Viet Nam, most of the public health staff (84%) currently works in rural areas, where 80% of the people live. To provide good quality health care services, it is important to develop strategies influencing staff motivation for better performance. METHOD: An exploratory qualitative research was carried out among health workers in two provinces in North Viet Nam so as to identify entry points for developing strategies that improve staff performance in rural areas. The study aimed to determine the major motivating factors and it is the first in Viet Nam that looks at health workers' job perception and motivation. Apart from health workers, managers at national and at provincial level were interviewed as well as some community representatives. RESULTS: The study showed that motivation is influenced by both financial and non-financial incentives. The main motivating factors for health workers were appreciation by managers, colleagues and the community, a stable job and income and training. The main discouraging factors were related to low salaries and difficult working conditions. CONCLUSION: Activities associated with appreciation such as performance management are currently not optimally implemented, as health workers perceive supervision as control, selection for training as unclear and unequal, and performance appraisal as not useful. The kind of non-financial incentives identified should be taken into consideration when developing HRM strategies. Areas for further studies are identified.

  12. Identifying factors for job motivation of rural health workers in North Viet Nam

    Directory of Open Access Journals (Sweden)

    Anh Le

    2003-11-01

    Full Text Available Abstract Background In Viet Nam, most of the public health staff (84% currently works in rural areas, where 80% of the people live. To provide good quality health care services, it is important to develop strategies influencing staff motivation for better performance. Method An exploratory qualitative research was carried out among health workers in two provinces in North Viet Nam so as to identify entry points for developing strategies that improve staff performance in rural areas. The study aimed to determine the major motivating factors and it is the first in Viet Nam that looks at health workers' job perception and motivation. Apart from health workers, managers at national and at provincial level were interviewed as well as some community representatives. Results The study showed that motivation is influenced by both financial and non-financial incentives. The main motivating factors for health workers were appreciation by managers, colleagues and the community, a stable job and income and training. The main discouraging factors were related to low salaries and difficult working conditions. Conclusion Activities associated with appreciation such as performance management are currently not optimally implemented, as health workers perceive supervision as control, selection for training as unclear and unequal, and performance appraisal as not useful. The kind of non-financial incentives identified should be taken into consideration when developing HRM strategies. Areas for further studies are identified.

  13. Health Care Seeking Behavior of Persons with Acute Chagas Disease in Rural Argentina: A Qualitative View

    Science.gov (United States)

    Dinardi, Graciela; Canevari, Cecilia; Torabi, Nahal

    2016-01-01

    Chagas disease (CD) is a tropical parasitic disease largely underdiagnosed and mostly asymptomatic affecting marginalized rural populations. Argentina regularly reports acute cases of CD, mostly young individuals under 14 years old. There is a void of knowledge of health care seeking behavior in subjects experiencing a CD acute condition. Early treatment of the acute case is crucial to limit subsequent development of disease. The article explores how the health outcome of persons with acute CD may be conditioned by their health care seeking behavior. The study, with a qualitative approach, was carried out in rural areas of Santiago del Estero Province, a high risk endemic region for vector transmission of CD. Narratives of 25 in-depth interviews carried out in 2005 and 2006 are analyzed identifying patterns of health care seeking behavior followed by acute cases. Through the retrospective recall of paths for diagnoses, weaknesses of disease information, knowledge at the household level, and underperformance at the provincial health care system level are detected. The misdiagnoses were a major factor in delaying a health care response. The study results expose lost opportunities for the health care system to effectively record CD acute cases. PMID:27829843

  14. Motivation of human resources for health: a case study at rural district level in Tanzania.

    Science.gov (United States)

    Zinnen, Véronique; Paul, Elisabeth; Mwisongo, Aziza; Nyato, Daniel; Robert, Annie

    2012-01-01

    An increasing number of studies explore the association between financial and non-financial incentives and the retention of health workers in developing countries. This study aims to contribute to empirical evidence on human resource for health motivation factors to assist policy makers in promoting effective and realistic interventions. A cross-sectional survey was conducted in four rural Tanzanian districts to explore staff stability and health workers' motivation. Data were collected using qualitative and quantitative techniques, covering all levels and types of health facilities. Stability of staff was found to be quite high. Public institutions remained very attractive with better job security, salary and retirement benefits. Satisfaction over working conditions was very low owing to inadequate working equipment, work overload, lack of services, difficult environment, favouritism and 'empty promotions'. Positive incentives mentioned were support for career development and supportive supervision. Attracting new staff in rural areas appeared to be more difficult than retaining staff in place. The study concluded that strategies to better motivate health personnel should focus on adequate remuneration, positive working and living environment and supportive management. However, by multiplying health facilities, the latest Tanzanian human resource for health plan could jeopardize current positive results.

  15. How well do patients understand written instructions?: health literacy assessment in rural and urban rheumatology outpatients.

    Science.gov (United States)

    Wong, Peter K K; Christie, Laura; Johnston, Jenny; Bowling, Alison; Freeman, Diane; Joshua, Fred; Bird, Paul; Chia, Karen; Bagga, Hanish

    2014-11-01

    The aim of this study was to assess health literacy (word recognition and comprehension) in patients at a rural rheumatology practice and to compare this to health literacy levels in patients from an urban rheumatology practice.Inclusion criteria for this cross-sectional study were as follows: ≥18-year-old patients at a rural rheumatology practice (Mid-North Coast Arthritis Clinic, Coffs Harbour, Australia) and an urban Sydney rheumatology practice (Combined Rheumatology Practice, Kogarah, Australia). Exclusion criteria were as follows: ill-health precluding participation; poor vision/hearing, non-English primary language. Word recognition was assessed using the Rapid Estimate of Adult Literacy in Medicine (REALM). Comprehension was assessed using the Test of Functional Health Literacy in Adults (TOFHLA). Practical comprehension and numeracy were assessed by asking patients to follow prescribing instructions for 5 common rheumatology medications.At the rural practice (Mid-North Coast Arthritis Clinic), 124/160 patients agreed to participate (F:M 83:41, mean age 60.3 ± 12.2) whereas the corresponding number at the urban practice (Combined Rheumatology Practice) was 99/119 (F:M 69:30, mean age 60.7 ± 17.5). Urban patients were more likely to be born overseas, speak another language at home, and be employed. There was no difference in REALM or TOFHLA scores between the 2 sites, and so data were pooled. REALM scores indicated 15% (33/223) of patients had a reading level ≤Grade 8 whereas 8% (18/223) had marginal or inadequate functional health literacy as assessed by the TOFHLA. Dosing instructions for ibuprofen and methotrexate were incorrectly understood by 32% (72/223) and 21% (46/223) of patients, respectively.Up to 15% of rural and urban patients had low health literacy and rheumatology drugs.There was no significant difference in word recognition, functional health literacy, and numeracy between rural and urban rheumatology patients.

  16. Health effects of the war in two rural communities in Nicaragua. Nicaragua Health Study Collaborative at Harvard, CIES, and UNAN.

    Science.gov (United States)

    1989-04-01

    We report on a pilot study to assess the effects of low intensity war in Nicaragua on the health of the civilian population. The study compared data from two regions in Nicaragua, one in an area of intense conflict, the other further removed from the war's violence. Information was obtained from a questionnaire administered to female heads of randomly selected households; structured interviews with community leaders and health workers; group discussions with community residents; and a review of regional and municipal death records. Height and mid-upper arm circumference of children were measured, and immunization records reviewed. The war has had a serious negative effect on the lives of the civilian population in both the war zone and the non-war zone, with the effects most severe in the war zone. In both communities, over half of the respondents reported the death of a friend or relative. In the war zone community, over one-fourth of respondents reported attacks on family members in non-combat situations around their homes. Death by firearms was the leading cause of death in persons over age 6 in the war zone. Vaccination coverage, nutritional indices, and familial disruption were worse in the war zone community. The findings suggest that continued funding of the Nicaraguan contra forces by the United States may be harming the ostensible beneficiaries of that policy, and that use of such low intensity conflict as a foreign policy tool should be questioned.

  17. ICT applications as e-health solutions in rural healthcare in the Eastern Cape Province of South Africa.

    Science.gov (United States)

    Ruxwana, Nkqubela L; Herselman, Marlien E; Conradie, D Pieter

    2010-01-01

    Information and Communication Technology (ICT) solutions (e.g. e-health, telemedicine, e-education) are often viewed as vehicles to bridge the digital divide between rural and urban healthcare centres and to resolve shortcomings in the rural health sector. This study focused on factors perceived to influence the uptake and use of ICTs as e-health solutions in selected rural Eastern Cape healthcare centres, and on structural variables relating to these facilities and processes. Attention was also given to two psychological variables that may underlie an individual&s acceptance and use of ICTs: usefulness and ease of use. Recommendations are made with regard to how ICTs can be used more effectively to improve health systems at fi ve rural healthcare centres where questionnaire and interview data were collected: St. Lucy&s Hospital, Nessie Knight Hospital, the Tsilitwa Clinic, the Madzikane Ka-Zulu Memorial Hospital and the Nelson Mandela General Hospital.

  18. Type 2 diabetes in rural Uganda : prevalence, risk factors, perceptions and implications for the health system

    OpenAIRE

    Mayega, Roy William

    2014-01-01

    Background: Between 2010 and 2030, a 69% increase in type-2 diabetes is expected in low-income countries compared to a 20% increase in high income countries. Yet health system responsiveness to non-communicable diseases has been slow in sub-Saharan Africa. Data on the prevalence of type 2 diabetes and its associated factors in mainly rural settings is lacking, yet such data can guide planning for diabetes control. Objective: The aim of these studies was to assess the preval...

  19. Prehypertension and hypertension among young Indonesian adults at a primary health care in a rural area

    Directory of Open Access Journals (Sweden)

    Felix F. Widjaja

    2013-02-01

    Full Text Available Background: Prehypertension and hypertension were related with many complications of nearly every organ, but often neglected by young adults in rural area. This research was done to observe the prevalence of prehypertension and hypertension among young adult in a primary health care of rural area at Cicurug, Sukabumi District, West Java.Methods: This cross-sectional study was done in Cicurug Public Health Center, Sukabumi District, West Java. The subjects were consecutively recruited from the outpatient clinic on Monday until Saturday in September 2012,18–25 years old, not pregnant nor having shock. They were interviewed about their age, gender, physical activity, sitting hours, smoking habit, alcohol consumption, and family history and examined by trained health professionals (weight, height, body mass index [BMI], systolic and diastolic blood pressure.Results: From 111 young adults, 34.2% had prehypertension and 17.1% had hypertension. Within sex groups, the prevalence of prehypertension was higher in females, whereas hypertension was occurred more in males. Neither of family history from mother nor father were associated with prehypertension and hypertension compared with normotension. Total activity was not associated with prehypertension (OR = 2.6; p = 0.052 and hypertension (OR = 1.758; p = 0.498. BMI was associated with hypertension (OR = 3.354; p = 0.041 and not associated with prehypertension (OR = 2.343; p = 0.099.Conclusion: Prevalence of prehypertension and hypertension were relatively high among young adult in primary health care of rural area. Intervention to prevent further complications needs to be done early with lifestyle modification because blood pressure is associated with modifiable risk factors, such as BMI and total activity. (Med J Indones. 2013;22:39-45Keywords: Hypertension, prehypertension, rural area, young adult

  20. Community as classroom: teaching and learning public health in rural Appalachia.

    Science.gov (United States)

    Florence, James; Behringer, Bruce

    2011-01-01

    Traditional models for public health professional education tend to be didactic, with brief, discrete practica appended. National reports of both practitioners and academicians have called for more competency-driven, interdisciplinary-focused, community-based, service-oriented, and experientially-guided learning for students across the curriculum. East Tennessee State University began its own curricular revisioning in health professions education nearly 2 decades ago with a grant from the W.K. Kellogg Foundation, emphasizing competencies development through community-based learning in community-academic partnerships. This article describes 3 examples that grew from that initiative. In the first example, students in multiple classes delivered a longitudinal community-based employee wellness intervention for a rural county school district. BS public health students conducted needs assessments and prepared health education materials; MPH students conducted health assessments and worked with school wellness councils to deliver client-centered interventions; DrPH students supervised the project and provided feedback to the schools using participatory methods. In the second example, MPH students in a social-behavioral foundations course used experiential learning to investigate the region's elevated cancer mortality ranking. Following meetings with multiple community groups, students employed theoretical constructs to frame regional beliefs about cancer and presented findings to community leaders. One outcome was a 5-year community-based participatory research study of cancer in rural Appalachia. In the third example, MPH students in a health-consulting course assessed local African Americans' awareness of the university's health and education programs and perceptions of their community health issues. Students learned consultation methods by assisting at multiple regional African American community meetings to discover issues and interest that resulted in the

  1. Inequalities in advice provided by public health workers to women during antenatal sessions in rural India.

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    Abhishek Singh

    Full Text Available OBJECTIVES: Studies have widely documented the socioeconomic inequalities in maternal and child health related outcomes in developing countries including India. However, there is limited research on the inequalities in advice provided by public health workers on maternal and child health during antenatal visits. This paper investigates the inequalities in advice provided by public health workers to women during antenatal visits in rural India. METHODS AND FINDINGS: The District Level Household Survey (2007-08 was used to compute rich-poor ratios and concentration indices. Binary logistic regressions were used to investigate inequalities in advice provided by public health workers. The dependent variables comprised the advice provided on seven essential components of maternal and child health care. A significant proportion of pregnant women who attended at least four ANC sessions were not advised on these components during their antenatal sessions. Only 51%-72% of the pregnant women were advised on at least one of the components. Moreover, socioeconomic inequalities in providing advice were significant and the provision of advice concentrated disproportionately among the rich. Inequalities were highest in the case of advice on family planning methods. Advice on breastfeeding was least unequal. Public health workers working in lower level health facilities were significantly less likely than their counterparts in the higher level health facilities to provide specific advice. CONCLUSION: A significant proportion of women were not advised on recommended components of maternal and child health in rural India. Moreover, there were enormous socioeconomic inequalities. The findings of this study raise questions about the capacity of the public health care system in providing equitable services in India. The Government of India must focus on training and capacity building of the public health workers in communication skills so that they can deliver

  2. Prevalence and Mental Health Correlates of Sleep Disruption Among Military Members Serving in a Combat Zone

    Science.gov (United States)

    2014-07-01

    worn actigraphy ) is tenuous.49 Also, naps were not accounted for in this study. It is also possible that “need for sleep ” may have been under-reported...in Marines sent to war. Mil Med 2009; 174(7): 737-44. 32. Tomfohr L, Pung MA, Edwards KM, Dimsdale JE: Racial differences in sleep architecture : the...Naval Health Research Center Prevalence and Mental Health Correlates of Sleep Disruption Among Military Members Serving in a Combat Zone

  3. The Health and Well-Being of Children in Rural Areas: A Portrait of the Nation 2007. The National Survey of Children's Health

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    US Department of Health and Human Services, 2011

    2011-01-01

    The National Survey of Children's Health (NSCH) provides a unique resource with which to analyze the health status, health care use, activities, and family and community environments experienced by children in rural and urban areas. The NSCH was designed to measure the health and well-being of children from birth through age 17 in the United…

  4. Self-rated health in rural Appalachia: health perceptions are incongruent with health status and health behaviors

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    Pyle Donald N

    2011-04-01

    Full Text Available Abstract Background Appalachia is characterized by poor health behaviors, poor health status, and health disparities. Recent interventions have not demonstrated much success in improving health status or reducing health disparities in the Appalachian region. Since one's perception of personal health precedes his or her health behaviors, the purpose of this project was to evaluate the self-rated health of Appalachian adults in relation to objective health status and current health behaviors. Methods Appalachian adults (n = 1,576 were surveyed regarding health behaviors - soda consumer (drink ≥ 355 ml/d, or non-consumer (drink 30 min > 1 d/wk and sedentary (exercise Results Respondents reported being healthy, while being sedentary (65%, hypertensive (76%, overweight (73%, or hyperlipidemic (79%. Between 57% and 66% of the respondents who considered themselves healthy had at least two disease conditions or poor health behaviors. Jaccard Binary Similarity coefficients and odds ratios showed the probability of reporting being healthy when having a disease condition or poor health behavior was high. Conclusions The association between self-rated health and poor health indicators in Appalachian adults is distorted. The public health challenge is to formulate messages and programs about health and health needs which take into account the current distortion about health in Appalachia and the cultural context in which this distortion was shaped.

  5. Residual Barriers for Utilization of Maternal and Child Health Services: Community Perceptions From Rural Pakistan.

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    Memon, Zahid; Zaidi, Shehla; Riaz, Atif

    2015-11-03

    Low utilization of maternal and child care services in rural areas has constrained Pakistan from meeting targets of Millennium Development Goals (MDGs) 4 and 5. This study explores community barriers in accessing Maternal and Child Health (MCH) services in ten remote rural districts of Pakistan. It further presents how the barriers differ across a range of MCH services, and also whether the presence of Community Health Workers (CHWs) reduces client barriers. Qualitative methods were used involving altogether sixty focus group discussions with mothers, their spouses and community health workers. Low awareness, formidable distances, expense, and poorly functional services were the main barriers reported, while cultural and religious restrictions were lesser reported. For preventive services including antenatal care (ANC), facility deliveries, postnatal care (PNC), childhood immunization and family planning, the main barrier was low awareness. Conversely, formidable distances and poorly functional services were the main reported constraints in the event of maternal complications and acute child illnesses. The study also found that clients residing in areas served by CHWs had better awareness only of ANC and family planning, while other MCH services were overlooked by the health worker program. The paper highlights that traditional policy emphasis on health facility infrastructure expansion is not likely to address poor utilization rates in remote rural areas. Preventive MCH services require concerted attention to building community awareness, task shifting from facility to community for services provision, and re-energization of CHW program. For maternal and child emergencies there is strong community demand to utilize health facilities, but this will require catalytic support for transport networks and functional health care centers.

  6. Avoiding Failure for Australia's Digital Health Record: The Findings from a Rural E-Health Participatory Research Project.

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    Almond, H; Cummings, E; Turner, P

    2016-01-01

    Low adoption and use of Australia's digital health record has driven the Australian Government to trial 'opt-out' registration from mid-June 2016. The assumption that automatic registration will increase use and thereby deliver benefit requires further investigation especially amongst those sections of the population in rural, regional, remote Australia living with complex chronic conditions. This paper reports on findings from a community based participatory e-health research project based on an initiative where people with complex chronic conditions and their carers attended a rural health promotion and lifestyle modification program. Through co-operative enquiry, health promotion officers and their clients were actively supported to adopt and use Australia's digital health record as an intervention. Simultaneously they were encouraged to reflect on its design and their perceptions of its overall impact on their individual ability to self-manage complex chronic conditions. The findings, ultimately contributing to a conceptual implementation and evaluation framework for Australia's digital health record that could directly avoid failure of the new 'opt-out' approach being adopted.

  7. Risk distribution across multiple health insurance funds in rural Tanzania.

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    Chomi, Eunice Nahyuha; Mujinja, Phares Gamba; Enemark, Ulrika; Hansen, Kristian; Kiwara, Angwara Dennis

    2014-01-01

    Multiple insurance funds serving different population groups may compromise equity due to differential revenue raising capacity and an unequal distribution of high risk members among the funds. This occurs when the funds exist without mechanisms in place to promote income and risk cross-subsidisation across the funds. This paper analyses whether the risk distribution varies across the Community Health Fund (CHF) and National Health Insurance Fund (NHIF) in two districts in Tanzania. Specifically we aim to 1) identify risk factors associated with increased utilisation of health services and 2) compare the distribution of identified risk factors among the CHF, NHIF and non-member households. Data was collected from a survey of 695 households. A multivariate logisitic regression model was used to identify risk factors for increased health care utilisation. Chi-square tests were performed to test whether the distribution of identified risk factors varied across the CHF, NHIF and non-member households. There was a higher concentration of identified risk factors among CHF households compared to those of the NHIF. Non-member households have a similar wealth status to CHF households, but a lower concentration of identified risk factors. Mechanisms for broader risk spreading and cross-subsidisation across the funds are necessary for the promotion of equity. These include risk equalisation to adjust for differential risk distribution and revenue raising capacity of the funds. Expansion of CHF coverage is equally important, by addressing non-financial barriers to CHF enrolment to encourage wealthy non-members to join, as well as subsidised membership for the poorest.

  8. Health care decision making autonomy of women from rural districts of Southern Ethiopia: a community based cross-sectional study

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    Alemayehu M

    2017-04-01

    Full Text Available Mihiretu Alemayehu, Mengistu Meskele School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia Introduction: Millions of women have little health care decision making autonomy in many cultures and tribes. African women are often perceived to have little participation in health care decisions. However, little has been investigated to identify factors contributing to decision making autonomy. Hence, it is important to obtain information on the contributing factors of decision making autonomy and disparities across different socio-cultural contexts. Methodology: A cross-sectional study was conducted in Wolaita and Dawro zones, Southern Ethiopia from February to March 2015. A total of 967 women were selected through multi-stage sampling. A survey was administered face-to-face through an interview format. EpiData v1.4.4.0 and SPSS version 20 were used to enter and analyze data, respectively. Proportions and means were used to describe the study population. Variables with P-value <0.2 in bivariate analysis were selected for multivariable regression. Finally, variables with P-value <0.05 in multivariable logistic regressions were identified as independent predictors. Odds ratios along with confidence intervals were used to determine the presence of association. Result: It was determined that 58.4% of women have autonomy, while 40.9% of study participants’ health care decisions were made by their husbands. The husband’s education (adjusted odds ratio [AOR] =1.91 [1.10, 3.32], wealth index (AOR =0.62 [0.42, 0.92], age (AOR =2.42 [1.35, 4.32] and AOR =7 [3.45, 14.22], family size (AOR =0.53 [0.33, 0.85] and AOR =0.42 [0.23, 0.75], and occupation (AOR =1.66 [1.14, 2.41], were predictors of health care decision making autonomy. Conclusion: Even though every woman has the right to participate in her own health care decision making, more than two fifths of them have no role in making health care

  9. Ocular health assessment of cocoa farmers in a rural community in Ghana.

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    Boadi-Kusi, Samuel Bert; Hansraj, Rekha; Kumi-Kyereme, Akwasi; Mashige, Khathutshelo Percy; Awusabo-Asare, Kofi; Ocansey, Stephen; Kyei, Samuel

    2014-01-01

    Cocoa farming provides employment for over 800,000 households in rural Ghana, with the country currently touted as the second largest producer of cocoa worldwide. Agriculture is one of the riskiest occupations for the eyes due to the numerous ocular hazards on farms. The authors conducted an ocular health assessment among cocoa farmers at Mfuom, a rural community in the Central Region of Ghana, to examine the ocular health status and the ocular safety measures used by cocoa farmers. A structured questionnaire was used to evaluate demographic characteristics, ocular injuries, and utilization of eye care services and ocular protection, and a clinical examination was used to evaluate their ocular status. Cocoa farmers were at high risk for ocular injuries and farm-related vision disorders and utilized eye care services and ocular protection poorly. Ocular condition identified were mainly refractive error (28.6%), cataract (20.0%), glaucoma (11.7%), conjunctivitis (13%), pterygium (2.7%), and cornea opacity (2.2%). There is a need for the introduction of an interventional eye care program to help address the ocular health challenges identified among the farmers. This can be done through collaborative efforts by educational institutions, government, and other role players in the agricultural industry to improve the quality of life of the vulnerable cocoa farmers in rural Ghana.

  10. Feasibility of a multifaceted educational strategy for strengthening rural primary health care

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    Hortensia Reyes-Morales

    2017-05-01

    Full Text Available Objective. To evaluate the feasibility and acceptability of a comprehensive educational strategy designed to improve care quality in rural areas of Mexico. Materials and methods. A demonstration study was performed in 18 public rural health centers in Mexico, including an educational intervention that consists of the following steps: Development of the strat­egy; Selection and training of instructors (specialist physicians from the referral hospital and multidisciplinary field teams; Implementation of the strategy among health care teams for six priority causes of visit, through workshops, individual tutorials, and round-table case-review sessions. Feasibility and acceptability were evaluated using checklists, direct observa­tion, questionnaires and in-depth interviews with key players. Results. Despite some organizational barriers, the strategy was perceived as worthy by the participants because of the personalized tutorials and the improved integration of health teams within their usual professional practice. Conclusion. The educational strategy proved to be acceptable; its feasibil­ity for usual care conditions will depend on the improvement of organizational processes at rural facilities.

  11. Rural health professionals' experiences in implementing advance care planning: a focus group study.

    Science.gov (United States)

    Fletcher, Sophie; Sinclair, Craig; Rhee, Joel; Goh, Desiree; Auret, Kirsten

    2015-09-02

    Advance care planning (ACP) is described as an ongoing discussion between a patient, their family and healthcare professionals (HCPs) to understand a patient's wishes for future health care. Legislation supporting ACP in Western Australia is relatively new and HCPs are still learning about the process and implementation. This study aimed to provide a rich description of rural health professionals' perceptions and experiences with ACP within the context of their professional role and to identify systemic issues and training needs. Ten focus groups were conducted throughout 2014 with a total of 55 rural participants including general practitioners (n = 15), general practice registrars (n = 6), practice nurses (n = 18), community nurses (n = 4) and hospital nurses (n = 12) in the south-western regions of Western Australia. Thematic analysis has identified the following themes regarding ACP: benefits to patients and families; professional roles in ACP; barriers and enablers; and systems for communicating ACP. HCPs have self-determined their roles in the ACP process, which currently leaves some components of the process unaccounted for, suggesting that collaboration between HCPs working together in a rural health setting and a standardised system for distributing these documents may assist with the implementation of ACP.

  12. Nutritional Status of Rural Older Adults Is Linked to Physical and Emotional Health.

    Science.gov (United States)

    Jung, Seung Eun; Bishop, Alex J; Kim, Minjung; Hermann, Janice; Kim, Giyeon; Lawrence, Jeannine

    2017-06-01

    Although nutritional status is influenced by multidimensional aspects encompassing physical and emotional well-being, there is limited research on this complex relationship. The purpose of this study was to examine the interplay between indicators of physical health (perceived health status and self-care capacity) and emotional well-being (depressive affect and loneliness) on rural older adults' nutritional status. The cross-sectional study was conducted from June 1, 2007, to June 1, 2008. A total of 171 community-dwelling older adults, aged 65 years and older, residing within nonmetro rural communities in the United States participated in this study. Participants completed validated instruments measuring self-care capacity, perceived health status, loneliness, depressive affect, and nutritional status. Structural equation modeling was employed to investigate the complex interplay of physical and emotional health status with nutritional status among rural older adults. The χ(2) test, comparative fit index, root mean square error of approximation, and standardized root mean square residual were used to assess model fit. The χ(2) test and the other model fit indexes showed the hypothesized structural equation model provided a good fit to the data (χ(2) (2)=2.15; P=0.34; comparative fit index=1.00; root mean square error of approximation=0.02; and standardized root mean square residual=0.03). Self-care capacity was significantly related with depressive affect (γ=-0.11; P=0.03), whereas self-care capacity was not significantly related with loneliness. Perceived health status had a significant negative relationship with both loneliness (γ=-0.16; P=0.03) and depressive affect (γ=-0.22; P=0.03). Although loneliness showed no significant direct relationship with nutritional status, it showed a significant direct relationship with depressive affect (β=.4; Pnutritional status (β=-.30; Phealth and emotional indicators have significant multidimensional associations

  13. Health Profile Of Aged Persons In Urban & Rural Field Practice Areas Of Medical College, Amrisar

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    Padda A.S

    1998-01-01

    Full Text Available Research question: What is the health status of aged persons in urban and rural area? Objectives: 1. To study the socio-demographic profile. 2. To study the health status of aged persons in urban and rural areas and factors associated with it. Study design: Cross-sectional Participants: Persons aged 60 years and above. Sample size: 698 (423 males and 275 females Study variables: Age, Sex, marital status, occupation, literacy status, addition, morbidity pattern and disability. Results: Among 698 aged persons, 423(60.60% were males and 275(39.40% were females, 393(56.3% were in the age group of 60-65 years while only 34(4.8% were more than 80 years. Majority (58.45% belonged to Sikh community followed by Hindus (39.9%. 61.37% aged persons were literate and 38.63% were illiterate. 73.74% of all aged were living in joint families. 68.39% aged persons were engaged in one or other works while 31.61% were dependent on other family members. It was observed that 46.08% of rural aged and 32.97% of urban aged persons were going for morning/evening walk. 33.69% of urban aged and 20.69% of rural aged were reading newspapers or books. Out of total 423 males, 363(85.81% were addicted to one or the other intoxicants. 374(53.58% were feeling satisfactory at this age while 324(46.42% were not feeling so. Majority of them were ill at the time of survey. Arthritis (60.60% being the commonest cause of illness followed by cataract or visual impairment (54.01%. 16.62% of the aged were hypertensive, it was more (19.35% in urban aged as compared to rural aged (13.79%. Diabetes mellitus was observed in 5.3% aged persons and it was more commonly seen in urban area (6.81% than in rural area (2.51%. Prevalence of peptic ulcers/chromic gastritis was found to be 5.87% (6.09% in urban area (6.27% in rural area aged. The problems due to socio-psychology causes were minimal, probably because majority (73.74% of them were residing with their families

  14. Expansion of antiretroviral treatment to rural health centre level by a mobile service in Mumbwa district, Zambia

    Science.gov (United States)

    Dube, Christopher; Hayakawa, Tadao; Kakimoto, Kazuhiro; Yamada, Norio; Simpungwe, James B

    2010-01-01

    Abstract Problem Despite the Government’s effort to expand services to district level, it is still hard for people living with HIV to access antiretroviral treatment (ART) in rural Zambia. Strong demands for expanding ART services at the rural health centre level face challenges of resource shortages. Approach The Mumbwa district health management team introduced mobile ART services using human resources and technical support from district hospitals, and community involvement at four rural health centres in the first quarter of 2007. This paper discusses the uptake of the mobile ART services in rural Mumbwa. Local setting Mumbwa is a rural district with an area of 23 000 km2 and a population of 167 000. Before the introduction of mobile services, ART services were provided only at Mumbwa District Hospital. Relevant changes The mobile services improved accessibility to ART, especially for clients in better functional status, i.e. still able to work. In addition, these mobile services may reduce the number of cases “lost to follow-up”. This might be due to the closer involvement of the community and the better support offered by these services to rural clients. Lessons learnt These mobile ART services helped expand services to rural health facilities where resources are limited, bringing them as close as possible to where clients live. PMID:20931065

  15. Why do health workers in rural Tanzania prefer public sector employment?

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    Songstad Nils Gunnar

    2012-04-01

    Full Text Available Abstract Background Severe shortages of qualified health workers and geographical imbalances in the workforce in many low-income countries require the national health sector management to closely monitor and address issues related to the distribution of health workers across various types of health facilities. This article discusses health workers' preferences for workplace and their perceptions and experiences of the differences in working conditions in the public health sector versus the church-run health facilities in Tanzania. The broader aim is to generate knowledge that can add to debates on health sector management in low-income contexts. Methods The study has a qualitative study design to elicit in-depth information on health workers' preferences for workplace. The data comprise ten focus group discussions (FGDs and 29 in-depth interviews (IDIs with auxiliary staff, nursing staff, clinicians and administrators in the public health sector and in a large church-run hospital in a rural district in Tanzania. The study has an ethnographic backdrop based on earlier long-term fieldwork in Tanzania. Results The study found a clear preference for public sector employment. This was associated with health worker rights and access to various benefits offered to health workers in government service, particularly the favourable pension schemes providing economic security in old age. Health workers acknowledged that church-run hospitals generally were better equipped and provided better quality patient care, but these concerns tended to be outweighed by the financial assets of public sector employment. In addition to the sector specific differences, family concerns emerged as important in decisions on workplace. Conclusions The preference for public sector employment among health workers shown in this study seems to be associated primarily with the favourable pension scheme. The overall shortage of health workers and the distribution between health

  16. Why do households invest in sanitation in rural Benin: Health, wealth, or prestige?

    Science.gov (United States)

    Gross, Elena; Günther, Isabel

    2014-10-01

    Seventy percent of the rural population in sub-Saharan Africa does not use adequate sanitation facilities. In rural Benin, as much as 95% of the population does not use improved sanitation. By analyzing a representative sample of 2000 rural households, this paper explores why households remain without latrines. Our results show that wealth and latrine prices play the most decisive role for sanitation demand and ownership. At current income levels, sanitation coverage will only increase to 50% if costs for construction are reduced from currently 190 USD to 50 USD per latrine. Our analysis also suggests that previous sanitation campaigns, which were based on prestige and the allure of a modern lifestyle as motives for latrine construction, have had no success in increasing sanitation coverage. Moreover, improved public health, which is the objective of public policies promoting sanitation, will not be effective at low sanitation coverage rates. Fear at night, especially of animals, and personal harassment, are stated as the most important motivational factors for latrine ownership and the intention to build one. We therefore suggest changing the message of sanitation projects and introduce new low-cost technologies into rural markets; otherwise, marketing strategies will continue to fail in increasing sanitation demand.

  17. Physical and mental health perspectives of first year undergraduate rural university students.

    Science.gov (United States)

    Hussain, Rafat; Guppy, Michelle; Robertson, Suzanne; Temple, Elizabeth

    2013-09-15

    University students are often perceived to have a privileged position in society and considered immune to ill-health and disability. There is growing evidence that a sizeable proportion experience poor physical health, and that the prevalence of psychological disorders is higher in university students than their community peers. This study examined the physical and mental health issues for first year Australian rural university students and their perception of access to available health and support services. Cross-sectional study design using an online survey form based on the Adolescent Screening Questionnaire modeled on the internationally recognised HEADSS survey tool. The target audience was all first-year undergraduate students enrolled in an on-campus degree program. The response rate was 41% comprising 355 students (244 females, 111 males). Data was analysed using standard statistical techniques including descriptive and inferential statistics; and thematic analysis of the open-ended responses. The mean age of the respondents was 20.2 years (SD 4.8). The majority of the students lived in on-campus residential college style accommodation, and a third combined part-time paid work with full-time study. Most students reported being in good physical health. However, on average two health conditions were reported over the past six months, with the most common being fatigue (56%), frequent headaches (26%) and allergies (24%). Mental health problems included anxiety (25%), coping difficulties (19.7%) and diagnosed depression (8%). Most respondents reported adequate access to medical doctors and support services for themselves (82%) and friends (78%). However the qualitative comments highlighted concerns about stigma, privacy and anonymity in seeking counselling. The present study adds to the limited literature of physical and mental health issues as well as barriers to service utilization by rural university students. It provides useful baseline data for the

  18. Is a decentralized continuing medical education program feasible for Chinese rural health professionals?

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    Guijie Hu

    2016-04-01

    Full Text Available Purpose: Rural health professionals in township health centers (THCs tend to have less advanced educational degrees. This study aimed to ascertain the perceived feasibility of a decentralized continuing medical education (CME program to upgrade their educational levels. Methods: A cross-sectional survey of THC health professionals was conducted using a self-administered, structured questionnaire in Guangxi Zhuang Autonomous Region, China. Results: The health professionals in the THCs were overwhelmingly young with low education levels. They had a strong desire to upgrade their educational degrees. The decentralized CME program was perceived as feasible by health workers with positive attitudes about the benefit for license examination, and by those who intended to improve their clinical diagnosis and treatment skills. The target groups of such a program were those who expected to undertake a bachelor’s degree and who rated themselves as “partially capable” in clinical competency. They reported that 160-400 USD annually would be an affordable fee for the program. Conclusion: A decentralized CME program was perceived feasible to upgrade rural health workers’ education level to a bachelor’s degree and improve their clinical competency.

  19. A geographical perspective on access to sexual and reproductive health care for women in rural Africa.

    Science.gov (United States)

    Yao, Jing; Murray, Alan T; Agadjanian, Victor

    2013-11-01

    Utilization of sexual and reproductive health (SRH) services can significantly impact health outcomes, such as pregnancy and birth, prenatal and neonatal mortality, maternal morbidity and mortality, and vertical transmission of infectious diseases like HIV/AIDS. It has long been recognized that access to SRH services is essential to positive health outcomes, especially in rural areas of developing countries, where long distances as well as poor transportation conditions, can be potential barriers to health care acquisition. Improving accessibility of health services for target populations is therefore critical for specialized healthcare programs. Thus, understanding and evaluation of current access to health care is crucial. Combining spatial information using geographical information system (GIS) with population survey data, this study details a gravity model-based method to measure and evaluate access to SRH services in rural Mozambique, and analyzes potential geographic access to such services, using family planning as an example. Access is found to be a significant factor in reported behavior, superior to traditional distance-based indicators. Spatial disparities in geographic access among different population groups also appear to exist, likely affecting overall program success.

  20. Disabled women׳s maternal and newborn health care in rural Nepal: A qualitative study

    Science.gov (United States)

    Morrison, Joanna; Basnet, Machhindra; Budhathoki, Bharat; Adhikari, Dhruba; Tumbahangphe, Kirti; Manandhar, Dharma; Costello, Anthony; Groce, Nora

    2014-01-01

    Objective there is little evidence about disabled women׳s access to maternal and newborn health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and care seeking. Our study explores disabled women׳s experiences of maternal and newborn care in rural Nepal. Design we used a qualitative methodology, using semi-structured interviews. Setting rural Makwanpur District of central Nepal. Participants we purposively sampled married women with different impairments who had delivered a baby in the past 10 years from different topographical areas of the district. We also interviewed maternal health workers. We compared our findings with a recent qualitative study of non-disabled women in the same district to explore the differences between disabled and non-disabled women. Findings married disabled women considered pregnancy and childbirth to be normal and preferred to deliver at home. Issues of quality, cost and lack of family support were as pertinent for disabled women as they were for their non-disabled peers. Health workers felt unprepared to meet the maternal health needs of disabled women. Key conclusions and implications for practice integration of disability into existing Skilled Birth Attendant training curricula may improve maternal health care for disabled women. There is a need to monitor progress of interventions that encourage institutional delivery through the use of disaggregated data, to check that disabled women are benefiting equally in efforts to improve access to maternal health care. PMID:24768318

  1. Community-Based Mental Health Intervention for Underprivileged Women in Rural India: An Experiential Report

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    Kiran Rao

    2011-01-01

    Full Text Available Objective. To share experiences from a project that integrates a mental health intervention within a developmental framework of microcredit activity for economically underprivileged women in rural India. Method. The mental health intervention had two components: group counseling and stress management. The former comprised of ventilation and reassurance and the latter strengthening of coping skills and a relaxation technique. Focus group discussions were used to understand women's perception of how microcredit economic activity and the mental health intervention had affected their lives. Results. Women in the mental health intervention group reported reduction in psychological distress and bodily aches and pains. Majority (86% reported that the quality of their sleep had improved with regular practice of relaxation and that sharing their problems in the group had helped them to unburden. The social support extended by the members to each other, made them feel that they were not alone and could face any life situation. Conclusion. The study provided qualitative evidence that adding the mental health intervention to the ongoing economic activity had made a positive difference in the lives of the women. Addressing mental health concerns along with livelihood initiatives can help to enhance both economic and social capital in rural poor women.

  2. Geographic influences on sexual and reproductive health service utilization in rural Mozambique.

    Science.gov (United States)

    Yao, Jing; Murray, Alan T; Agadjanian, Victor; Hayford, Sarah R

    2012-03-01

    The HIV/AIDS epidemic remains a major public health issue across the globe, and it is of particular concern in sub-Saharan Africa. Utilization of sexual and reproductive health (SRH) services can significantly impact HIV prevention, transmission, and treatment. SRH service utilization may be determined by individual characteristics, such as education and economic status, but also by the location and accessibility of health care facilities. Using population-based survey data, this study applies exploratory spatial analysis techniques to examine spatial patterns of SRH service utilization among rural married women in southern Mozambique. Clustering among those using services is found as are spatial associations, indicating significant spatial variability in the utilization of health services. The findings provide valuable insights for current and future health care program planning and configuration.

  3. Elderly parent health and the migration decisions of adult children: evidence from rural China.

    Science.gov (United States)

    Giles, John; Mu, Ren

    2007-05-01

    Recent research has shown that participation in migrant labor markets has led to substantial increases in income for families in rural China. This article addresses the question of how participation is affected by elderly parent health. We find that younger adults are less likely to work as migrants when a parent is ill. Poor health of an elderly parent has less impact on the probability of employment as a migrant when an adult child has siblings who may be available to provide care. We also highlight the potential importance of including information on nonresident family members when studying how parent illness and elder care requirements influence the labor supply decisions of adult children.

  4. Burnout: Interpreting the perception of Iranian primary rural health care providers from working and organizational conditions

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    Mahrokh Keshvari

    2012-01-01

    Results: During the content analysis process, six themes were obtained; "instability and frequent changes", "involved in laws and regulations", "pressure and stress due to unbalanced workload and manpower", "helplessness in performing the tasks and duties", "sense of identity threat and low self-concept", and "deprivation of professional development". The mentioned themes indicate a main and more important theme called "burnout". Conclusions: Health services providers in the rural health centers are working in stressful and challenging work conditions and are suffered from deprivation of something for which are responsible to the community.

  5. Capacity building for health through community-based participatory nutrition intervention research in rural communities.

    Science.gov (United States)

    Downey, Laura H; Castellanos, Diana Cuy; Yadrick, Kathy; Threadgill, Paula; Kennedy, Betty; Strickland, Earline; Prewitt, T Elaine; Bogle, Margaret

    2010-01-01

    Since its inception, capacity building has been a stated goal of the Delta Nutrition Intervention Research Initiative, a tri-state collaboration in the Lower Mississippi Delta to address high rates of chronic disease. Textual analysis of project documents identifies and describes strategies carried out to foster capacity building. Strategies to build community capacity include fostering participation, cultivating leadership opportunities, training community members as co-researchers, securing community resources, and implementing the intervention together. Incorporating capacity-building approaches in health promotion and nutrition-intervention programming in rural communities provides a means to enhance potential for sustainability of health outcomes and developed effectiveness.

  6. Children at Risk: The Effect of Crop Loss on Child Health in Rural Mexico

    OpenAIRE

    Michaelsen, Maren M.; Tolan, Songül

    2012-01-01

    This study investigates the effect of an economic shock due to crop loss on health outcomes of children in rural Mexico. Data from the Mexican Family Life Survey for the years 2002 and 2005 off er retrospective information on economic shocks since 1997 and height-for-age z-scores (HAZ) to measure long-term effects on child health. Since crop losses are exogenous to the children, simple OLS regressions are used to estimate the effect of crop loss overall and over time. Children who were hit by...

  7. Child health inequities in developing countries: differences across urban and rural areas

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    Fotso Jean-Christophe

    2006-07-01

    Full Text Available Abstract Objectives To document and compare the magnitude of inequities in child malnutrition across urban and rural areas, and to investigate the extent to which within-urban disparities in child malnutrition are accounted for by the characteristics of communities, households and individuals. Methods The most recent data sets available from the Demographic and Health Surveys (DHS of 15 countries in sub-Saharan Africa (SSA are used. The selection criteria were set to ensure that the number of countries, their geographical spread across Western/Central and Eastern/Southern Africa, and their socioeconomic diversities, constitute a good yardstick for the region and allow us to draw some generalizations. A household wealth index is constructed in each country and area (urban, rural, and the odds ratio between its uppermost and lowermost category, derived from multilevel logistic models, is used as a measure of socioeconomic inequalities. Control variables include mother's and father's education, community socioeconomic status (SES designed to represent the broad socio-economic ecology of the neighborhoods in which families live, and relevant mother- and child-level covariates. Results Across countries in SSA, though socioeconomic inequalities in stunting do exist in both urban and rural areas, they are significantly larger in urban areas. Intra-urban differences in child malnutrition are larger than overall urban-rural differentials in child malnutrition, and there seem to be no visible relationships between within-urban inequities in child health on the one hand, and urban population growth, urban malnutrition, or overall rural-urban differentials in malnutrition, on the other. Finally, maternal and father's education, community SES and other measurable covariates at the mother and child levels only explain a slight part of the within-urban differences in child malnutrition. Conclusion The urban advantage in health masks enormous disparities

  8. Preventive palliation in the elderly - Organizing health camps for the rural aged

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    Abhijit Dam

    2010-01-01

    Full Text Available Most of the needs of elders for support and assistance in the later stages of life are fulfilled by informal helpers. The position of a large number of older persons has become vulnerable due to which it cannot be taken for granted that their children will be able to look after them when they need care in old age, specially in view of the longer life span implying an extended period of dependency and higher costs to meet health and other needs. The condition of the rural elderly is even more pitiable, contrary to our beliefs, as availability, affordability and accessibility to medicare facilities are poor. We undertook the task of organizing a health camp in a rural set-up with the idea of implementing our concept of "preventive palliation" in which excellent palliative care was coupled with a pinch of prevention, like routine checks of blood pressure, routine physical check-ups, etc, so that any aberration can be detected early and necessary rectification measures can be implemented. These periods of routine check-ups can also be used to assess the psycho-social, cultural and emotional problems, if any. Such an approach, say every monthly, gives the elderly something to look forward to and ensures a high degree of customer satisfaction and greatly reduces the burden on the current health system. The challenges faced and the data obtained from this study were shocking. The elderly living in rural areas of the tribal state of Jharkhand suffer from poor physical and mental health, a factor which was rather unexpected in the Indian cultural system in the rural setting. Simple strategies like implementing routine health check ups with provision of "nutritious meal program" can go a long way in mitigating these problems in a cost-effective and simple manner. To make the government-based programs accessible and available to the end-users, participation of local bodies like NGOs is mandatory. Preventive palliation, a concept introduced by Kosish, is

  9. Faculty of health sciences, walter sisulu university: training doctors from and for rural South african communities.

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    Iputo, Jehu E

    2008-10-01

    Introduction The South African health system has disturbing inequalities, namely few black doctors, a wide divide between urban and rural sectors, and also between private and public services. Most medical training programs in the country consider only applicants with higher-grade preparation in mathematics and physical science, while most secondary schools in black communities have limited capacity to teach these subjects and offer them at standard grade level. The Faculty of Health Sciences at Walter Sisulu University (WSU) was established in 1985 to help address these inequities and to produce physicians capable of providing quality health care in rural South African communities. Intervention Access to the physician training program was broadened by admitting students who obtained at least Grade C (60%) in mathematics and physical science at standard grade, and who demonstrated appropriate personal attributes. An innovative curriculum, combining problem-based learning with community-based education (PBL/CBE) in small tutorial group settings, was also adopted. This approach was aimed at educating and graduating a broader cohort of students, while training future doctors to identify, analyze, and treat health problems in the rural South African context. Outcomes To date, 745 doctors (72% black Africans) have graduated from the program, and 511 students (83% black Africans) are currently enrolled. After the PBL/CBE curriculum was adopted, the attrition rate for black students dropped from 23% to 80%, and the proportion of students graduating within the minimum period rose from 55% to >70%. Many graduates are still completing internships or post-graduate training, but preliminary research shows that 36% percent of graduates practice in small towns and rural settings. Further research is underway to evaluate the impact of their training on health services in rural Eastern Cape Province and elsewhere in South Africa. Conclusions The WSU program increased access to

  10. Is there any role for community involvement in the community-based health planning and services skilled delivery program in rural Ghana?

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    Sakeah, Evelyn; McCloskey, Lois; Bernstein, Judith; Yeboah-Antwi, Kojo; Mills, Samuel; Doctor, Henry V

    2014-08-11

    In Ghana, between 1,400 and 3,900 women and girls die annually due to pregnancy related complications and an estimated two-thirds of these deaths occur in late pregnancy through to 48 hours after delivery. The Ghana Health Service piloted a strategy that involved training Community Health Officers (CHOs) as midwives to address the gap in skilled attendance in rural Upper East Region (UER). CHO-midwives collaborated with community members to provide skilled delivery services in rural areas. This paper presents findings from a study designed to assess the extent to which community residents and leaders participated in the skilled delivery program and the specific roles they played in its implementation and effectiveness. We employed an intrinsic case study design with a qualitative methodology. We conducted 29 in-depth interviews with health professionals and community stakeholders. We used a random sampling technique to select the CHO-midwives in three Community-based Health Planning and Services (CHPS) zones for the interviews and a purposive sampling technique to identify and interview District Directors of Health Services from the three districts, the Regional Coordinator of the CHPS program and community stakeholders. Community members play a significant role in promoting skilled delivery care in CHPS zones in Ghana. We found that community health volunteers and traditional birth attendants (TBAs) helped to provide health education on skilled delivery care, and they also referred or accompanied their clients for skilled attendants at birth. The political authorities, traditional leaders, and community members provide resources to promote the skilled delivery program. Both volunteers and TBAs are given financial and non-financial incentives for referring their clients for skilled delivery. However, inadequate transportation, infrequent supply of drugs, attitude of nurses remains as challenges, hindering women accessing maternity services in rural areas. Mutual

  11. Health status and quality of life among older adults in rural Tanzania

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    Mathew A. Mwanyangala

    2010-09-01

    Full Text Available Background: Increasingly, human populations throughout the world are living longer and this trend is developing in sub-Saharan Africa. In developing African countries such as Tanzania, this demographic phenomenon is taking place against a background of poverty and poor health conditions. There has been limited research on how this process of ageing impacts upon the health of older people within such low-income settings. Objective: The objective of this study is to describe the impacts of ageing on the health status, quality of life and well-being of older people in a rural population of Tanzania. Design: A short version of the WHO Survey on Adult Health and Global Ageing questionnaire was used to collect information on the health status, quality of life and well-being of older adults living in Ifakara Health and Demographic Surveillance System, Tanzania, during early 2007. Questionnaires were administered through this framework to 8,206 people aged 50 and over. Results: Among people aged 50 and over, having good quality of life and health status was significantly associated with being male, married and not being among the oldest old. Functional ability assessment was associated with age, with people reporting more difficulty in performing routine activities as age increased, particularly among women. Reports of good quality of life and well-being decreased with increasing age. Women were significantly more likely to report poor quality of life (odds ratio 1.31; p<0.001, 95% CI 1.15–1.50. Conclusions: Older people within this rural Tanzanian setting reported that the ageing process had significant impacts on their health status, quality of life and physical ability. Poor quality of life and well-being, and poor health status in older people were significantly associated with marital status, sex, age and level of education. The process of ageing in this setting is challenging and raises public health concerns.

  12. Community perspectives on the determinants of maternal health in rural southern Mozambique: a qualitative study.

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    Firoz, Tabassum; Vidler, Marianne; Makanga, Prestige Tatenda; Boene, Helena; Chiaú, Rogério; Sevene, Esperança; Magee, Laura A; von Dadelszen, Peter; Munguambe, Khátia

    2016-09-30

    Mozambique has one of the highest rates of maternal mortality in sub-Saharan Africa. The main influences on maternal health encompass social, economic, political, environmental and cultural determinants of health. To effectively address maternal mortality in the post-2015 agenda, interventions need to consider the determinants of health so that their delivery is not limited to the health sector. The objective of this exploratory qualitative study was to identify key community groups' perspectives on the perceived determinants of maternal health in rural areas of southern Mozambique. Eleven focus group discussions were conducted with women of reproductive age, pregnant women, matrons, male partners, community leaders and health workers. Participants were recruited using sampling techniques of convenience and snow balling. Focus groups had an average of nine participants each. The heads of 12 administrative posts were also interviewed to understand the local context. Data were coded and analysed thematically using NVivo software. A broad range of political, economic, socio-cultural and environmental determinants of maternal health were identified by community representatives. It was perceived that the civil war has resulted in local unemployment and poverty that had a number of downstream effects including lack of funds for accessing medical care and transport, and influence on socio-cultural determinants, particularly gender relations that disadvantaged women. Socio-cultural determinants included intimate partner violence toward women, and strained relationships with in-laws and co-spouses. Social relationships were complex as there were both negative and positive impacts on maternal health. Environmental determinants included natural disasters and poor access to roads and transport exacerbated by the wet season and subsequent flooding. In rural southern Mozambique, community perceptions of the determinants of maternal health included political, economic, socio

  13. Implementation factors and their effect on e-Health service adoption in rural communities : a systematic literature review

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    Hage, M.L.; Roo, J.P.; van Offenbeek, M.A.G.; Boonstra, A.

    2013-01-01

    Background: An ageing population is seen as a threat to the quality of life and health in rural communities, and it is often assumed that e-Health services can address this issue. As successful e-Health implementation in organizations has proven difficult, this systematic literature review considers

  14. Low-Income Rural Mothers' Perceptions of Parent Confidence: The Role of Family Health Problems and Partner Status

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    Ontai, Lenna; Sano, Yoshie; Hatton, Holly; Conger, Katherine J.

    2008-01-01

    Parenting confidence can be undermined by the presence of frequent or persistent health problems, particularly for people living in rural communities that have limited access to adequate health care. However, little is known about how minor health problems in the family impact parenting. The current study examined single and coresident mothers'…

  15. Low-Income Rural Mothers' Perceptions of Parent Confidence: The Role of Family Health Problems and Partner Status

    Science.gov (United States)

    Ontai, Lenna; Sano, Yoshie; Hatton, Holly; Conger, Katherine J.

    2008-01-01

    Parenting confidence can be undermined by the presence of frequent or persistent health problems, particularly for people living in rural communities that have limited access to adequate health care. However, little is known about how minor health problems in the family impact parenting. The current study examined single and coresident mothers'…

  16. Food Avoidance and Food Modification Practices of Older Rural Adults: Association with Oral Health Status and Implications for Service Provision

    Science.gov (United States)

    Quandt, Sara A.; Chen, Haiying; Bell, Ronny A.; Savoca, Margaret R.; Anderson, Andrea M.; Leng, Xiaoyan; Kohrman, Teresa; Gilbert, Gregg H.; Arcury, Thomas A.

    2010-01-01

    Purpose: Dietary variation is important for health maintenance and disease prevention among older adults. However, oral health deficits impair ability to bite and chew foods. This study examines the association between oral health and foods avoided or modified in a multiethnic rural population of older adults. It considers implications for…

  17. Rural health workers and their work environment: the role of inter-personal factors on job satisfaction of nurses in rural Papua New Guinea

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    Jayasuriya Rohan

    2012-06-01

    Full Text Available Abstract Background Job satisfaction is an important focal attitude towards work. Understanding factors that relate to job satisfaction allows interventions to be developed to enhance work performance. Most research on job satisfaction among nurses has been conducted in acute care settings in industrialized countries. Factors that relate to rural nurses are different. This study examined inter-personal, intra-personal and extra-personal factors that influence job satisfaction among rural primary care nurses in a Low and Middle Income country (LMIC, Papua New Guinea. Methods Data was collected using self administered questionnaire from rural nurses attending a training program from 15 of the 20 provinces. Results of a total of 344 nurses were available for analysis. A measure of overall job satisfaction and measures for facets of job satisfaction was developed in the study based on literature and a qualitative study. Multi-variate analysis was used to test prediction models. Results There was significant difference in the level of job satisfaction by age and years in the profession. Higher levels of overall job satisfaction and intrinsic satisfaction were seen in nurses employed by Church facilities compared to government facilities (P Conclusions This study provides empirical evidence that inter-personal relationships: work climate and supportive supervision are the most important influences of job satisfaction for rural nurses in a LMIC. These findings highlight that the provision of a conducive environment requires attention to human relations aspects. For PNG this is very important as this critical cadre provide the frontline of primary health care for more than 70% of the population of the country. Many LMIC are focusing on rural health, with most of the attention given to aspects of workforce numbers and distribution. Much less attention is given to improving the aspects of the working environment that enhances intrinsic satisfaction and

  18. Understanding health constraints among rural-to-urban migrants in China.

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    Li, Yan

    2013-11-01

    The main purpose of this article is to examine the understanding and experience of health and health care among rural-to-urban migrants in China, and to explain the impact of the internal factors of migrants themselves and the external factors of their social environment. Understanding the perceptions and consciousness of health issues among migrants is crucial to prevention, intervention, and other health-related measures for the migrant population in China, but this has rarely been explored in studies. On the basis of a case study of a migrant community in Beijing, I explore the migrants' understandings of health and health care and analyze factors in the social environment, including exclusion from the social system and the possibility of health participation, exclusion from social relation networks, obstructed channels of health maintenance, and exclusion of crowd psychology, which impact heavily on their health understanding and health behavior. I argue that the internal and the external factors are linked together closely and interact as reciprocal causation. However, the migrants should not be seen as primarily responsible, because their poor understanding of health mainly results from the socioeconomic environment in which they live and work.

  19. Health disparities among the western, central and eastern rural regions of China after a decade of health promotion and disease prevention programming.

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    Zhang, Xi-Fan; Tian, Xiang-Yang; Cheng, Yu-Lan; Feng, Zhan-Chun; Wang, Liang; Southerland, Jodi

    2015-08-01

    Health disparities between the western, central and eastern regions of rural China, and the impact of national health improvement policies and programming were assessed. A total of 400 counties were randomly sampled. ANOVA and Logistic regression modeling were employed to estimate differences in health outcomes and determinants. Significant differences were found between the western, central and eastern rural regions in community infrastructure and health outcomes. From 2000 to 2010, health indicators in rural China were improved significantly, and the infant mortality rate (IMR), maternal mortality rate (MMR) and under 5 mortality rate (U5MR) had fallen by 62.79%, 71.74% and 61.92%, respectively. Central rural China had the greatest decrease in IMR (65.05%); whereas, western rural China had the greatest reduction in MMR (72.99%) but smallest reduction in U5MR (57.36%). Despite these improvements, Logistic regression analysis showed regional differences in key health outcome indicators (odds ratios): IMR (central: 2.13; western: 5.31), U5MR (central: 2.25; western: 5.69), MMR (central: 1.94; western: 3.31), and prevalence of infectious diseases (central: 1.62; western: 3.58). The community infrastructure and health outcomes of the western and central rural regions of China have been improved markedly during the first decade of the 21st century. However, health disparities still exist across the three regions. National efforts to increase per capita income, community empowerment and mobilization, community infrastructure, capacity of rural health facilities, and health literacy would be effective policy options to attain health equity.

  20. Design framework for developing ict products and services for rural development: A persuasive health information system for rural India

    NARCIS (Netherlands)

    Parmar, V.S.

    2009-01-01

    Information poverty cannot be addressed by simply giving away computers and installing internet connections in rural areas. What is really needed is to offer rural users relevant, personalized information that enables them to make positive changes in their daily lives, rather than give them the type

  1. Design framework for developing ict products and services for rural development: A persuasive health information system for rural India

    NARCIS (Netherlands)

    Parmar, V.S.

    2009-01-01

    Information poverty cannot be addressed by simply giving away computers and installing internet connections in rural areas. What is really needed is to offer rural users relevant, personalized information that enables them to make positive changes in their daily lives, rather than give them the type

  2. Acceptability and effectiveness of a breast health awareness programme for rural women in India

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    Rao R

    2005-09-01

    Full Text Available Background: Breast cancer being one of the leading cancers among women in developing countries, prevention or identification of the disease at an early stage is of paramount importance in saving as well as improving the quality of life. Breast health awareness appears to be a pragmatic method for this. Objective: To determine the acceptability and effectiveness of an educational intervention programme on breast health awareness for rural women by trained female health workers. Settings and Design: Community based nonrandomised educational intervention study carried out over a period of 1 year. Three hundred and sixty rural women in the age group 30-59 years were randomly selected (and age-wise stratified, from a coastal village in Southern India. Methods: Women were educated on breast health and breast self-examination by specifically trained health workers and their awareness and proficiency levels were evaluated at the end of 1 and 3 months postintervention. Statistical analysis: This was done using the Statistical Package for Social Sciences Version 10. Results: Following the educational intervention, a significant increase in overall awareness regarding breast cancer (z=-15.807; P<0.001 as well as in the performance of self-examination of the breast 321/342 (93% was observed. Forgetfulness or being too busy appeared to be the two most frequently perceived barriers. Conclusion: This study clearly shows that a community oriented educational intervention programme emphasizing on proper technique can bring about the desirable behavioural change among women.

  3. [The cultural aspects of the practice of Community Health Agents in rural areas].

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    Lara, Maristela Oliveira; Brito, Maria José Menezes; Rezende, Lilian Cristina

    2012-06-01

    The daily practice of Community Health Agents (CHAs) is permeated with educational interventions aimed at preventive care and health promotion. The sociocultural universe of these professionals can affect the dynamics of their practice within the community, particularly in rural areas, where there is evidence that the population expects to obtain information relative to their health and/or disease by means of cultural rites. Based on a case study, we sought to analyze the influence of the cultural practices of the agents working in a rural area in the interior of the state of Minas Gerais. The analysis revealed the presence of a strong connection between the culture and their activities. Religious beliefs and knowledge developed from the fusion of biomedical information and values based on family tradition regarding the health-disease process have a direct effect on their practices. It is emphasized that they have an important role as facilitators in the practice of health care, with a positive effect stemming from the similarity of their life experiences and inherited cultures with those of the clients, thus making it possible to develop effective interventions.

  4. Equity of inpatient health care in rural Tanzania: a population- and facility-based survey

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    Ferry Grace A

    2012-02-01

    Full Text Available Abstract Objective To explore the equity of utilization of inpatient health care at rural Tanzanian health centers through the use of a short wealth questionnaire. Methods Patients admitted to four rural health centers in the Kigoma Region of Tanzania from May 2008 to May 2009 were surveyed about their illness, asset ownership and demographics. Principal component analysis was used to compare the wealth of the inpatients to the wealth of the region's general population, using data from a previous population-based survey. Results Among inpatients, 15.3% were characterized as the most poor, 19.6% were characterized as very poor, 16.5% were characterized as poor, 18.9% were characterized as less poor, and 29.7% were characterized as the least poor. The wealth distribution of all inpatients (p Conclusion The findings indicated that while current Tanzanian health financing policies may have improved access to health care for children under five, additional policies are needed to further close the equity gap, especially for obstetric inpatients.

  5. Development and Evaluation of Training for Rural LGBTQ Mental Health Peer Advocates.

    Science.gov (United States)

    Israel, Tania; Willging, Cathleen; Ley, David

    2016-01-01

    Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) people in rural areas experience negative mental health consequences of minority stress, and encounter multiple barriers to accessing mental health and substance use treatment services. As part of a larger intervention study, we developed and piloted a unique training program to prepare peer advocates for roles as paraprofessionals who assist rural LGBTQ people with mental health needs. Thirty-seven people in New Mexico took part in either the initial training or a second revised training to improve their knowledge and skills to address LGBTQ mental health needs. Evaluation of this training consisted of self-administered structured assessments, focus groups, and open-ended interviews. Results for the initial training showed no significant increases from pre- and post-test scores on knowledge about LGBTQ people and their mental health issues, whereas significant increases were detected for the revised training. There also were significant increases in self-efficacy to perform tasks associated with the peer advocate role for all but a subset of tasks for the revised training. Qualitative data reveal that participants appreciated the opportunity to increase information and skills, especially concerning bisexual and transgender persons, and the opportunity to connect with others in the community who want to support LGBTQ people.

  6. Explanatory models and mental health treatment: is vodou an obstacle to psychiatric treatment in rural Haiti?

    Science.gov (United States)

    Khoury, Nayla M; Kaiser, Bonnie N; Keys, Hunter M; Brewster, Aimee-Rika T; Kohrt, Brandon A

    2012-09-01

    Vodou as an explanatory framework for illness has been considered an impediment to biomedical psychiatric treatment in rural Haiti by some scholars and Haitian professionals. According to this perspective, attribution of mental illness to supernatural possession drives individuals to seek care from houngan-s (Vodou priests) and other folk practitioners, rather than physicians, psychologists, or psychiatrists. This study investigates whether explanatory models of mental illness invoking supernatural causation result in care-seeking from folk practitioners and resistance to biomedical treatment. The study comprised 31 semi-structured interviews with community leaders, traditional healers, religious leaders, and biomedical providers, 10 focus group discussions with community members, community health workers, health promoters, community leaders, and church members; and four in-depth case studies of individuals exhibiting mental illness symptoms conducted in Haiti's Central Plateau. Respondents invoked multiple explanatory models for mental illness and expressed willingness to receive treatment from both traditional and biomedical practitioners. Folk practitioners expressed a desire to collaborate with biomedical providers and often referred patients to hospitals. At the same time, respondents perceived the biomedical system as largely ineffective for treating mental health problems. Explanatory models rooted in Vodou ethnopsychology were not primary barriers to pursuing psychiatric treatment. Rather, structural factors including scarcity of treatment resources and lack of psychiatric training among health practitioners created the greatest impediments to biomedical care for mental health concerns in rural Haiti.

  7. Utilization of Functional Exercises to Build Regional Emergency Preparedness among Rural Health Organizations in the US.

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    Obaid, Jannah M; Bailey, Ginger; Wheeler, Heidi; Meyers, Laura; Medcalf, Sharon J; Hansen, Keith F; Sanger, Kristine K; Lowe, John J

    2017-01-30

    Rural communities face barriers to disaster preparedness and considerable risk of disasters. Emergency preparedness among rural communities has improved with funding from federal programs and implementation of a National Incident Management System. The objective of this project was to design and implement disaster exercises to test decision making by rural response partners to improve regional planning, collaboration, and readiness. Six functional exercises were developed and conducted among three rural Nebraska (USA) regions by the Center for Preparedness Education (CPE) at the University of Nebraska Medical Center (Omaha, Nebraska USA). A total of 83 command centers participated. Six functional exercises were designed to test regional response and command-level decision making, and each 3-hour exercise was followed by a 3-hour regional after action conference. Participant feedback, single agency debriefing feedback, and regional After Action Reports were analyzed. Functional exercises were able to test command-level decision making and operations at multiple agencies simultaneously with limited funding. Observations included emergency management jurisdiction barriers to utilization of unified command and establishment of joint information centers, limited utilization of documentation necessary for reimbursement, and the need to develop coordinated public messaging. Functional exercises are a key tool for testing command-level decision making and response at a higher level than what is typically achieved in tabletop or short, full-scale exercises. Functional exercises enable evaluation of command staff, identification of areas for improvement, and advancing regional collaboration among diverse response partners. Obaid JM , Bailey G , Wheeler H , Meyers L , Medcalf SJ , Hansen KF , Sanger KK , Lowe JJ . Utilization of functional exercises to build regional emergency preparedness among rural health organizations in the US. Prehosp Disaster Med. 2017;32(2):1-7.

  8. Ambulatory health services utilization in patients with dementia - Is there an urban-rural difference?

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    Glaeske Gerd

    2010-11-01

    Full Text Available Abstract Background Due to demographic changes and an un-equal distribution of physicians, regional analyses of service utilization of elderly patients are crucial, especially for diseases with an impact like dementia. This paper focuses on dementia patients. The aim of the study is to identify differences in service utilization of incident dementia patients in urban and rural areas. Methods Basis for the analysis were all insured persons of a German Health Insurance fund (the GEK aged 65 years and older living in rural and urban areas. We focussed on physician contacts in the outpatient sector during the first year after an incidence diagnosis of dementia. Special attention was given to contacts with primary care physicians and neurologists/psychiatrists. The dementia cohort was analyzed together with a non-dementia control group drawn according to age, gender and amount of physician contacts. Uni- and bivariate as well as multivariate analysis were performed to estimate the influences on service utilization. Results Results show that the provision of primary care seems to be equally given in urban and rural areas. For specialists contacts however, rural patients are less likely to consult neurologists or psychiatrists. This trend can already be seen before the incident diagnosis of dementia. All consultations rise in the quarter of the incident dementia diagnosis compared to the control group. The results were also tested in a linear and a logistic regression, showing a higher chance for persons living in urban areas to visit a specialist and an overall higher rate in service utilization for dementia patients. Conclusions Because of a probable increase in the number of dementia patients, service provision has to be accessible even in rural areas. Due to this and the fact that demographic change is happening at different paces in different regions, regional variations have to be considered to ensure the future service provision.

  9. Barriers in health care access faced by children with intellectual disabilities living in rural Uttar Pradesh

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    Jubin Varghese

    2015-09-01

    Full Text Available Purpose: People with disability in rural India face multiple barriers accessing healthcare; our hypothesis is that children with intellectual disability suffer the same but little is known about the barriers faced by them. The objectives of the study were to identify the health seeking behaviours of families with children with intellectual disabilities and the barriers they faced accessing healthcare. Methods: This qualitative study involved interviewing caregivers of children with intellectual disability from a pre-existing community development project in the Sahadoli Kadim block of rural Uttar Pradesh. Semi-structured interviews were also conducted with the local practitioners frequented by these caregivers. Results: Barriers identified were grouped under cognitive, structural and financial barriers which were found to be consistent with the Health Care Access Barrier Model (Carrillo, et al., 2011; WHO, 2011. Cognitive barriers included caregivers being unable to identify the complex health needs of their children. Caregivers lacked appropriate knowledge of intellectual disability, with doctors failing to educate them. Structural and financial barriers encompassed poor availability of healthcare providers and contributed to poor access to specialists. Caregivers had no information about government financial aid and healthcare providers did not refer them to these. Conclusion: Children with intellectual disabilities are forced to live with a poor quality of life because of cognitive, structural and financial barriers they face in accessing health care. Results are specific to children with intellectual disability in rural Sahadoli Kadim and could be used to inform policies and strategies to reduce disparities in health care access for these children.

  10. Application of Handheld Tele-ECG for Health Care Delivery in Rural India

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    Meenu Singh

    2014-01-01

    Full Text Available Telemonitoring is a medical practice that involves remotely monitoring patients who are not at the same location as the health care provider. The purpose of our study was to use handheld tele-electrocardiogram (ECG developed by Bhabha Atomic Research Center (BARC to identify heart conditions in the rural underserved population where the doctor-patient ratio is low and access to health care is difficult. The objective of our study was clinical validation of handheld tele-ECG as a screening tool for evaluation of cardiac diseases in the rural population. ECG was obtained in 450 individuals (mean age 31.49 ± 20.058 residing in the periphery of Chandigarh, India, from April 2011 to March 2013, using the handheld tele-ECG machine. The data were then transmitted to physicians in Postgraduate Institute of Medical Education and Research (PGIMER, Chandigarh, for their expert opinion. ECG was interpreted as normal in 70% individuals. Left ventricular hypertrophy (9.3% was the commonest abnormality followed closely by old myocardial infarction (5.3%. Patient satisfaction was reported to be ~95%. Thus, it can be safely concluded that tele-ECG is a portable, cost-effective, and convenient tool for diagnosis and monitoring of heart diseases and thus improves quality and accessibility, especially in rural areas.

  11. Community health workers as cultural producers in addressing gender-based violence in rural South Africa.

    Science.gov (United States)

    de Lange, Naydene; Mitchell, Claudia

    2016-01-01

    South Africa has been experiencing an epidemic of gender-based violence (GBV) for a long time and in some rural communities health workers, who are trained to care for those infected with HIV, are positioned at the forefront of addressing this problem, often without the necessary support. In this article, we pose the question: How might cultural production through media making with community health workers (CHWs) contribute to taking action to address GBV and contribute to social change in a rural community? This qualitative participatory arts-based study with five female CHWs working from a clinic in a rural district of South Africa is positioned as critical research, using photographs in the production of media posters. We offer a close reading of the data and its production and discuss three data moments: CHWs drawing on insider cultural knowledge; CHWs constructing messages; and CHWs taking action. In our discussion, we take up the issue of cultural production and then offer concluding thoughts on 'beyond engagement' when the researchers leave the community.

  12. The relationship between stigma and self-reported willingness to use mental health services among rural and urban older adults.

    Science.gov (United States)

    Stewart, Hannah; Jameson, John Paul; Curtin, Lisa

    2015-05-01

    The large number of rural older adults suffering from untreated psychiatric illnesses suggests that stigma may be a significant barrier to the utilization of mental health services in this population. The current study examines self-stigma, public stigma, and attitudes toward specialty mental health care in a community sample of older adults living in a geographically isolated rural area, a rural area adjacent to a metropolitan area, and an urban area. One hundred and 29 older adults age 60 and above from the 3 geographic areas completed self-report measures of these constructs, and differences on the measures were assessed among the groups. Results indicated that older adults living in isolated rural counties demonstrated higher levels of public and self-stigma and lower levels of psychological openness than older adults in urban areas even after accounting for education, employment, and income. However, no differences emerged in reported willingness to use specialized mental health care in the event of significant distress. Results are discussed in the context of rural values, beliefs, and community structural factors. We further suggest that conventional binary rural/urban distinctions are not sufficient to understand the relationship between rurality and stigma. (c) 2015 APA, all rights reserved).

  13. Assessing young unmarried men's access to reproductive health information and services in rural India

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    Saavala Minna

    2011-06-01

    Full Text Available Abstract Background We investigated the accessibility of reproductive health information and contraceptives in a relatively less developed area of rural central India and assessed the risks facing young unmarried men. Methods This cross-sectional study used both qualitative and quantitative methods. Participants included 38 unmarried rural men in four focus-group discussions and a representative sample of 316 similarly profiled men, aged 17-22 years, in a survey. Information was collected on the men's socioeconomic characteristics; awareness, knowledge, and perceptions of family planning; attitudes toward future contraceptive use; intra-family communication; knowledge about STIs/HIV/AIDS; and access and use of condoms. Content analysis for qualitative information and descriptive analysis for survey data were used to draw conclusions. Results Young unmarried rural Indian men's sexual and reproductive health (SRH knowledge is limited, although the majority is familiar with condoms (99%. The young men identified electronic mass media (67% as the prime source of reproductive health information, yet they lacked detailed knowledge of various contraceptives and felt ignored by health providers, who, they felt, would be capable of providing SRH information through interpersonal communication. Young men are more concerned about avoiding infections and securing sexual pleasure and less concerned about avoiding potential pregnancies. For example, 68% of the young men were aware of condoms and their HIV/AIDS preventive role, but only about two-fifths mentioned condom use to prevent unwanted pregnancies. Although most young men (96% knew where to access a condom, they felt uncomfortable or embarrassed doing so in their own villages or close by because of socio-cultural norms that prevented them from using contraceptives. Very few respondents (4% disclosed using condoms themselves, but 59% said they knew someone from their peer group who had used them

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

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    Sychareun Vanphanom

    2012-08-01

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

  15. Assessing young unmarried men's access to reproductive health information and services in rural India.

    Science.gov (United States)

    Char, Arundhati; Saavala, Minna; Kulmala, Teija

    2011-06-17

    We investigated the accessibility of reproductive health information and contraceptives in a relatively less developed area of rural central India and assessed the risks facing young unmarried men. This cross-sectional study used both qualitative and quantitative methods. Participants included 38 unmarried rural men in four focus-group discussions and a representative sample of 316 similarly profiled men, aged 17-22 years, in a survey. Information was collected on the men's socioeconomic characteristics; awareness, knowledge, and perceptions of family planning; attitudes toward future contraceptive use; intra-family communication; knowledge about STIs/HIV/AIDS; and access and use of condoms. Content analysis for qualitative information and descriptive analysis for survey data were used to draw conclusions. Young unmarried rural Indian men's sexual and reproductive health (SRH) knowledge is limited, although the majority is familiar with condoms (99%). The young men identified electronic mass media (67%) as the prime source of reproductive health information, yet they lacked detailed knowledge of various contraceptives and felt ignored by health providers, who, they felt, would be capable of providing SRH information through interpersonal communication. Young men are more concerned about avoiding infections and securing sexual pleasure and less concerned about avoiding potential pregnancies. For example, 68% of the young men were aware of condoms and their HIV/AIDS preventive role, but only about two-fifths mentioned condom use to prevent unwanted pregnancies. Although most young men (96%) knew where to access a condom, they felt uncomfortable or embarrassed doing so in their own villages or close by because of socio-cultural norms that prevented them from using contraceptives. Very few respondents (4%) disclosed using condoms themselves, but 59% said they knew someone from their peer group who had used them. Young unmarried men in rural India are underserved with

  16. Attraction and retention of qualified health workers to rural areas in Nigeria: a case study of four LGAs in Ogun State, Nigeria.

    Science.gov (United States)

    Ebuehi, Olufunke M; Campbell, Princess C

    2011-01-01

    INTRTODUCTION: A shortage of health workers is a major problem for Nigeria, especially in rural areas where more than 70% of the population live. At the primary care level, trained community health officers provide services normally reserved for doctors or medical specialists. The community health officers must therefore be supported and motivated to provide effective quality healthcare services. This study aimed to determine factors that will attract and retain rural and urban health workers to rural Nigerian communities, and to examine differences between the two groups. A cross-sectional survey measured health workers' work experience, satisfaction with, and reasons for undertaking their current work; as well as reasons for leaving a work location. Data were also gathered on factors that attract health workers to rural settings and also retain them. RESULTS; Rural health workers were generally more likely to work in rural settings (62.5%) than their urban counterparts (16.5%). Major rural motivators for both groups included: assurances of better working conditions; effective and efficient support systems; opportunities for career development; financial incentives; better living conditions and family support systems. The main de-motivator was poor job satisfaction resulting from inadequate infrastructure. Rural health workers were particularly dissatisfied with career advancement opportunities. More urban than rural health workers expressed a wish to leave their current job due to poor job satisfaction resulting from poor working and living conditions and the lack of career advancement opportunities. Motivational factors for attraction to and retention in rural employment were similar for both groups although there were subtle differences. Addressing rural health manpower shortages will require the development of a comprehensive, evidence-based rural health manpower improvement strategy that incorporates a coordinated intersectoral approach, involving partnership

  17. Assessments of wind-energy potential in selected sites from three geopolitical zones in Nigeria: implications for renewable/sustainable rural electrification.

    Science.gov (United States)

    Okeniyi, Joshua Olusegun; Ohunakin, Olayinka Soledayo; Okeniyi, Elizabeth Toyin

    2015-01-01

    Electricity generation in rural communities is an acute problem militating against socioeconomic well-being of the populace in these communities in developing countries, including Nigeria. In this paper, assessments of wind-energy potential in selected sites from three major geopolitical zones of Nigeria were investigated. For this, daily wind-speed data from Katsina in northern, Warri in southwestern and Calabar in southeastern Nigeria were analysed using the Gumbel and the Weibull probability distributions for assessing wind-energy potential as a renewable/sustainable solution for the country's rural-electrification problems. Results showed that the wind-speed models identified Katsina with higher wind-speed class than both Warri and Calabar that were otherwise identified as low wind-speed sites. However, econometrics of electricity power simulation at different hub heights of low wind-speed turbine systems showed that the cost of electric-power generation in the three study sites was converging to affordable cost per kWh of electric energy from the wind resource at each site. These power simulations identified cost/kWh of electricity generation at Kaduna as €0.0507, at Warri as €0.0774, and at Calabar as €0.0819. These bare positive implications on renewable/sustainable rural electrification in the study sites even as requisite options for promoting utilization of this viable wind-resource energy in the remote communities in the environs of the study sites were suggested.

  18. Ecosystem health evaluation system of the water-fluctuating zone in the Three Gorges Area

    Institute of Scientific and Technical Information of China (English)

    WANG Li-ao; YUAN Hui; ZHANG Yan-hui; HU Gang

    2004-01-01

    This paper discribes the definition of ecosystem health for the water-level flutuation zone of the Three Gorges Region and puts forward an evaluation system involving indicators in three groups: 1) structural indicators comprise slope, biodiversity,environmental capacity, stability, restoration ability and damage situation; 2) functional indicators including probability of geological hazard, erosion rate, habitat rate, land use intension and days of tourist season; 3) environmental indicatiors made up of population quality, potential intension of human, ground water quality, ambient air quality, wastewater treatment rate, pesticide use rate, fertilizer use rate, environmental management and public participation. In the design of the system, the subject zone is regarded as the type similar to wetland and the impacts of human activities on the zone are attached great importance to.

  19. Assessment of pharmacists’ delivery of public health services in rural and urban areas in Iowa and North Dakota

    OpenAIRE

    Scott DM; Strand M; Undem T; Anderson G; Clarens A; liu X.

    2016-01-01

    Background: The profession of pharmacy is expanding its involvement in public health, but few studies have examined pharmacists’ delivery of public health services. Objective: To assess Iowa and North Dakota pharmacists’ practices, frequency of public health service delivery, level of involvement in achieving the essential services of public health, and barriers to expansion of public health services in rural and urban areas. Methods: This study implemented an on-line survey sent to al...

  20. Geospatial Technology in Disease Mapping, E- Surveillance and Health Care for Rural Population in South India

    Science.gov (United States)

    Praveenkumar, B. A.; Suresh, K.; Nikhil, A.; Rohan, M.; Nikhila, B. S.; Rohit, C. K.; Srinivas, A.

    2014-11-01

    Providing Healthcare to rural population has been a challenge to the medical service providers especially in developing countries. For this to be effective, scalable and sustainable, certain strategic decisions have to be taken during the planning phase. Also, there is a big gap between the services available and the availability of doctors and medical resources in rural areas. Use of Information Technology can aid this deficiency to a good extent. In this paper, a mobile application has been developed to gather data from the field. A cloud based interface has been developed to store the data in the cloud for effective usage and management of the data. A decision tree based solution developed in this paper helps in diagnosing a patient based on his health parameters. Interactive geospatial maps have been developed to provide effective data visualization facility. This will help both the user community as well as decision makers to carry out long term strategy planning.

  1. How do small rural primary health care services sustain themselves in a constantly changing health system environment?

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    Buykx Penny

    2012-03-01

    Full Text Available Abstract Background The ability to sustain comprehensive primary health care (PHC services in the face of change is crucial to the health of rural communities. This paper illustrates how one service has proactively managed change to remain sustainable. Methods A 6-year longitudinal evaluation of the Elmore Primary Health Service (EPHS located in rural Victoria, Australia, is currently underway, examining the performance, quality and sustainability of the service. Threats to, and enablers of, sustainability have been identified from evaluation data (audit of service indicators, community surveys, key stakeholder interviews and focus groups and our own observations. These are mapped against an overarching framework of service sustainability requirements: workforce organisation and supply; funding; governance, management and leadership; service linkages; and infrastructure. Results Four years into the evaluation, the evidence indicates EPHS has responded effectively to external and internal changes to ensure viability. The specific steps taken by the service to address risks and capitalise on opportunities are identified. Conclusions This evaluation highlights lessons for health service providers, policymakers, consumers and researchers about the importance of ongoing monitoring of sentinel service indicators; being attentive to changes that have an impact on sustainability; maintaining community involvement; and succession planning.

  2. Accessing health care in a rural area: an evaluation of a voluntary medical transport scheme in the English Midlands.

    Science.gov (United States)

    Sherwood, K B; Lewis, G J

    2000-12-01

    In recent years notions of self-help and voluntarism have emerged as key elements in the delivery of services in rural England. This paper explores these themes by reference to 'Rural Wheels', a voluntary medical transport scheme in rural Northamptonshire, introduced to overcome the closure of branch surgeries and to provide access to a new medical centre. By focusing upon the organisation and operations of the scheme, the paper highlights the important role it plays in the welfare of rural residents, particularly elderly women. Yet, because effectively it is run by a small core group, the paper raises questions not just about the viability of this scheme but also about the increasing commitment of central government to the voluntary sector as a means of delivering health care to rural people.

  3. mHealth and the management of chronic conditions in rural areas: a note of caution from southern India.

    Science.gov (United States)

    Nahar, Papreen; Kannuri, Nanda Kishore; Mikkilineni, Sitamma; Murthy, G V S; Phillimore, Peter

    2017-04-01

    This article examines challenges facing implementation of likely mHealth programmes in rural India. Based on fieldwork in Andhra Pradesh in 2014, and taking as exemplars two chronic medical 'conditions' - type 2 diabetes and depression - we look at ways in which people in one rural area currently access medical treatment; we also explore how adults there currently use mobile phones in daily life, to gauge the realistic likelihood of uptake for possible mHealth initiatives. We identify the very different pathways to care for these two medical conditions, and we highlight the importance to the rural population of healthcare outside the formal health system provided by those known as registered medical practitioners (RMP), who despite their title are neither registered nor trained. We also show how limited is the use currently made of very basic mobile phones by the majority of the older adult population in this rural context. Not only may this inhibit mHealth potential in the near future; just as importantly, our data suggest how difficult it may be to identify a clinical partner for patients or their carers for any mHealth application designed to assist the management of chronic ill-health in rural India. Finally, we examine how the promotion of patient 'self-management' may not be as readily translated to a country like India as proponents of mHealth might assume.

  4. Valuing health effects from the industrial air pollution in rural Tianjin,China

    Institute of Scientific and Technical Information of China (English)

    YANG Zhi-feng; XU Lin-yu

    2004-01-01

    High concentrations of air pollutants such as total suspended particulates(TSP) and sulfur dioxide(SO2 ) have serious impacts on nearby populations. In this paper, a survey of rural Tianjin residents' willingness-to-pay for health improvement was reported on, and the MBDC( multiple bounded discrete choice) model was adopted to study the respondents' willingness-to-pay to prevent respiratory illnesses.The results showed that the willingness-to-pay for health improvement was affected by respondents' health condition, work situation and environmental awareness, but not by personal habits, such as smoking. If person's willingness-to-pay to avoid respiratory diseases can be considered equal to the cost to personal health caused by air pollution, the total cost will reach 538 x 106 RMB Yuan( RMB, equal to 65million USD) per year.

  5. Attracting and retaining health workers in rural areas: investigating nurses’ views on rural posts and policy interventions

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    Goodman Catherine

    2010-07-01

    Full Text Available Abstract Background Kenya has bold plans for scaling up priority interventions nationwide, but faces major human resource challenges, with a lack of skilled workers especially in the most disadvantaged rural areas. Methods We investigated reasons for poor recruitment and retention in rural areas and potential policy interventions through quantitative and qualitative data collection with nursing trainees. We interviewed 345 trainees from four purposively selected Medical Training Colleges (MTCs (166 pre-service and 179 upgrading trainees with prior work experience. Each interviewee completed a self-administered questionnaire including likert scale responses to statements about rural areas and interventions, and focus group discussions (FGDs were conducted at each MTC. Results Likert scale responses indicated mixed perceptions of both living and working in rural areas, with a range of positive, negative and indifferent views expressed on average across different statements. The analysis showed that attitudes to working in rural areas were significantly positively affected by being older, but negatively affected by being an upgrading student. Attitudes to living in rural areas were significantly positively affected by being a student at the MTC furthest from Nairobi. During FGDs trainees raised both positive and negative aspects of rural life. Positive aspects included lower costs of living and more autonomy at work. Negative issues included poor infrastructure, inadequate education facilities and opportunities, higher workloads, and inadequate supplies and supervision. Particular concern was expressed about working in communities dominated by other tribes, reflecting Kenya’s recent election-related violence. Quantitative and qualitative data indicated that students believed several strategies could improve rural recruitment and retention, with particular emphasis on substantial rural allowances and the ability to choose their rural location

  6. Effect of rural residence on use of VHA mental health care among OEF/OIF veterans.

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    Hudson, Teresa J; Fortney, John C; Williams, James Silas; Austen, Mark A; Pope, Sandra K; Hayes, Corey J

    2014-12-01

    The Veterans Health Administration (VHA) has worked to increase availability of mental health treatment for rural veterans. The objective was to understand the impact of rural residence on screening for, diagnosis of, and treatment for depression and posttraumatic stress disorder (PTSD) among veterans of Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) using VHA care. A cohort of veterans from a five-state region was identified whose first VHA clinic visit occurred between January 1, 2008, and March 17, 2009. The cohort was retrospectively followed for three months to identify a cohort who used VHA care at least twice. The sample included 4,782 OEF/OIF veterans known to be using VHA care; mean age was 31 years (range 18-64); most were male (88%). Screening rates were 85% for depression and 84% for PTSD. Compared with veterans in small or isolated rural towns, those in urban areas were less likely to be diagnosed as having PTSD (odds ratio [OR]=.79, 95% confidence interval [CI]=.66-.95, p<.05) and less likely to receive psychotropic medications (OR=.52, CI=.33-.79, p<.01) or psychotherapy (OR=.61, CI=.40-.94, p<.05) for PTSD. Veterans living in urban areas were also less likely to receive antidepressants (OR=.56, CI=.32-.98, p<.05) or psychotherapy (OR=.61, CI=.40-.93, p<.05) for treatment of depression. Among veterans who used VHA care at least twice, those living in urban areas were less likely than those living in rural areas to receive diagnoses of and treatment for PTSD and depression.

  7. Smart density: a more accurate method of measuring rural residential density for health-related research

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    Gibson Lucinda

    2010-02-01

    Full Text Available Abstract Background Studies involving the built environment have typically relied on US Census data to measure residential density. However, census geographic units are often unsuited to health-related research, especially in rural areas where development is clustered and discontinuous. Objective We evaluated the accuracy of both standard census methods and alternative GIS-based methods to measure rural density. Methods We compared residential density (units/acre in 335 Vermont school neighborhoods using conventional census geographic units (tract, block group and block with two GIS buffer measures: a 1-kilometer (km circle around the school and a 1-km circle intersected with a 100-meter (m road-network buffer. The accuracy of each method was validated against the actual residential density for each neighborhood based on the Vermont e911 database, which provides an exact geo-location for all residential structures in the state. Results Standard census measures underestimate residential density in rural areas. In addition, the degree of error is inconsistent so even the relative rank of neighborhood densities varies across census measures. Census measures explain only 61% to 66% of the variation in actual residential density. In contrast, GIS buffer measures explain approximately 90% of the variation. Combining a 1-km circle with a road-network buffer provides the closest approximation of actual residential density. Conclusion Residential density based on census units can mask clusters of development in rural areas and distort associations between residential density and health-related behaviors and outcomes. GIS-defined buffers, including a 1-km circle and a road-network buffer, can be used in conjunction with census data to obtain a more accurate measure of residential density.

  8. Does the Universal Health Insurance Program Affect Urban-Rural Differences in Health Service Utilization among the Elderly? Evidence from a Longitudinal Study in Taiwan

    Science.gov (United States)

    Liao, Pei-An; Chang, Hung-Hao; Yang, Fang-An

    2012-01-01

    Purpose: To assess the impact of the introduction of Taiwan's National Health Insurance (NHI) on urban-rural inequality in health service utilization among the elderly. Methods: A longitudinal data set of 1,504 individuals aged 65 and older was constructed from the Survey of Health and Living Status of the Elderly. A difference-in-differences…