WorldWideScience

Sample records for traditional health plans

  1. The role of traditional healers in the provision of health care and family planning services: Sinseh.

    Science.gov (United States)

    Kuek, K; Liow, T S

    1985-01-01

    The Chinese traditional medical system and pharmacology have a 1000-year history, and practitioners of Chinese traditional medicine play an important role in providing health care and family planning services in China. Vast numbers of patients from all walks of life and of all races benefit from Chinese traditional medicine. Although there are no official government records on the activities of practitioners of traditional medicine, the Chinese charitable medical organizations have some data on the nature of available services and their use. In China, in the context of significant government investment in health care facilities throughout the country and the proliferation of private hospitals, specialist centers, and general practitioners providing modern health care, the number of Chinese traditional charity medical aid departments, instead of falling by the wayside, has increased. The Chinese Traditional Medicine and Physician and Medicine Dealers Association of Malaysia was established 27 years ago. There are now officially 719 Chinese physicians and 1869 medical halls and Chinese physician infirmaries in Malaysia. The authors describe the status of Chinese physicians and medical halls in Malaysia, charitable organizations, and applications of Chinese traditional medicine.

  2. HMOs outscore both PPOs, traditional indemnity plans in degree of customer satisfaction.

    Science.gov (United States)

    Jensen, J

    1992-12-14

    A higher percentage of participants in health maintenance organizations say they are satisfied with their health plans than are those who have traditional indemnity plans or are enrolled in preferred provider organizations. The results, derived from a new study of consumer satisfaction, also show that 85% of Americans who have health insurance coverage say they are satisfied with those plans.

  3. Achieving compliance with environmental health-related land use planning conditions in Hong Kong: perspectives from traditional motivation theories.

    Science.gov (United States)

    Man, Rita Li Yi

    2009-11-01

    Environmental health-related land use planning conditions can enhance the environment in Hong Kong. Previous research by others has shown, however, that a lack of compliance with planning conditions often occurs. And as no direct enforcement of planning conditions exists in Hong Kong, it is of interest to understand possible ways in which to increase the motivation of land developers and property owners to comply with planning conditions. The author looked at motivation from the perspective of three traditional motivation theories: Theory X, Theory Y, and incentive theory. While the majority of this article focuses on the enforcement and the legal tests in land use planning conditions, it also presents the results of the first study of the motivations behind Hong Kong land developers to comply with land use planning conditions.

  4. Health Plan Performance Measurement within Medicare Subvention.

    Science.gov (United States)

    1998-06-01

    the causes of poor performance (Siren & Laffel, 1996). Although outcomes measures such as nosocomial infection rates, admission rates for select...defined. Traditional outcomes measures include infection rates, morbidity, and mortality. The problem with these traditional measures is... Maternal /Child Care Indicators Nursing Staffing Indicators Outcome Indicators Technical Outcomes Plan Performance Stability of Health Plan

  5. The role of traditional healers in the provision of health care and family planning services: Malay traditional and indigenous medicine.

    Science.gov (United States)

    Raden Sanusi, H R; Werner, R

    1985-01-01

    The practitioners of traditional and indigenous medicine rely mainly upon medicinal plants and herbs for the preparation of therapeutic substances. The therapeutic properties of several medicinal plants and popular traditional medicine remedies are being investigated and validated. Present health care systems place people from developing countries in a dilemma. Countries can either continue providing a type of health care which cannot be extended to all in need or rethink and offer more inclusive types of medical care and delivery systems. Traditional medicine has a clear role to play in society, and even the World Health Organization supports the practice of traditional medicine to complement modern medicine. Traditional Malay medicine is the distillation of vast historical experience dating back more than 1000 years. It is often based upon observation, clinical trials, and experiments. The promotion and development of Malay traditional medicine can both foster dignity and self-confidence in communities through self-reliance, while considerably reducing the country's drug costs. The integrity and dignity of a people stems from self-respect and self-reliance. The practice of traditional medicine practitioners can help promote such conditions in many ways. It serves as an important focus for international technical cooperation and offers the potential for major breakthroughs in therapeutics and health care delivery. Effort should be taken to keep the practice of traditional medicine alive in Malaysia.

  6. The role of traditional healers in the provision of health care and family planning services: Ayurveda and Sidda.

    Science.gov (United States)

    Bin Mohammed, A; Abdul Raheem, K P; Kaivalyam, K

    1985-01-01

    The Ayurvedic manuscript was first composed in Sanskrit by Agnivesha, an individual who lived sometime before 750 B.C. The Ayurveda contains instructions on how to live in order to prevent the occurrence of sickness and how to cure it, if illness arises. The medical work of Ayurveda is comprised of elements of Physiology, Pathology, Pharmacology, Materia Medica, and Surgery, among others. It originally consisted of 100 sections each with 1000 stanzas comprising up to 100,000 verses in eight books. All recent medical works on Ayurveda are based upon the writings of Charaka and Sushruta, who rearranged the books into chapters on surgery, nosology, anatomy, therapeutics, toxicology, and local diseases. The authors explain the use of traditional medicine for health and family planning, and the extent of self-medication in sections on the role of Ayurvedic medicine for health, clinics and medical centers on Ayurveda in Malaysia, oleo-therapy/massage through the application of medicated oil and liniment, institutions and laboratories, research, the extent of self-medication, family planning, and Malaysian Ayurvedic or the Siddha practice of contraception.

  7. The importance of traditional healers in the planning of rural ...

    African Journals Online (AJOL)

    The importance of traditional healers in the planning of rural healthcare ... Journal of Science and Technology (Ghana) ... There has been increasing debate on whether traditional healers actually matter in planning for healthcare delivery and ...

  8. Family planning uses traditional theater in Mali.

    Science.gov (United States)

    Schubert, J

    1988-01-01

    Mali's branch of the International Planned Parenthood Federation has found a vehicle that effectively conveys the idea of family planning through the use of contraception, a method that blends the country's cultural heritage and modern technology. Despite becoming the first sub-Saharan francophone country to promote family planning, Mali only counted 1% of its population using a modern method of contraception. So with the aid of The Johns Hopkins University/Population COmmunication Services (JHU/PCS), the Association Malienne pour la Protection et la Promotion de la Famille (AMPPF) developed several programs to promote contraception, but none were more successful than the Koteba Project, which used Mali's traditional theater form to communicate the message. While comical, the Koteba generally deals with social issues -- it informs and entertains. This particular Koteba told the story of two government employees, one with two wives and many children, the other with one wife and few children. The first one sees nothing but family problems: fighting wives and delinquent children. The second one, who had used family planning, enjoys a peaceful home. Upon hearing of his friend's successes with family planning, the tormented government employee becomes convinced of its needs, and persuades his wives to accompany him to a family planning clinic. Developed at a cost of approximately US $3000 and televised nationwide, the Koteba proved effective. A survey of 500 people attending an AMPPF clinic revealed that 1/4 of them remembered the program. With the success of the Koteba, JHU/PCS and AMPPF are now exploring other traditional channels of communication.

  9. Physician Reimbursement in Medicare Advantage Compared With Traditional Medicare and Commercial Health Insurance.

    Science.gov (United States)

    Trish, Erin; Ginsburg, Paul; Gascue, Laura; Joyce, Geoffrey

    2017-09-01

    Nearly one-third of Medicare beneficiaries are enrolled in a Medicare Advantage (MA) plan, yet little is known about the prices that MA plans pay for physician services. Medicare Advantage insurers typically also sell commercial plans, and the extent to which MA physician reimbursement reflects traditional Medicare (TM) rates vs negotiated commercial prices is unclear. To compare prices paid for physician and other health care services in MA, traditional Medicare, and commercial plans. Retrospective analysis of claims data evaluating MA prices paid to physicians and for laboratory services and durable medical equipment between 2007 and 2012 in 348 US core-based statistical areas. The study population included all MA and commercial enrollees with a large national health insurer operating in both markets, as well as a 20% sample of TM beneficiaries. Enrollment in an MA plan. Mean reimbursement paid to physicians, laboratories, and durable medical equipment suppliers for MA and commercial enrollees relative to TM rates for 11 Healthcare Common Procedure Coding Systems (HCPCS) codes spanning 7 sites of care. The sample consisted of 144 million claims. Physician reimbursement in MA was more strongly tied to TM rates than commercial prices, although MA plans tended to pay physicians less than TM. For a mid-level office visit with an established patient (Current Procedural Terminology [CPT] code 99213), the mean MA price was 96.9% (95% CI, 96.7%-97.2%) of TM. Across the common physician services we evaluated, mean MA reimbursement ranged from 91.3% of TM for cataract removal in an ambulatory surgery center (CPT 66984; 95% CI, 90.7%-91.9%) to 102.3% of TM for complex evaluation and management of a patient in the emergency department (CPT 99285; 95% CI, 102.1%-102.6%). However, for laboratory services and durable medical equipment, where commercial prices are lower than TM rates, MA plans take advantage of these lower commercial prices, ranging from 67.4% for a walker

  10. Comparison of a Restricted and Unrestricted Vegan Diet Plan with a Restricted Omnivorous Diet Plan on Health-Specific Measures.

    Science.gov (United States)

    Bloomer, Richard J; Gunnels, Trint A; Schriefer, JohnHenry M

    2015-07-14

    We have previously noted beneficial health outcomes when individuals follow a dietary restriction plan in accordance with the Daniel Fast (DF). This is true whether individuals eliminate all animal products or include small amounts of meat and dairy in their plan. The present study sought to compare anthropometric and biochemical measures of health in individuals following a traditional DF (i.e., restricted vegan) or modified DF (i.e., restricted omnivorous; inclusive of ad libitum meat and skim milk consumption), with those following an unrestricted vegan diet plan. 35 subjects (six men; 29 women; 33 ± 2 years; range: 18-67 years) completed a 21-day diet plan. Subjects reported to the lab for pre- (day 1) and post-intervention testing (day 22) in a 10 h fasted state. Blood samples were collected and assayed for complete blood count, metabolic panel, lipid panel, insulin, HOMA-IR, C-reactive protein, and oxidative stress biomarkers (malondialdehyde, advanced oxidation protein products, and nitrate/nitrite). Heart rate and blood pressure were measured and body composition was determined via dual energy X-ray absorptiometry. Subjects' self-reported compliance, mental and physical health, and satiety in relation to the dietary modification were recorded. No interaction effects were noted for our outcome measures (p > 0.05). However, subjects in the traditional DF group reported an approximate 10% increase in perceived mental and physical health, with a 25% reduction in malondialdehyde and a 33% reduction in blood insulin. Systolic BP was reduced approximately 7 mmHg in subjects assigned to the traditional DF, with an approximate 5 mmHg reduction in subjects assigned to the modified DF and the unrestricted vegan plan. A small (2 mmHg) reduction in diastolic BP was noted for subjects in both DF groups; a slight increase in diastolic BP was noted for subjects assigned to the unrestricted vegan group. An approximate 20% reduction was noted in total and LDL cholesterol

  11. Comparison of a Restricted and Unrestricted Vegan Diet Plan with a Restricted Omnivorous Diet Plan on Health-Specific Measures

    Science.gov (United States)

    Bloomer, Richard J.; Gunnels, Trint A.; Schriefer, JohnHenry M.

    2015-01-01

    Background: We have previously noted beneficial health outcomes when individuals follow a dietary restriction plan in accordance with the Daniel Fast (DF). This is true whether individuals eliminate all animal products or include small amounts of meat and dairy in their plan. The present study sought to compare anthropometric and biochemical measures of health in individuals following a traditional DF (i.e., restricted vegan) or modified DF (i.e., restricted omnivorous; inclusive of ad libitum meat and skim milk consumption), with those following an unrestricted vegan diet plan. Methods: 35 subjects (six men; 29 women; 33 ± 2 years; range: 18–67 years) completed a 21-day diet plan. Subjects reported to the lab for pre- (day 1) and post-intervention testing (day 22) in a 10 h fasted state. Blood samples were collected and assayed for complete blood count, metabolic panel, lipid panel, insulin, HOMA-IR, C-reactive protein, and oxidative stress biomarkers (malondialdehyde, advanced oxidation protein products, and nitrate/nitrite). Heart rate and blood pressure were measured and body composition was determined via dual energy X-ray absorptiometry. Subjects’ self-reported compliance, mental and physical health, and satiety in relation to the dietary modification were recorded. Results: No interaction effects were noted for our outcome measures (p > 0.05). However, subjects in the traditional DF group reported an approximate 10% increase in perceived mental and physical health, with a 25% reduction in malondialdehyde and a 33% reduction in blood insulin. Systolic BP was reduced approximately 7 mmHg in subjects assigned to the traditional DF, with an approximate 5 mmHg reduction in subjects assigned to the modified DF and the unrestricted vegan plan. A small (2 mmHg) reduction in diastolic BP was noted for subjects in both DF groups; a slight increase in diastolic BP was noted for subjects assigned to the unrestricted vegan group. An approximate 20% reduction was

  12. Comparison of a Restricted and Unrestricted Vegan Diet Plan with a Restricted Omnivorous Diet Plan on Health-Specific Measures

    Directory of Open Access Journals (Sweden)

    Richard J. Bloomer

    2015-07-01

    Full Text Available Background: We have previously noted beneficial health outcomes when individuals follow a dietary restriction plan in accordance with the Daniel Fast (DF. This is true whether individuals eliminate all animal products or include small amounts of meat and dairy in their plan. The present study sought to compare anthropometric and biochemical measures of health in individuals following a traditional DF (i.e., restricted vegan or modified DF (i.e., restricted omnivorous; inclusive of ad libitum meat and skim milk consumption, with those following an unrestricted vegan diet plan. Methods: 35 subjects (six men; 29 women; 33 ± 2 years; range: 18–67 years completed a 21-day diet plan. Subjects reported to the lab for pre- (day 1 and post-intervention testing (day 22 in a 10 h fasted state. Blood samples were collected and assayed for complete blood count, metabolic panel, lipid panel, insulin, HOMA-IR, C-reactive protein, and oxidative stress biomarkers (malondialdehyde, advanced oxidation protein products, and nitrate/nitrite. Heart rate and blood pressure were measured and body composition was determined via dual energy X-ray absorptiometry. Subjects’ self-reported compliance, mental and physical health, and satiety in relation to the dietary modification were recorded. Results: No interaction effects were noted for our outcome measures (p > 0.05. However, subjects in the traditional DF group reported an approximate 10% increase in perceived mental and physical health, with a 25% reduction in malondialdehyde and a 33% reduction in blood insulin. Systolic BP was reduced approximately 7 mmHg in subjects assigned to the traditional DF, with an approximate 5 mmHg reduction in subjects assigned to the modified DF and the unrestricted vegan plan. A small (2 mmHg reduction in diastolic BP was noted for subjects in both DF groups; a slight increase in diastolic BP was noted for subjects assigned to the unrestricted vegan group. An approximate 20

  13. Marketing health care to employees: the structure of employee health care plan satisfaction.

    Science.gov (United States)

    Mascarenhas, O A

    1993-01-01

    Providing cost-contained comprehensive quality health care to maintain healthy and productive employees is a challenging problem for all employers. Using a representative panel of metropolitan employees, the author investigates the internal and external structure of employee satisfaction with company-sponsored health care plans. Employee satisfaction is differentiated into four meaningful groups of health care benefits, whereas its external structure is supported by the traditional satisfaction paradigms of expectation-disconfirmation, attribution, and equity. Despite negative disconfirmation, employees register sufficiently high health care satisfaction levels, which suggests some useful strategies that employers may consider implementing.

  14. The present and future roles of Traditional Health Practitioners within the formal healthcare sector of South Africa, as guided by the Traditional Health Practitioners Act No 22 (2007

    Directory of Open Access Journals (Sweden)

    Gabriel Louw

    2016-12-01

    thus a definite need to establish how the South African traditional healers are equipped to compete independently in the healthcare sector. If this is not possible, what alternatives are available to steer some of them into the country’s healthcare sector and still make them useful as health practitioners. Coupled to this need is the future status and role of the Traditional Health Practitioners Act No 22 (2007, to uphold the roles of traditional healers. Aims The study aims to determine the present and future roles of the traditional health practitioner in the South African formal healthcare sector, as guided by the Traditional Health Practitioners Act No 22 (2007. Methods This is an exploratory and descriptive study that makes use of a historical approach by means of investigation and a literature review. The emphasis is upon using current documentation such as articles, books and newspapers as primary sources to reflect upon the present and future roles of traditional health practitioners within the regulated healthcare sector of South Africa, as guided by the Traditional Health Practitioners Act No 22 (2007. The findings are offered in narrative form. Results It seems as though the professional position and foundation of the Traditional Health Practitioners Act No 22 (2007 is on a level that is meant for the governing of a healthcare group with a well-established learning and management infrastructure. This is an unfortunate situation wherein the incoming traditional healer unfortunately cannot meet the requirements at the moment. Various negative factors have affected the South African traditional healers’ development and position. These include early political out-casting and discrimination from training facilities and work opportunities in the healthcare sector under White Rule, while poor organization, strategy and future planning and a lack of self-promotion by traditional healers themselves regarding their positions and roles over the years, seem also to

  15. Who plans for health improvement? SEA, HIA and the separation of spatial planning and health planning

    International Nuclear Information System (INIS)

    Bond, Alan; Cave, Ben; Ballantyne, Rob

    2013-01-01

    This study examines whether there is active planning for health improvement in the English spatial planning system and how this varies across two regions using a combination of telephone surveys and focus group interviews in 2005 and 2010. The spatial planning profession was found to be ill-equipped to consider the health and well-being implications of its actions, whilst health professionals are rarely engaged and have limited understanding and aspirations when it comes to influencing spatial planning. Strategic Environmental Assessment was not considered to be successful in integrating health into spatial plans, given it was the responsibility of planners lacking the capacity to do so. For their part, health professionals have insufficient knowledge and understanding of planning and how to engage with it to be able to plan for health gains rather than simply respond to health impacts. HIA practice is patchy and generally undertaken by health professionals outside the statutory planning framework. Thus, whilst appropriate assessment tools exist, they currently lack a coherent context within which they can function effectively and the implementation of the Kiev protocol requiring the engagement of health professionals in SEA is not to likely improve the consideration of health in planning while there continues to be separation of functions between professions and lack of understanding of the other profession. -- Highlights: ► Health professionals have limited aspirations for health improvement through the planning system. ► Spatial planners are ill-equipped to understand the health and well-being implications of their activities. ► SEA and HIA currently do not embed health consideration in planning decisions. ► The separation of health and planning functions is problematic for the effective conduct of SEA and/or HIA

  16. Who plans for health improvement? SEA, HIA and the separation of spatial planning and health planning

    Energy Technology Data Exchange (ETDEWEB)

    Bond, Alan, E-mail: alan.bond@uea.ac.uk [InteREAM (Interdisciplinary Research in Environmental Assessment and Management), School of Environmental Sciences, University of East Anglia, Norwich, NR4 7TJ (United Kingdom); Cave, Ben, E-mail: ben.cave@bcahealth.co.uk [Ben Cave Associates Ltd., Leeds (United Kingdom); Ballantyne, Rob, E-mail: robdballantyne@gmail.com [Planning and Health Consultant, Oxfordshire (United Kingdom)

    2013-09-15

    This study examines whether there is active planning for health improvement in the English spatial planning system and how this varies across two regions using a combination of telephone surveys and focus group interviews in 2005 and 2010. The spatial planning profession was found to be ill-equipped to consider the health and well-being implications of its actions, whilst health professionals are rarely engaged and have limited understanding and aspirations when it comes to influencing spatial planning. Strategic Environmental Assessment was not considered to be successful in integrating health into spatial plans, given it was the responsibility of planners lacking the capacity to do so. For their part, health professionals have insufficient knowledge and understanding of planning and how to engage with it to be able to plan for health gains rather than simply respond to health impacts. HIA practice is patchy and generally undertaken by health professionals outside the statutory planning framework. Thus, whilst appropriate assessment tools exist, they currently lack a coherent context within which they can function effectively and the implementation of the Kiev protocol requiring the engagement of health professionals in SEA is not to likely improve the consideration of health in planning while there continues to be separation of functions between professions and lack of understanding of the other profession. -- Highlights: ► Health professionals have limited aspirations for health improvement through the planning system. ► Spatial planners are ill-equipped to understand the health and well-being implications of their activities. ► SEA and HIA currently do not embed health consideration in planning decisions. ► The separation of health and planning functions is problematic for the effective conduct of SEA and/or HIA.

  17. Contribution of traditional birth attendants to the formal health system in Ethiopia: the case of Afar region.

    Science.gov (United States)

    Temesgen, Tedla Mulatu; Umer, Jemal Yousuf; Buda, Dawit Seyoum; Haregu, Tilahun Nigatu

    2012-01-01

    Traditional birth attendants (TBAs) have been a subject of discussion in the provision of maternal and newborn health care. The objective of this study was to assess the role of trained traditional birth attendants in maternal and newborn health care in Afar Regional State of Ethiopia. A qualitative study was used where 21 in-depth interviews and 6 focus group discussions were conducted with health service providers, trained traditional birth attendants, mothers, men, kebele leaders and district health personnel. The findings of this study indicate that trained traditional birth attendants are the backbone of the maternal and child health development in pastoralist communities. However, the current numbers are inadequate and cannot meet the needs of the pastoralist communities including antenatal care, delivery, postnatal care and family planning. In addition to service delivery, all respondents agreed on multiple contributions of trained TBAs, which include counselling, child care, immunisation, postnatal care, detection of complication and other social services. Without deployment of adequate numbers of trained health workers for delivery services, trained traditional birth attendants remain vital for the rural community in need of maternal and child health care services. With close supportive supervision and evaluation of the trainings, the TBAs can greatly contribute to decreasing maternal and newborn mortality rates.

  18. Awakening consumer stewardship of health benefits: prevalence and differentiation of new health plan models.

    Science.gov (United States)

    Rosenthal, Meredith; Milstein, Arnold

    2004-08-01

    consumer-directed health plans are in tiered models (primarily point-of-care tiered networks) rather than HRAs. Tiers are predominantly determined based on both cost and quality criteria. Enrollment in HRAs has grown substantially, in part because of the entry of mainstream managed care plans into the consumer-directed market. Health reimbursement accounts, tiered networks, and traditional managed care plans vary in their capacity to support consumers in managing their health risks and selection of provider and treatment options, with HRAs providing the most and mainstream plans the least. While enrollment in consumer-directed health plans continues to grow steadily, it remains a tiny fraction of all employer-sponsored coverage. Decision support in these plans, a critical link to help consumers make more informed choices, is also still limited. This lack may be of concern in light of the fact that only a minority of such plans report that they monitor claims to protect against underuse. Tiered benefit models appear to be more readily accepted by the market than HRAs. If they are to succeed in optimizing consumers' utility from health benefit spending, careful attention needs to be paid to how well these models inform consumers about the consequences of their selections.

  19. Reasons for using traditional methods and role of nurses in family planning.

    Science.gov (United States)

    Yurdakul, Mine; Vural, Gülsen

    2002-05-01

    The withdrawal method and other traditional methods of contraception are still used in Turkey. Ninety-eight percent of women in Turkey know about modern family planning methods and where to find contraceptives. In fact, only one in every three women uses an effective method. The aim of this descriptive and experimental study was to investigate reasons for using traditional methods and the role of nurses in family planning. The women included in the sample were visited in their homes by nurses and educated for family planning in four sessions. Overall, 53.3% of women were using an effective method. However, 54.3% of women living in the Sirintepe district and 41.6% of women living in the Yenikent district were still using the traditional methods they used before. After the education sessions, the most widely used method was found to be intrauterine device (22.8%) in Sirintepe and condom (25%) in Yenikent. There was a significant difference in family planning methods between these two districts (p < 0.001).

  20. Health Workforce Planning

    Science.gov (United States)

    Al-Sawai, Abdulaziz; Al-Shishtawy, Moeness M.

    2015-01-01

    In most countries, the lack of explicit health workforce planning has resulted in imbalances that threaten the capacity of healthcare systems to attain their objectives. This has directed attention towards the prospect of developing healthcare systems that are more responsive to the needs and expectations of the population by providing health planners with a systematic method to effectively manage human resources in this sector. This review analyses various approaches to health workforce planning and presents the Six-Step Methodology to Integrated Workforce Planning which highlights essential elements in workforce planning to ensure the quality of services. The purpose, scope and ownership of the approach is defined. Furthermore, developing an action plan for managing a health workforce is emphasised and a reviewing and monitoring process to guide corrective actions is suggested. PMID:25685381

  1. Understanding health insurance plans

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000879.htm Understanding health insurance plans To use the sharing features on this ... plan for you and your family. Types of Health Insurance Plans Depending on how you get your health ...

  2. Strategic Planning in Population Health and Public Health Practice: A Call to Action for Higher Education.

    Science.gov (United States)

    Phelps, Charles; Madhavan, Guruprasad; Rappuoli, Rino; Levin, Scott; Shortliffe, Edward; Colwell, Rita

    2016-03-01

    Scarce resources, especially in population health and public health practice, underlie the importance of strategic planning. Public health agencies' current planning and priority setting efforts are often narrow, at times opaque, and focused on single metrics such as cost-effectiveness. As demonstrated by SMART Vaccines, a decision support software system developed by the Institute of Medicine and the National Academy of Engineering, new approaches to strategic planning allow the formal incorporation of multiple stakeholder views and multicriteria decision making that surpass even those sophisticated cost-effectiveness analyses widely recommended and used for public health planning. Institutions of higher education can and should respond by building on modern strategic planning tools as they teach their students how to improve population health and public health practice. Strategic planning in population health and public health practice often uses single indicators of success or, when using multiple indicators, provides no mechanism for coherently combining the assessments. Cost-effectiveness analysis, the most complex strategic planning tool commonly applied in public health, uses only a single metric to evaluate programmatic choices, even though other factors often influence actual decisions. Our work employed a multicriteria systems analysis approach--specifically, multiattribute utility theory--to assist in strategic planning and priority setting in a particular area of health care (vaccines), thereby moving beyond the traditional cost-effectiveness analysis approach. (1) Multicriteria systems analysis provides more flexibility, transparency, and clarity in decision support for public health issues compared with cost-effectiveness analysis. (2) More sophisticated systems-level analyses will become increasingly important to public health as disease burdens increase and the resources to deal with them become scarcer. The teaching of strategic planning in public

  3. Traditional-Aged College Juniors' Career Planning Self-Efficacy: A Case Study

    Science.gov (United States)

    Sherman, Dawn C.

    2012-01-01

    The purpose of this single-site case study was to explore and describe traditional-age college juniors' reports of self-efficacy (Bandura, 1997) regarding Career Planning (Barker & Kellen, 1998). More specifically, the career planning confidence levels of college juniors enrolled in a required career development course at a private business…

  4. The unwritten new practice rights of the traditional health practitioner as stipulated by the Traditional Health Practitioners Act No 22 (2007 of South Africa

    Directory of Open Access Journals (Sweden)

    Gabriel Louw

    2016-11-01

    Full Text Available Background In 2007, a practice directive was issued for the new legal entity traditional health practitioner with the promulgation of the Traditional Health Practitioners Act (No 22 of 2007 in the Republic of South Africa. Although the Act describes this new pathway in terms of various definitions, the future practice rights and impact on healthcare were left undefined and unwritten. To date the negative legal implications and career consequences that the Act has for the regulated health practitioners, have gone unnoticed. The derogation and degrading of their work domains and rights, seem of no concern.1 Aims The aim of the present study is to determine and describe the unwritten new practice rights of the traditional health practitioner. Methods This is an exploratory and descriptive study in line with the modern historical approach of investigation by means of a literature review. The emphasis is on using documentation such as articles, books and newspapers as primary resources to reflect on the traditional health practitioner’s new unsaid and unwritten future practice rights. Results The future practice and services of traditional health practitioners seem to incorporate many new unwritten practice rights and activities, which is contrary to the Act’s written intentions. Conclusion The new traditional health practitioner‘s future practice rights are legally comprehensive and masked. It holds serious consequences for the practices of the established healthcare professions.

  5. The role of traditional organization on family planning acceptance in Indonesia.

    Science.gov (United States)

    Ancok, D

    1991-01-01

    The nature of and the reasons for the decline in Indonesian fertility and the utilization of the village traditional organization, banjar, in the family planning (FP) program are discussed. The total fertility rate computed from census data shows a decline in fertility from 5.6 in the mid-1960s to 4.1 for 1981-1984, a 28% decline in 15 years. A further 23% decline evidenced in the Contraceptive Prevalence Survey appeared as 4.3 children reproductive woman in 1981-83 and 3.3 between 1984-87. The success of the FP program in contributing a major impact on the decline is attributed to a strong political commitment to antinatalist policy which meant increased allocation to FP when government income was declining, effective organizational structure, and effective strategies such as the mobilization of traditional village organizations. The impact of FP can also be seen in the increase in the number of family acceptors. Another source of the fertility decline is due to the impact of development. 1) Improvement in education has contributed to fertility decline in the increase in the number graduating from elementary and secondary school, the increased value of children, the acceptance of new ideas, the postponement of marriage, and the increase in the never-married group. 2) The decline in the infant mortality rate from 142 in 1971 to 70.2/1000 births in 1982-87 due to the improvement in health facilities and service also contributed to fertility decline. 3) The growth in the number of women participating in the nonagricultural labor force has also contributed to fertility decline. To what extent each has contributed to the decline has not been empirically tested. Molyneaux' study is cited for demonstrating that both socioeconomic variables and contraceptive use, which are affected by socioeconomic variables and family planning, have influenced the fertility decline. Households with electricity, children engaged in the labor force, and frequency of mobile medical team

  6. Regional health workforce planning through action research: lessons for commissioning health services from a case study in Far North Queensland.

    Science.gov (United States)

    Panzera, Annette June; Murray, Richard; Stewart, Ruth; Mills, Jane; Beaton, Neil; Larkins, Sarah

    2016-01-01

    Creating a stable and sustainable health workforce in regional, rural and remote Australia has long been a challenge to health workforce planners, policy makers and researchers alike. Traditional health workforce planning is often reactive and assumes continuation of current patterns of healthcare utilisation. This demonstration project in Far North Queensland exemplifies how participatory regional health workforce planning processes can accurately model current and projected local workforce requirements. The recent establishment of Primary Health Networks (PHNs) with the intent to commission health services tailored to individual healthcare needs underlines the relevance of such an approach. This study used action research methodology informed by World Health Organization (WHO) systems thinking. Four cyclical stages of health workforce planning were followed: needs assessment; health service model redesign; skills-set assessment and workforce redesign; and development of a workforce and training plan. This study demonstrated that needs-based loco-regional health workforce planning can be achieved successfully through participatory processes with stakeholders. Stronger health systems and workforce training solutions were delivered by facilitating linkages and planning processes based on community need involving healthcare professionals across all disciplines and sectors. By focusing upon extending competencies and skills sets, local health professionals form a stable and sustainable local workforce. Concrete examples of initiatives generated from this process include developing a chronic disease inter-professional teaching clinic in a rural town and renal dialysis being delivered locally to an Aboriginal community. The growing trend of policy makers decentralising health funding, planning and accountability and rising health system costs increase the future utility of this approach. This type of planning can also assist the new PHNs to commission health services

  7. The effect of traditional architecture elements on architectureal and planning forming develop and raise the efficency of using the traditional energy (study case Crater/Aden, Yemen)

    International Nuclear Information System (INIS)

    Ghanem, Wadee Ahmed

    2006-01-01

    This paper discuss the role of architecture in Center city-Aden, Republic of Yemen which has a historical traditional architecture which is a unique sample with many elements that make the building of this city as an effective helper in keeping the sources traditional energy. This architecture could be meritoriously described as courtyards, high ceiling for suitable air circling are used as well as the main building material used are local and environmental such as stones, wood and lime stone (Pumic). The research aim at studying and analyzing the planning forming and architectural specification of this city through studying some examples of its buildings to recognize the traditional building role in saving the traditional energy by studying the building material, ventilation system, orientation and opening, for using these elements to raise the efficiency of using the resources of traditional sources. The research is abbreviated to several results such as: 1. Urbanization planning side: a. Elements of urban planning represented in the mass and opening their environmental role. b. Method of forming the urban planning. c. Series in arrangement of elements of urban planning. 2. Architectural side: a. Ratio between solid and void. b. opening shapes. c. internal courtyards. d. Unique architectural elements (Mashrabiyas (Oriels), sky lines, opening covering...etc). e. Building material used . f. building construction methods. g. Kind of walls.(Author)

  8. Traditional Methods Used in Family Planning and Conception in ...

    African Journals Online (AJOL)

    ... knowledge and incorporate it into the national health care delivery service. Researchers should document the available indigenous knowledge before they are forgotten while ascertaining the validity of some of the methods. Keywords: Maternal health, family planning, pregnancy management, homebased health care.

  9. The Importance of Documenting and Including Traditional Wisdom in Community-Based Ecotourism Planning

    Directory of Open Access Journals (Sweden)

    Vesna Đukić

    2017-01-01

    Full Text Available This article accords to the theory of community-based tourism, which represents a concept that respects natural and cultural resources of a particular community and encourages participation of its members in the process of tourist product creation. The article operates in the planning phase and aims to give insights into the process of establishing the groundwork for community-based tourism. The key element is documenting and illustrating everything that could be a part of what is known as “traditional wisdom,” namely, the skills and knowledge of traditional life practices. The methods of case study, content analysis, and observation of the village of Omoljica, Serbia, were used. The positive aspect of this locality is reflected in the existing short-term initiatives of organizations and individuals engaging in preserving traditional practices, but without systematic, long-term planning and management of community-based tourism, these individual efforts to revalue traditional life practices would stay unrecognizable and invisible for visitors and stakeholders. Thus, the main goal of this article is to understand the relation between short-term bottom-up initiatives and long-term top-down strategic planning of specific ecotourism destinations, one that would embrace the traditional ways of rural community life. The contribution of this study, in addition to documenting and illustrating “traditional wisdom” of the specific rural community placed in the protected area which encompasses a particular local social system, will be reflected in the creation of a set of guidelines for sustainable, rural, community-based ecotourism as a soft-driver development of protected areas near big cities of the postsocialist countries.

  10. 75 FR 51831 - Request for Measures of Health Plan Efforts To Address Health Plan Members' Health Literacy Needs

    Science.gov (United States)

    2010-08-23

    ... and health plans. The results of the planned survey may become an important source of information for... services and nurse advice lines, the quality and accessibility of health plan information on coverage...

  11. Perceptions and experiences of allopathic health practitioners on collaboration with traditional health practitioners in post-apartheid South Africa.

    Science.gov (United States)

    Nemutandani, Simon M; Hendricks, Stephen J; Mulaudzi, Mavis F

    2016-06-10

    The indigenous health system was perceived to be a threat to the allopathic health system. It was associated with 'witchcraft', and actively discouraged, and repressed through prohibition laws. The introduction of the Traditional Health Practitioners Act No 22 of 2007 brought hope that those centuries of disrespect for traditional health systems would change. The study examined the perceptions and experiences of allopathic health practitioners on collaboration with traditional health practitioners in post-apartheid South Africa. Qualitative descriptive research methodology was used to collect data from allopathic health practitioners employed by Limpopo's Department of Health. In-depth focus group discussions and meetings were conducted between January and August 2014. Perceptions and experiences of working with traditional health practitioners were explored. Ethical clearance was obtained from the University of Pretoria and approval from the Department's Research Committee. Dominant views were that the two health systems were not compatible with respect to the science involved and the source of knowledge. Overall, quality of health care will be compromised if traditional health practitioners are allowed to work in public health facilities. Allopathic health practitioners do not appear ready to work with traditional health practitioners, citing challenges of quality of health care, differences regarding concept of sciences and source of knowledge; and lack of policy on collaboration. Lack of exposure to traditional medicine seems to impede opportunities to accept and work with traditional healers. Exposure and training at undergraduate level regarding the traditional health system is recommended. Policy guidelines on collaborations are urgently required.

  12. Strategic planning as a tool for achieving alignment in academic health centers.

    Science.gov (United States)

    Higginbotham, Eve J; Church, Kathryn C

    2012-01-01

    After the passage of the Patient Protection and Affordable Care Act in March 2010, there is an urgent need for medical schools, teaching hospitals, and practice plans to work together seamlessly across a common mission. Although there is agreement that there should be greater coordination of initiatives and resources, there is little guidance in the literature to address the method to achieve the necessary transformation. Traditional approaches to strategic planning often engage a few leaders and produce a set of immeasurable initiatives. A nontraditional approach, consisting of a Whole-Scale (Dannemiller Tyson Associates, Ann Arbor, MI) engagement, appreciative inquiry, and a balanced scorecard can, more rapidly transform an academic health center. Using this nontraditional approach to strategic planning, increased organizational awareness was achieved in a single academic health center. Strategic planning can be an effective tool to achieve alignment, enhance accountability, and a first step in meeting the demands of the new landscape of healthcare.

  13. Strategic Planning as a Tool for Achieving Alignment in Academic Health Centers

    Science.gov (United States)

    Higginbotham, Eve J.; Church, Kathryn C.

    2012-01-01

    After the passage of the Patient Protection and Affordable Care Act in March 2010, there is an urgent need for medical schools, teaching hospitals, and practice plans to work together seamlessly across a common mission. Although there is agreement that there should be greater coordination of initiatives and resources, there is little guidance in the literature to address the method to achieve the necessary transformation. Traditional approaches to strategic planning often engage a few leaders and produce a set of immeasurable initiatives. A nontraditional approach, consisting of a Whole-Scale (Dannemiller Tyson Associates, Ann Arbor, MI) engagement, appreciative inquiry, and a balanced scorecard can, more rapidly transform an academic health center. Using this nontraditional approach to strategic planning, increased organizational awareness was achieved in a single academic health center. Strategic planning can be an effective tool to achieve alignment, enhance accountability, and a first step in meeting the demands of the new landscape of healthcare. PMID:23303997

  14. Maternal health practices, beliefs and traditions in southeast Madagascar.

    Science.gov (United States)

    Morris, Jessica L; Short, Samm; Robson, Laura; Andriatsihosena, Mamy Soafaly

    2014-09-01

    Contextualising maternal health in countries with high maternal mortality is vital for designing and implementing effective health interventions. A research project was therefore conducted to explore practices, beliefs and traditions around pregnancy, delivery and postpartum in southeast Madagascar. Interviews and focus groups were conducted with 256 pregnant women, mothers of young children, community members and stakeholders; transcripts were analysed to identify and explore predetermined and emerging themes. A questionnaire was also conducted with 373 women of reproductive age from randomly selected households. Data was analysed using STATA. Results confirmed high local rates of maternal mortality and morbidity and revealed a range of traditional health care practices and beliefs impacting on women's health seeking behaviours. The following socio-cultural barriers to health were identified: 1) lack of knowledge, 2) risky practices, 3) delays seeking biomedical care, and 4) family and community expectations. Recommendations include educational outreach and behaviour change communications targeted for women, their partners and family, increased engagement with traditional midwives and healers, and capacity building of formal health service providers.

  15. Patients Consulting Traditional Health Practioners In The Context Of ...

    African Journals Online (AJOL)

    Patients Consulting Traditional Health Practioners In The Context Of Hiv/Aids In Urban Areas In Kwazulu-Natal, South Africa. ... A number of HIV positive patients were using traditional medicine and ART concurrently, dropped out of ART because of side effects and were using traditional medicine for HIV. Keywords: Patients ...

  16. Multistate Health Plans

    Directory of Open Access Journals (Sweden)

    Robert E. Moffit PhD

    2015-09-01

    Full Text Available We discuss and evaluate the Multi-State Plan (MSP Program, a provision of the Affordable Care Act that has not been the subject of much debate as yet. The MSP Program provides the Office of Personnel Management with new authority to negotiate and implement multistate insurance plans on all health insurance exchanges within the United States. We raise the concern that the MSP Program may lead to further consolidation of the health insurance industry despite the program’s stated goal of increasing competition by means of health insurance exchanges. The MSP Program arguably gives a competitive advantage to large insurers, which already dominate health insurance markets. We also contend that the MSP Program’s failure to produce increased competition may motivate a new effort for a public health insurance option.

  17. A Comparison of Traditional Worksheet and Linear Programming Methods for Teaching Manure Application Planning.

    Science.gov (United States)

    Schmitt, M. A.; And Others

    1994-01-01

    Compares traditional manure application planning techniques calculated to meet agronomic nutrient needs on a field-by-field basis with plans developed using computer-assisted linear programming optimization methods. Linear programming provided the most economical and environmentally sound manure application strategy. (Contains 15 references.) (MDH)

  18. Role of traditional health workers in prevention and control of AIDS in Africa.

    Science.gov (United States)

    Staugaard, F

    1991-01-01

    The WHO held an Expert Committee Meeting in Botswana to identify ways by which traditional health practitioners might contribute to AIDS prevention and treatment. Medium Term Plans for AIDS control in Botswana, Kenya, Zimbabwe, Tanzania and Uganda have already defined areas of community-based care, counseling and symptomatic treatment appropriate for traditional healers. Traditional healers and midwives often play central roles in maintenance of social stability, provide valuable information on sexual behavior, teach young people about sexual roles, and act as informal networks for women, especially in Islamic communities. Many indigenous concepts on the cause and transmission of HIV/AIDS are compatible with modern scientific concepts, although expressed in different terms and conceptual frameworks. AIDS is often considered an indigenous disease, caused by contact of blood and semen, therefore treatable by indigenous methods. In their role as informal community leaders and guardians of social norms, healers and midwives can channel educational messages and act as change agents. Healers can convey technically appropriate home care, dispense symptomatic care, treat opportunistic infections and counsel young people about control of HIV.

  19. [Occupational health protection in business economics--business plan for health intervention].

    Science.gov (United States)

    Rydlewska-Liszkowska, Izabela

    2011-01-01

    One of the company's actions for strengthening human capital is the protection of health and safety of its employees. Its implementation needs financial resources, therefore, employers expect tangible effectiveness in terms of health and economics. Business plan as an element of company planning can be a helpful tool for new health interventions management. The aim of this work was to elaborate a business plan framework for occupational health interventions at the company level, combining occupational health practices with company management and economics. The business plan of occupational health interventions was based on the literature review, the author's own research projects and meta-analysis of research reports on economic relations between occupational health status and company productivity. The study resulted in the development of the business plan for occupational health interventions at the company level. It consists of summary and several sections that address such issues as the key elements of the intervention discussed against a background of the company economics and management, occupational health and safety status of the staff, employees' health care organization, organizational plan of providing the employees with health protection, marketing plan, including specificity of health interventions in the company marketing plan and financial plan, reflecting the economic effects of health care interventions on the overall financial management of the company. Business plan defines occupational health and safety interventions as a part of the company activities as a whole. Planning health care interventions without relating them to the statutory goals of the company may have the adverse impact on the financial balance and profitability of the company. Therefore, business plan by providing the opportunity of comparing different options of occupational health interventions to be implemented by employers is a key element of the management of employees

  20. Allopathic and traditional health practitioners: A reply to Nemutandani, Hendricks and Mulaudzi

    Directory of Open Access Journals (Sweden)

    Rudi W. de Lange

    2017-04-01

    Full Text Available An earlier paper in this journal reported on the perception and experience of 77 allopathic health practitioners (AHPs and health managers about working together with South African traditional health practitioners (THPs. The paper stated that the abolishment of the Witchcraft Suppression Act of 1957 and the introduction of the Traditional Health Practitioners Act No. 22 of 2007 is a milestone in the development of traditional health knowledge, and for the eventual incorporation thereof into modern health care practices. The authors also comment that a decolonisation of mindset and a change of attitude is required to change one’s perception of traditional healer practices and to develop them parallel to allopathic health practice. This opinion paper is a response to the paper, to negate its claims about the Witchcraft Suppression Act of 1957 and to provide clarity on the Traditional Health Practitioners Act No. 22 of 2007 and related policies and regulations. Although this Act recognises THP, the Act and other regulations actually require THP to conform to practices analogous to those of AHP. It is rather a systematic and scientific ‘mindset’ that is required to develop THP parallel to AHP. The Traditional Health Practitioners Act of 2007 and the Draft Policy on African Traditional Medicine (TM for South Africa dictate that a substantial THP sectoral transformation is required before there can be a parallel system. Legislation and regulations have excluded THP and African TM from operating (present and future in the same space as AHP.

  1. Qualified Health Plan (QHP) Landscape

    Data.gov (United States)

    U.S. Department of Health & Human Services — QHP Landscape Files present basic information about certified Qualified Health Plans and Stand-alone Dental Plans for individuals-families and small businesses...

  2. Identification of relevant ICF categories for indication, intervention planning and evaluation of health resort programs: a Delphi exercise

    Science.gov (United States)

    Morita, E.; Weigl, M.; Schuh, A.; Stucki, G.

    2006-01-01

    Health resort programs have a long tradition, mainly in European countries and Japan. They rely on local resources and the physical environment, physical medicine interventions and traditional medicine to optimise functioning and health. Arguably because of the long tradition, there is only a limited number of high-quality studies that examine the effectiveness of health resort programs. Specific challenges to the evaluation of health resort programs are to randomise the holistic approach with a varying number of specific interventions but also the reliance on the effect of the physical environment. Reference standards for the planning and reporting of health resort studies would be highly beneficial. With the International Classification of Functioning Disability and Health (ICF), we now have such a standard that allows us to describe body functions and structures, activities and participation and interaction with environmental factors. A major challenge when applying the ICF in practice is its length. Therefore, the objective of this project was to identify the ICF categories most relevant for health resort programs. We conducted a consensus-building, three-round, e-mail survey using the Delphi technique. Based on the consensus of the experts, it was possible to come up with an ICF Core Set that can serve as reference standards for the indication, intervention planning and evaluation of health resort programs. This preliminary ICF Core Set should be tested in different regions and in subsets of health resort visitors with varying conditions.

  3. The South African traditional health practitioner as a beneficiary of and provider to medical funds and schemes through the traditional health practitioners Act (Act No 22, 2007: A present-day perspective

    Directory of Open Access Journals (Sweden)

    Gabriel Louw

    2017-01-01

    Full Text Available Background Payments to traditional health practitioners for services rendered from medical funds and schemes, as envisaged by the Traditional Health Practitioners Act (Act No 22, 2007, is controversial and a point of contention. Such policy was followed before in South Africa in the 1990s when some funds and schemes offered limited alternative healthcare benefits for members consulting traditional healers. Aims The study aimed to offer a contemporary view of the South African traditional health practitioner as a provider to and beneficiary of the medical funds and schemes through the Traditional Health Practitioners Act (No 22, 2007. Methods This is an exploratory and descriptive study that makes use of an historical approach by means of investigation and a literature review. The emphasis is on using current documentation like articles, books and newspapers as primary sources to reflect on the South African traditional health practitioner as a provider to and beneficiary of the medical schemes and funds through the Traditional Health Practitioners Act (No 22, 2007. The findings are offered in narrative form. Results It seems as if the South African authorities completely misunderstand the future implications of the Traditional Health Practitioners Act (No 22, 2007 on healthcare. This is specifically true when it comes to the right to claim from medical funds and schemes for services rendered by traditional health practitioners and the possible extra costs for these medical schemes and funds. Conclusion The implications of Section 42(2 of the Traditional Health Practitioners Act (No 22, 2007 which aims to set up a claiming process for traditional health practitioners, seems to be very problematic. The fact that Act No 22 (2007 has not been enacted properly nine years after its promulgation has put a halt on the professionalization of traditional healers until 2015. This also affected their status as a beneficiary of and service provider to the

  4. Health and healing: traditional medicine and the Karen experience.

    Science.gov (United States)

    Oleson, Heather E; Chute, Sara; O'Fallon, Ann; Sherwood, Nancy E

    2012-01-01

    To examine the beliefs, attitudes and health-seeking behavior surrounding the use of traditional medicine among the Karen (refugees from Burma). Three focus groups and two key-informant interviews were conducted with the Karen along with observations by researchers. The Karen continue to use elements of their traditional healthcare system after resettling in the U.S. Accessibility and perceived efficacy of treatments influence their health-seeking behavior. The participants discussed beliefs about health and healing, spirituality, and their experience as refugees. Implications for improving the quality of healthcare for the Karen and recommendations for further research are discussed.

  5. Male involvement in maternal healthcare through Community- based Health Planning and Services: the views of the men in rural Ghana.

    Science.gov (United States)

    Bougangue, Bassoumah; Ling, How Kee

    2017-09-06

    The need to promote maternal health in Ghana has committed the government to extend maternal healthcare services to the door steps of rural families through the community-based Health Planning and Services. Based on the concerns raised in previous studies that male spouses were indifferent towards maternal healthcare, this study sought the views of men on their involvement in maternal healthcare in their respective communities and at the household levels in the various Community-based Health Planning and Services zones in Awutu-Senya West District in the Central Region of Ghana. A qualitative method was employed. Focus groups and individual interviews were conducted with married men, community health officers, community health volunteers and community leaders. The participants were selected using purposive, quota and snowball sampling techniques. The study used thematic analysis for analysing the data. The study shows varying involvement of men, some were directly involved in feminine gender roles; others used their female relatives and co-wives to perform the women's roles that did not have space for them. They were not necessarily indifferent towards maternal healthcare, rather, they were involved in the spaces provided by the traditional gender division of labour. Amongst other things, the perpetuation and reinforcement of traditional gender norms around pregnancy and childbirth influenced the nature and level of male involvement. Sustenance of male involvement especially, husbands and CHVs is required at the household and community levels for positive maternal outcomes. Ghana Health Service, health professionals and policy makers should take traditional gender role expectations into consideration in the planning and implementation of maternal health promotion programmes.

  6. Behavioral Health Services in the Changing Landscape of Private Health Plans.

    Science.gov (United States)

    Horgan, Constance M; Stewart, Maureen T; Reif, Sharon; Garnick, Deborah W; Hodgkin, Dominic; Merrick, Elizabeth L; Quinn, Amity E

    2016-06-01

    Health plans play a key role in facilitating improvements in population health and may engage in activities that have an impact on access, cost, and quality of behavioral health care. Although behavioral health care is becoming more integrated with general medical care, its delivery system has unique aspects. The study examined how health plans deliver and manage behavioral health care in the context of the Affordable Care Act (ACA) and the 2008 Mental Health Parity and Addiction Equity Act (MHPAEA). This is a critical time to examine how health plans manage behavioral health care. A nationally representative survey of private health plans (weighted N=8,431 products; 89% response rate) was conducted in 2010 during the first year of MHPAEA, when plans were subject to the law but before final regulations, and just before the ACA went into effect. The survey addressed behavioral health coverage, cost-sharing, contracting arrangements, medical home innovations, support for technology, and financial incentives to improve behavioral health care. Coverage for inpatient and outpatient behavioral health services was stable between 2003 and 2010. In 2010, health plans were more likely than in 2003 to manage behavioral health care through internal arrangements and to contract for other services. Medical home initiatives were common and almost always included behavioral health, but financial incentives did not. Some plans facilitated providers' use of technology to improve care delivery, but this was not the norm. Health plans are key to mainstreaming and supporting delivery of high-quality behavioral health services. Since 2003, plans have made changes to support delivery of behavioral health services in the context of a rapidly changing environment.

  7. Health traditions of Sikkim Himalaya

    Directory of Open Access Journals (Sweden)

    Ashok Kumar Panda

    2010-01-01

    Full Text Available Ancient medical systems are still prevalent in Sikkim, popularly nurtured by Buddhist groups using the traditional Tibetan pharmacopoeia overlapping with Ayurvedic medicine. Traditional medical practices and their associated cultural values are based round Sikkim′s three major communities, Lepcha, Bhutia and Nepalis. In this study, a semi-structured questionnaire was prepared for folk healers covering age and sex, educational qualification, source of knowledge, types of practices, experience and generation of practice, and transformation of knowledge. These were administered to forty-eight folk healers identified in different parts of Sikkim. 490 medicinal plants find their habitats in Sikkim because of its large variations in altitude and climate. For 31 commonly used by these folk healers, we present botanical name, family, local name, distribution, and parts used, together with their therapeutic uses, mostly Rheumatoid arthritis, Gout, Gonorrhea, Fever, Viral flu, asthma, Cough and Cold, indigestion, Jaundice etc. A case treated by a folk healer is also recounted. This study indicates that, in the studied area, Sikkim′s health traditions and folk practices are declining due to shifts in socio-economic patterns, and unwillingness of the younger generation to adopt folk healing as a profession.

  8. Between tradition and innovation : Developing Flood Risk Management Plans in the Netherlands

    NARCIS (Netherlands)

    Jong, Pieter; Brink, Margo Van Den

    2013-01-01

    Traditionally, governmental authorities in the Netherlands have a strong focus on the construction and maintenance of flood defences, such as dikes and dams. The last decades, however, there has been a growing awareness of the importance of spatial planning for flood risk management. With the

  9. Eliciting consumer preferences for health plans.

    Science.gov (United States)

    Booske, B C; Sainfort, F; Hundt, A S

    1999-10-01

    To examine (1) what people say is important to them in choosing a health plan; (2) the effect, if any, that giving health plan information has on what people say is important to them; and (3) the effect of preference elicitation methods on what people say is important. A random sample of 201 Wisconsin state employees who participated in a health plan choice experiment during the 1995 open enrollment period. We designed a computer system to guide subjects through the review of information about health plan options. The system began by eliciting the stated preferences of the subjects before they viewed the information, at time 0. Subjects were given an opportunity to revise their preference structures first after viewing summary information about four health plans (time 1) and then after viewing more extensive, detailed information about the same options (time 2). At time 2, these individuals were also asked to rate the relative importance of a predefined list of health plan features presented to them. Data were collected on the number of attributes listed at each point in time and the importance weightings assigned to each attribute. In addition, each item on the attribute list was content analyzed. The provision of information changes the preference structures of individuals. Costs (price) and coverage dominated the attributes cited both before and after looking at health plan information. When presented with information on costs, quality, and how plans work, many of these relatively well educated consumers revised their preference structures; yet coverage and costs remained the primary cited attributes. Although efforts to provide health plan information should continue, decisions on the information to provide and on making it available are not enough. Individuals need help in understanding, processing, and using the information to construct their preferences and make better decisions.

  10. Porosity and Health: Perspective of Traditional Persian Medicine

    Science.gov (United States)

    Tafazoli, Vahid; Nimrouzi, Majid; Daneshfard, Babak

    2016-01-01

    Background: The authors of this manuscript aimed to show the importance of porosity and condensation in health according to traditional Persian medicine (TPM) with consideration of new evidence in conventional medicine. Methods: Cardinal traditional medical and pharmacological texts were searched for the traditional terms of takhalkhol (porosity) and takassof (condensity) focused on preventive methods. The findings were classified and compared with new medical findings. Results: According to traditional Persian medicine, porosity and condensity are the two crucial items that contribute to human health. Somatotype is a taxonomy based on embryonic development, which may be considered in parallel with porosity and condensation. However, these terms are not completely the same. There are many causes for acquired porosity comprising hot weather, too much intercourse, rage, starvation, and heavy exercises. In general, porosity increases the risk of diseases as it makes the body organs vulnerable to external hot and cold weather. On the other hand, the porose organs are more susceptible to accumulation of morbid matters because the cellular wastes cannot be evacuated in the normal way. There are some common points between traditional and conventional medicine in the context of porosity and condensity. The relation between diet and somatotype is an example. Conclusion: Condensity and porosity are the two basic items cited in the TPM resources and contribute to health maintenance and disease prevention of body organs. Creating a balance between these two states in different body organs, strongly contributes to disease prevention, treatment and diminishing chronic diseases period. Choosing proper modality including diet, drug therapy, and manual therapy depends on the amount porosity and stiffness of the considered organ and the preferred porosity of the affected organ keeping in a normal healthy state. PMID:27840513

  11. ERISA and health plans.

    Science.gov (United States)

    Schmidt, P; Mazo, J; Ladenheim, K

    1995-11-01

    This Issue Brief is designed to provide a basic understanding of the relationship of the Employee Retirement Income Security Act of 1974 (ERISA) to health plans. It is based, in part, on an Employee Benefit Research Institute-Education and Research Fund (EBRI-ERF) educational briefing held in March 1995. This report includes a section by Peter Schmidt of Arnold & Porter, a section about multiemployer plans written by Judy Mazo of The Segal Company; and a section about ERISA and state health reform written by Kala Ladenheim of the Intergovernmental Health Policy Project. Starting in the late 1980s, three trends converged to make ERISA a critical factor in state health reforms: increasingly comprehensive state health policy experimentation; changes in the makeup of the insurance market (including the rise in self-insurance and the growth of managed care); and increasingly expansive interpretations of ERISA by federal courts. The changing interpretations of ERISA's relationship to three categories of state health initiatives--insurance mandates, medical high risk pools, and uncompensated care pools--illustrate how these forces are playing out today. ERISA does have a very broad preemptive effect. Federal statutes do not need to say anything about preemption in order to preempt state law. For example, if there is a direct conflict, it would be quite clear under the Supremacy Clause [of the U.S. Constitution] that ERISA, or any federal statue, would preempt a directly conflicting state statute. States can indirectly regulate health care plans that provide benefits through insurance contracts by establishing the terms of the contract. And they also raise money by imposing premium taxes. But they cannot do the same with respect to self-funded plans. That is one of the factors that has caused a great rise in the number of self-funded plans. State regulation [of employee benefits] can create three kinds of problems: cost of taxes, fees, or other charges; cost of dealing

  12. Cost Comparison Model: Blended eLearning versus traditional training of community health workers.

    Science.gov (United States)

    Sissine, Mysha; Segan, Robert; Taylor, Mathew; Jefferson, Bobby; Borrelli, Alice; Koehler, Mohandas; Chelvayohan, Meena

    2014-01-01

    Another one million community healthcare workers are needed to address the growing global population and increasing demand of health care services. This paper describes a cost comparison between two training approaches to better understand costs implications of training community health workers (CHWs) in Sub-Saharan Africa. Our team created a prospective model to forecast and compare the costs of two training methods as described in the Dalburge Report - (1) a traditional didactic training approach ("baseline") and (2) a blended eLearning training approach ("blended"). After running the model for training 100,000 CHWs, we compared the results and scaled up those results to one million CHWs. A substantial difference exists in total costs between the baseline and blended training programs. RESULTS indicate that using a blended eLearning approach for training community health care workers could provide a total cost savings of 42%. Scaling the model to one million CHWs, the blended eLearning training approach reduces total costs by 25%. The blended eLearning savings are a result of decreased classroom time, thereby reducing the costs associated with travel, trainers and classroom costs; and using a tablet with WiFi plus a feature phone rather than a smartphone with data plan. The results of this cost analysis indicate significant savings through using a blended eLearning approach in comparison to a traditional didactic method for CHW training by as much as 67%. These results correspond to the Dalberg publication which indicates that using a blended eLearning approach is an opportunity for closing the gap in training community health care workers.

  13. Study on Rural Ecological Conservation and Health Care Plan to Respond Aging Population

    Science.gov (United States)

    Zhao, Jing Yu; Fu, Fei

    2018-05-01

    The problem of aging is a problem that the society must face now. Under the rapid development and expansion of modern cities, the traditional village which is the back garden of the city depends on its advantages and characteristics of the farmland water network ecological infrastructure to develop the health planning. It is an important way to develop economic and ecological protection. However, the study of this direction is still in its infancy in china. This paper attempts to establish an adaptive POE evaluation model for elderly open space through the investigation and analysis, and further explore the physiological and psychological needs of the elderly for the environment. Based on the above survey data, this paper studies the planning and planning strategy of the health industry in the natural villages in the suburbs of Dujiangyan. From the point of view of sustainable development, it is more effective to protect and develop the ecological infrastructure of villages.

  14. Religion and Public Health: Moral Tradition as Both Problem and Solution.

    Science.gov (United States)

    Rozier, Michael

    2017-06-01

    Despite strong religious influence in the development of medicine and medical ethics, religion has been relatively absent in the rise of preventive medicine and population health. Episodic, clinical medicine has a powerful hold on the religious imagination in health care. Nevertheless, Hebrew Scripture, elements of rabbinical teaching, and modern concepts of social justice all can be used to inspire action in health care that goes beyond clinical medicine. The Christian tradition can call upon the corporal works of mercy, virtue ethics, and Catholic social teaching, as well as the modern history Catholic sisters in the U.S. to do the same. By considering the moral imperative for public health, Jewish and Christian individuals and organizations reaffirm the notion that the human person is both sacred and social. This article suggests a need for religious traditions to consider their moral traditions anew with an eye toward prevention and population health.

  15. Are the healthy behaviors of US high-deductible health plan enrollees driven by people who chose these plans? Smoking as a case study.

    Directory of Open Access Journals (Sweden)

    Jeffrey T Kullgren

    Full Text Available To determine whether negative associations between enrollment in a high-deductible health plan (HDHP and one exemplar unhealthy behavior--daily smoking--are found only among people who chose these plans.Cross-sectional analysis of nationally-representative data.United States from 2007 to 2008.6,941 privately insured non-elderly adult participants in the 2007 Health Tracking Household Survey.Self-reported smoking status.We classified subjects as HDHP or traditional health plan enrollees with employer-sponsored insurance (ESI and no choice of plans, ESI with a choice of plans, or coverage through the non-group market. We used multivariate logistic regression to measure associations between HDHP enrollment and daily smoking within each of the 3 coverage source groups while controlling for potential confounders.HDHP enrollment was associated with lower odds of smoking among individuals with ESI and a choice of plans (AOR 0.55, 95% CI 0.33-0.90 and those with non-group coverage (AOR 0.64, 95% CI 0.34-1.22, though the latter association was not statistically significant. HDHP enrollment was not associated with lower odds of smoking among individuals with ESI and no choice of plans (AOR 1.04, 95% CI 0.69-1.56.HDHP enrollment is associated with lower odds of smoking only among individuals who chose to enroll in an HDHP. Lower rates of unhealthy behaviors among HDHP enrollees may be a reflection of individuals who choose these plans.

  16. Traditional medicine as an alternative form of health care system: A ...

    African Journals Online (AJOL)

    Traditional medicine as an alternative form of health care system: A preliminary case study of Nangabo sub-county, central Uganda. ... African Journal of Traditional, Complementary and Alternative Medicines ... The findings indicated that most (43%) respondents derive their livelihoods from traditional medicine practices.

  17. The traditional healer in obstetric care: A persistent wasted opportunity in maternal health.

    Science.gov (United States)

    Aborigo, Raymond Akawire; Allotey, Pascale; Reidpath, Daniel D

    2015-05-01

    Traditional medical systems in low income countries remain the first line service of choice, particularly for rural communities. Although the role of traditional birth attendants (TBAs) is recognised in many primary health care systems in low income countries, other types of traditional practitioners have had less traction. We explored the role played by traditional healers in northern Ghana in managing pregnancy-related complications and examined their relevance to current initiatives to reduce maternal morbidity and mortality. A grounded theory qualitative approach was employed. Twenty focus group discussions were conducted with TBAs and 19 in-depth interviews with traditional healers with expertise in managing obstetric complications. Traditional healers are extensively consulted to manage obstetric complications within their communities. Their clientele includes families who for either reasons of access or traditional beliefs, will not use modern health care providers, or those who shop across multiple health systems. The traditional practitioners claim expertise in a range of complications that are related to witchcraft and other culturally defined syndromes; conditions for which modern health care providers are believed to lack expertise. Most healers expressed a willingness to work with the formal health services because they had unique knowledge, skills and the trust of the community. However this would require a stronger acknowledgement and integration within safe motherhood programs. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Health Information in Chinese, Traditional (Cantonese dialect) (繁體中文)

    Science.gov (United States)

    ... Diabetes - 繁體中文 (Chinese, Traditional (Cantonese dialect)) Bilingual PDF Health Information Translations Fasting Blood Sugar Test - 繁體中文 (Chinese, Traditional (Cantonese dialect)) ...

  19. Environmental health action plan for Europe

    International Nuclear Information System (INIS)

    1994-06-01

    This Environmental Health Action Plan for Europe was endorsed by the second European Conference on Environment and Health, held in Helsinki, 20 to 22 June 1994. It sets out directions for the attainment of long term environment and health policy objectives define in the European Charter on Environment and Health. The Action Plan is primarily addressed at the public health and environmental protection sectors. 10 refs, 4 figs, 2 tabs

  20. 42 CFR 56.105 - Accord with health planning.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Accord with health planning. 56.105 Section 56.105... HEALTH SERVICES General Provisions § 56.105 Accord with health planning. A grant may be made under this... appropriate health planning agencies have been met. ...

  1. Estimated annual incomes of South African traditional healers as generated by their practices and sales of their pre-modern traditional health products for 2015/2016

    Directory of Open Access Journals (Sweden)

    Gabriel Louw

    2017-02-01

    Full Text Available Background In South Africa, it is an accepted fact that the main role players in the manufacturing and selling of so called traditional medicine (TAM are traditional healers. The Traditional Health Practitioners Act No 22 not only strengthened this perception in 2007 by giving statutory recognition to traditional healers as traditional health practitioners, but also with its various definitions as they are reflected in the Act. There is an estimation that South African research on traditional healing that TAM, specifically under the guardianship of the traditional healers, generates in excess of R2 billion (R2,000 million annually. The idea also exists that the traditional healers offer a widespread indispensable medical service, specifically through their medical and health products, which contributes to a further R1 billion (R1,000 million or more in income. Aims The study aims to estimate the annual income generated by South African traditional healers in their practices and with the manufacturing, prescription and selling of their traditional health products for the period 2015/2016. Methods This is an exploratory and descriptive study that makes use of an historical approach by means of investigation and a literature review. The emphasis is on using current documentation like articles, books and newspapers as primary sources to reflect on the South African traditional healers’ estimated annual incomes as generated by their practices and the manufacturing, prescription and selling of their health and medical products for the period 2015/2016. The findings are offered in narrative form. Results Over the years, it seems that a misconception was established in South Africa about what traditional medicines really are and who the specific manufacturers and sellers are. There is no differentiation between the traditional medicines offered and marketed in the South African retail and commercial market, and those prepared by traditional healers

  2. How to choose a health plan

    Science.gov (United States)

    ... patientinstructions/000861.htm How to choose a health plan To use the sharing features on this page, ... paperwork for tax purposes. How to Compare Health Plans Employers and government sites, such as the Marketplace , ...

  3. Energy and comfort in contemporary open plan and traditional personal offices

    International Nuclear Information System (INIS)

    Shahzad, Sally; Brennan, John; Theodossopoulos, Dimitris; Hughes, Ben; Calautit, John Kaiser

    2017-01-01

    Highlights: • User satisfaction is compared in offices with high and low thermal control. • Thermal control is secondary in British and main system in Norwegian approach. • Individual thermal control in Norway improved satisfaction (35%) and comfort (20%). • The energy use is much higher in the Norwegian than British case studies. • A balance is required between energy efficiency and providing thermal comfort. - Abstract: Two office layouts with high and low levels of thermal control were compared, respectively traditional cellular and contemporary open plan offices. The traditional Norwegian practice provided every user with control over a window, blinds, door, and the ability to adjust heating and cooling. Occupants were expected to control their thermal environment to find their own comfort, while air conditioning was operating in the background to ensure the indoor air quality. In contrast, in the British open plan office, limited thermal control was provided through openable windows and blinds only for occupants seated around the perimeter of the building. Centrally operated displacement ventilation was the main thermal control system. Users’ perception of thermal environment was recorded through survey questionnaires, empirical building performance through environmental measurements and thermal control through semi-structured interviews. The Norwegian office had 35% higher user satisfaction and 20% higher user comfort compared to the British open plan office. However, the energy consumption in the British practice was within the benchmark and much lower than the Norwegian office. Overall, a balance between thermal comfort and energy efficiency is required, as either extreme poses difficulties for the other.

  4. Traditional oral health beliefs and practices of Bulang people in Yunnan, China.

    Science.gov (United States)

    Zhang, Shinan; Lo, Edward C M; Chu, Chun-Hung

    2018-02-01

    The aim of the present study was to explore traditional oral health beliefs among the Bulang ethnic minority group in China. Eighteen village leaders, chiefs, elders, and seniors in Yunnan, China were assigned to three focus groups for discussion of traditional oral health beliefs. The discussions were led by a facilitator. Transcripts were made, and data were extracted. The focus group discussions on traditional oral health beliefs addressed three themes: (a) the perception of oral health; (b) the impact of healthy teeth (oral health), in that healthy teeth essentially have an impact on physical health, emotions, and social status; and (c) toothache management, which was regarded as tooth decay (dental caries). Blackening teeth was a pain relief method. Blackened teeth were reported to be part of ethnic identity, and considered esthetically pleasing. It also indicated the marital status of women. Some Bulang people believed that healthy dentition has no spacing, pain, or functioning problems. Well-aligned dentition was associated with higher social status. Toothaches were considered to be caused by tooth worms. Consulting a monk was another way to manage a toothache. Tooth blackening was considered traditional, and effective for caries prevention. © 2017 John Wiley & Sons Australia, Ltd.

  5. Public Health Agency Business plan 2010-2011

    OpenAIRE

    Public Health Agency

    2010-01-01

    This second corporate business plan explains the purpose of the PHA and focuses on health improvement, health protection and addressing health inequalities. The business plan is available to download below.

  6. Comparison of health conditions treated with traditional and biomedical health care in a Quechua community in rural Bolivia.

    Science.gov (United States)

    Vandebroek, Ina; Thomas, Evert; Sanca, Sabino; Van Damme, Patrick; Puyvelde, Luc Van; De Kimpe, Norbert

    2008-01-14

    The objective of the present study was to reveal patterns in the treatment of health conditions in a Quechua-speaking community in the Bolivian Andes based on plant use data from traditional healers and patient data from a primary health care (PHC) service, and to demonstrate similarities and differences between the type of illnesses treated with traditional and biomedical health care, respectively. A secondary analysis of plant use data from semi-structured interviews with eight healers was conducted and diagnostic data was collected from 324 patients in the community PHC service. Health conditions were ranked according to: (A) the percentage of patients in the PHC service diagnosed with these conditions; and (B) the citation frequency of plant use reports to treat these conditions by healers. Healers were also queried about the payment modalities they offer to their patients. Plant use reports from healers yielded 1166 responses about 181 medicinal plant species, which are used to treat 67 different health conditions, ranging from general symptoms (e.g. fever and body pain), to more specific ailments, such as arthritis, biliary colic and pneumonia. The results show that treatment offered by traditional medicine overlaps with biomedical health care in the case of respiratory infections, wounds and bruises, fever and biliary colic/cholecystitis. Furthermore, traditional health care appears to be complementary to biomedical health care for chronic illnesses, especially arthritis, and for folk illnesses that are particularly relevant within the local cultural context. Payment from patients to healers included flexible, outcome contingent and non-monetary options. Traditional medicine in the study area is adaptive because it corresponds well with local patterns of morbidity, health care needs in relation to chronic illnesses, cultural perceptions of health conditions and socio-economic aspects of health care. The quantitative analysis of plant use reports and patient

  7. Family planning and health: the Narangwal experiment.

    Science.gov (United States)

    Faruqee, R

    1983-06-01

    The findings of a 7-year field experiment conducted in the Indian Punjab show that integrating family planning with health services is more effective and efficient than providing family planning separately. The field experiment was conducted between 1968 and 1974 at Narangwal in the Indian State of Punjab. It involved 26 villages, with a total population of 35,000 in 1971-72. The demographic characteristics of the villages were found to be typical of the area. 5 groups of villages were provided with different combinations of services for health, nutrition and family planning. A control group received no project services. A population study was made of the effects of integrating family planning with maternal and child health services. A nutritional study looked at the results of integrating nutritional care and health services. The effectiveness of integration was evaluated by identifying it both with increased use of family planning and improved health. Efficiency was judged by relating effectiveness to input costs. Distribution of the benefits was also examined. The effectiveness of these different combinations of services on the use of family planning was measured: 1) by all changes in the use of modern methods of family planning, 2) by the number of new acceptors, 3) by the changes in the proportion of eligible women using contraceptives, and 4) by how many people started to use the more effective methods. Results showed the use of family planning increased substantially in the experimental groups, whereas the control group remained constant. It was also found that, though the services combining family planning with maternal health care stimulated more use of family planning, they were more costly than the more integrated srevices. The Narangwal experiment provides significant evidence in favor of combining the provision of family planning and health services, but its potential for replication on a large scale needs to be studied.

  8. [Consumer satisfaction study in philanthropic hospital health plans].

    Science.gov (United States)

    Gerschman, Silvia; Veiga, Luciana; Guimarães, César; Ugá, Maria Alicia Dominguez; Portela, Margareth Crisóstomo; Vasconcellos, Miguel Murat; Barbosa, Pedro Ribeiro; Lima, Sheyla Maria Lemos

    2007-01-01

    This paper presents the findings of research aimed at identifying and analyzing the argumentation and rationale that justify the satisfaction of consumers with their health plans. The qualitative method applied used the focus group technique, for which the following aspects were defined: the criteria for choosing the health plans which were considered, the composition of the group and its distribution, recruitment strategy, and infrastructure and dynamics of the meetings. The health plan beneficiaries were classified into groups according to their social class, the place where they lived, mainly, the relationship that they established with the health plan operators which enabled us to develop a typology for the plan beneficiaries. Initially, we indicated how the health plan beneficiaries assess and use the Brazilian Unified Health System (SUS), and, then, considering the types of plans defined, we evaluated their degree of satisfaction with the different aspects of health care, and identified which aspects mostly contributed explain their satisfaction.

  9. 42 CFR 495.336 - Health information technology planning advance planning document requirements (HIT PAPD).

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Health information technology planning advance... STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.336 Health information technology planning advance planning document requirements...

  10. State of emergency preparedness for US health insurance plans.

    Science.gov (United States)

    Merchant, Raina M; Finne, Kristen; Lardy, Barbara; Veselovskiy, German; Korba, Caey; Margolis, Gregg S; Lurie, Nicole

    2015-01-01

    Health insurance plans serve a critical role in public health emergencies, yet little has been published about their collective emergency preparedness practices and policies. We evaluated, on a national scale, the state of health insurance plans' emergency preparedness and policies. A survey of health insurance plans. We queried members of America's Health Insurance Plans, the national trade association representing the health insurance industry, about issues related to emergency preparedness issues: infrastructure, adaptability, connectedness, and best practices. Of 137 health insurance plans queried, 63% responded, representing 190.6 million members and 81% of US plan enrollment. All respondents had emergency plans for business continuity, and most (85%) had infrastructure for emergency teams. Some health plans also have established benchmarks for preparedness (eg, response time). Regarding adaptability, 85% had protocols to extend claim filing time and 71% could temporarily suspend prior medical authorization rules. Regarding connectedness, many plans shared their contingency plans with health officials, but often cited challenges in identifying regulatory agency contacts. Some health insurance plans had specific policies for assisting individuals dependent on durable medical equipment or home healthcare. Many plans (60%) expressed interest in sharing best practices. Health insurance plans are prioritizing emergency preparedness. We identified 6 policy modifications that health insurance plans could undertake to potentially improve healthcare system preparedness: establishing metrics and benchmarks for emergency preparedness; identifying disaster-specific policy modifications, enhancing stakeholder connectedness, considering digital strategies to enhance communication, improving support and access for special-needs individuals, and developing regular forums for knowledge exchange about emergency preparedness.

  11. The strategic planning of health management information systems.

    Science.gov (United States)

    Smith, J

    1995-01-01

    This paper discusses the roles and functions of strategic planning of information systems in health services. It selects four specialised methodologies of strategic planning for analysis with respect to their applicability in the health field. It then examines the utilisation of information planning in case studies of three health organisations (two State departments of health and community services and one acute care institution). Issues arising from the analysis concern the planning process, the use to which plans are put, and implications for management.

  12. 48 CFR 1602.170-9 - Health benefits plan.

    Science.gov (United States)

    2010-10-01

    ... EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION GENERAL DEFINITIONS OF WORDS AND TERMS Definitions of FEHBP Terms 1602.170-9 Health benefits plan. Health benefits plan means a group insurance policy, contract... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Health benefits plan. 1602...

  13. Health care's new game changer. Thinking like a health plan.

    Science.gov (United States)

    Eggbeer, Bill; Bowers, Krista

    2014-10-01

    The transition for hospitals from having only a provider's perspective to thinking more like a health plan will require strategic alignment on four fronts: Health plan alignment. Hospital and physician alignment. Leadership alignment. Organizational alignment.

  14. Traditional vs. Contemporary Management Control Practices for Developing Public Health Policies.

    Science.gov (United States)

    Naranjo-Gil, David; Sánchez-Expósito, María Jesús; Gómez-Ruiz, Laura

    2016-07-14

    Public health policies must address multiple goals and complex community health needs. Recently, management control practices have emerged to provide a broader type of information for evaluating the effectiveness of healthcare policies, and relate activities and processes to multiple strategic outcomes. This study compares the effect of traditional and contemporary management control practices on the achievement of public health policies. It is also analyzed how two different uses of such practices (enabling vs. coercive) facilitate the achievement of public health policies. Relationships are explored using data collected from managers from public health agencies and public hospitals in Spain. The findings show that contemporary management control practices are more suitable than traditional practices to achieve public health policies. Furthermore, results show that public health policies are better achieved when managers use management control practices in an enabling way rather than in a coercive way.

  15. Program Planning in Health Professions Education

    Science.gov (United States)

    Schmidt, Steven W.; Lawson, Luan

    2018-01-01

    In this chapter, the major concepts from program planning in adult education will be applied to health professions education (HPE). Curriculum planning and program planning will be differentiated, and program development and planning will be grounded in a systems thinking approach.

  16. Health contribution to local government planning

    International Nuclear Information System (INIS)

    France, Cheryl

    2004-01-01

    When local government considers future land-use plans, the local health authorities are not always included as a key partner. In Cambridgeshire, England, the former Cambridgeshire Health Authority formed a partnership with local government to address this issue. The relationship that developed and the subsequent health impact review provided an opportunity to influence strategic policy and ensure that health objectives are taken into account. Through partnership working, lessons were learned about how to incorporate health issues into a strategic land-use planning document to the overall benefit of the community

  17. Health Maintenance Organization (HMO) Plan

    Science.gov (United States)

    ... Find & compare doctors, hospitals, & other providers Health Maintenance Organization (HMO) Plan In most HMO Plans, you generally ... certain service when needed. Related Resources Preferred Provider Organization (PPO) Private Fee-for-Service (PFFS) Special Needs ...

  18. Health plans' disease management programs: extending across the medical and behavioral health spectrum?

    Science.gov (United States)

    Merrick, Elizabeth Levy; Horgan, Constance M; Garnick, Deborah W; Hodgkin, Dominic; Morley, Melissa

    2008-01-01

    Although the disease management industry has expanded rapidly, there is little nationally representative data regarding medical and behavioral health disease management programs at the health plan level. National estimates from a survey of private health plans indicate that 90% of health plan products offered disease management for general medical conditions such as diabetes but only 37% had depression programs. The frequency of specific depression disease management activities varied widely. Program adoption was significantly related to product type and behavioral health contracting. In health plans, disease management has penetrated more slowly into behavioral health and depression program characteristics are highly variable.

  19. Online schools and children with special health and educational needs: comparison with performance in traditional schools.

    Science.gov (United States)

    Thompson, Lindsay A; Ferdig, Rick; Black, Erik

    2012-04-30

    In the United States, primary and secondary online schools are institutions that deliver online curricula for children enrolled in kindergarten through 12th grade (K-12). These institutions commonly provide opportunities for online instruction in conjunction with local schools for students who may need remediation, have advanced needs, encounter unqualified local instructors, or experience scheduling conflicts. Internet-based online schooling may potentially help children from populations known to have educational and health disadvantages, such as those from certain racial or ethnic backgrounds, those of low socioeconomic status, and children with special health care needs (CSHCN). To describe the basic and applied demographics of US online-school users and to compare student achievement in traditional versus online schooling environments. We performed a brief parental survey in three states examining basic demographics and educational history of the child and parents, the child's health status as measured by the CSHCN Screener, and their experiences and educational achievement with online schools and class(es). Results were compared with state public-school demographics and statistical analyses controlled for state-specific independence. We analyzed responses from 1971 parents with a response rate of 14.7% (1971/13,384). Parents of online-school participants were more likely to report having a bachelor's degree or higher than were parents of students statewide in traditional schools, and more of their children were white and female. Most notably, the prevalence of CSHCN was high (476/1971, 24.6%) in online schooling. Children who were male, black, or had special health care needs reported significantly lower grades in both traditional and online schools. However, when we controlled for age, gender, race, and parental education, parents of CSHCN or black children reported significantly lower grades in online than in traditional schooling (adjusted odds ratio [a

  20. UMTRA Project environmental, health, and safety plan

    International Nuclear Information System (INIS)

    1989-02-01

    The basic health and safety requirements established in this plan are designed to provide guidelines to be applied at all Uranium Mill Tailings Remedial Action (UMTRA) Project sites. Specific restrictions are given where necessary. However, an attempt has been made to provide guidelines which are generic in nature, and will allow for evaluation of site-specific conditions. Health and safety personnel are expected to exercise professional judgment when interpreting these guidelines to ensure the health and safety of project personnel and the general population. This UMTRA Project Environmental, Health, and Safety (EH ampersand S) Plan specifies the basic Federal health and safety standards and special DOE requirements applicable to this program. In addition, responsibilities in carrying out this plan are delineated. Some guidance on program requirements and radiation control and monitoring is also included. An Environmental, Health, and Safety Plan shall be developed as part of the remedial action plan for each mill site and associated disposal site. Special conditions at the site which may present potential health hazards will be described, and special areas that should should be addressed by the Remedial Action Contractor (RAC) will be indicated. Site-specific EH ampersand S concerns will be addressed by special contract conditions in RAC subcontracts. 2 tabs

  1. Common and Critical Components Among Community Health Assessment and Community Health Improvement Planning Models.

    Science.gov (United States)

    Pennel, Cara L; Burdine, James N; Prochaska, John D; McLeroy, Kenneth R

    Community health assessment and community health improvement planning are continuous, systematic processes for assessing and addressing health needs in a community. Since there are different models to guide assessment and planning, as well as a variety of organizations and agencies that carry out these activities, there may be confusion in choosing among approaches. By examining the various components of the different assessment and planning models, we are able to identify areas for coordination, ways to maximize collaboration, and strategies to further improve community health. We identified 11 common assessment and planning components across 18 models and requirements, with a particular focus on health department, health system, and hospital models and requirements. These common components included preplanning; developing partnerships; developing vision and scope; collecting, analyzing, and interpreting data; identifying community assets; identifying priorities; developing and implementing an intervention plan; developing and implementing an evaluation plan; communicating and receiving feedback on the assessment findings and/or the plan; planning for sustainability; and celebrating success. Within several of these components, we discuss characteristics that are critical to improving community health. Practice implications include better understanding of different models and requirements by health departments, hospitals, and others involved in assessment and planning to improve cross-sector collaboration, collective impact, and community health. In addition, federal and state policy and accreditation requirements may be revised or implemented to better facilitate assessment and planning collaboration between health departments, hospitals, and others for the purpose of improving community health.

  2. Traditional healers and provision of mental health services in ...

    African Journals Online (AJOL)

    treatment of, mental health problems.3 This was recognized in ... Keywords: Traditional Healers; Mental illness; Informal settlements; Kenya .... students on their vacation. ..... and treatments in Malaysia, in Blakeney M (Ed) Perspectives on.

  3. 42 CFR 51c.105 - Accord with health planning.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Accord with health planning. 51c.105 Section 51c... COMMUNITY HEALTH SERVICES General Provisions § 51c.105 Accord with health planning. A grant may be made... approval by the appropriate health planning agencies have been met. ...

  4. Moving toward holistic wellness, empowerment and self-determination for Indigenous peoples in Canada: Can traditional Indigenous health care practices increase ownership over health and health care decisions?

    Science.gov (United States)

    Auger, Monique; Howell, Teresa; Gomes, Tonya

    2016-12-27

    This study aimed to understand the role that traditional Indigenous health care practices can play in increasing individual-level self-determination over health care and improving health outcomes for urban Indigenous peoples in Canada. This project took place in Vancouver, British Columbia and included the creation and delivery of holistic workshops to engage community members (n = 35) in learning about aspects of traditional health care practices. Short-term and intermediate outcomes were discussed through two gatherings involving focus groups and surveys. Data were transcribed, reviewed, thematically analyzed, and presented to the working group for validation. When participants compared their experiences with traditional health care to western health care, they described barriers to care that they had experienced in accessing medical doctors (e.g., racism, mistrust), as well as the benefits of traditional healing (e.g., based on relationships, holistic approach). All participants also noted that they had increased ownership over their choices around, and access to, health care, inclusive of both western and traditional options. They stressed that increased access to traditional health care is crucial within urban settings. Self-determination within Indigenous urban communities, and on a smaller scale, ownership for individuals, is a key determinant of health for Indigenous individuals and communities; this was made clear through the analysis of the research findings and is also supported within the literature. This research also demonstrates that access to traditional healing can enhance ownership for community members. These findings emphasize that there is a continued and growing need for support to aid urban Indigenous peoples in accessing traditional health care supports.

  5. Can the right to health inform public health planning in developing countries? A case study for maternal healthcare from Indonesia.

    Science.gov (United States)

    D'Ambruoso, Lucia; Byass, Peter; Nurul Qomariyah, Siti

    2008-09-09

    Maternal mortality remains unacceptably high in developing countries despite international advocacy, development targets, and simple, affordable and effective interventions. In recent years, regard for maternal mortality as a human rights issue as well as one that pertains to health, has emerged. We study a case of maternal death using a theoretical framework derived from the right to health to examine access to and quality of maternal healthcare. Our objective was to explore the potential of rights-based frameworks to inform public health planning from a human rights perspective. Information was elicited as part of a verbal autopsy survey investigating maternal deaths in rural settings in Indonesia. The deceased's relatives were interviewed to collect information on medical signs, symptoms and the social, cultural and health systems circumstances surrounding the death. In this case, a prolonged, severe fever and a complicated series of referrals culminated in the death of a 19-year-old primagravida at 7 months gestation. The cause of death was acute infection. The woman encountered a range of barriers to access; behavioural, socio-cultural, geographic and economic. Several serious health system failures were also apparent. The theoretical framework derived from the right to health identified that none of the essential elements of the right were upheld. The rights-based approach could identify how and where to improve services. However, there are fundamental and inherent conflicts between the public health tradition (collective and preventative) and the right to health (individualistic and curative). As a result, and in practice, the right to health is likely to be ineffective for public health planning from a human rights perspective. Collective rights such as the right to development may provide a more suitable means to achieve equity and social justice in health planning.

  6. Case-mix adjustment of consumer reports about managed behavioral health care and health plans.

    Science.gov (United States)

    Eselius, Laura L; Cleary, Paul D; Zaslavsky, Alan M; Huskamp, Haiden A; Busch, Susan H

    2008-12-01

    To develop a model for adjusting patients' reports of behavioral health care experiences on the Experience of Care and Health Outcomes (ECHO) survey to allow for fair comparisons across health plans. Survey responses from 4,068 individuals enrolled in 21 managed behavioral health plans who received behavioral health care within the previous year (response rate = 48 percent). Potential case-mix adjustors were evaluated by combining information about their predictive power and the amount of within- and between-plan variability. Changes in plan scores and rankings due to case-mix adjustment were quantified. The final case-mix adjustment model included self-reported mental health status, self-reported general health status, alcohol/drug treatment, age, education, and race/ethnicity. The impact of adjustment on plan report scores was modest, but large enough to change some plan rankings. Adjusting plan report scores on the ECHO survey for differences in patient characteristics had modest effects, but still may be important to maintain the credibility of patient reports as a quality metric. Differences between those with self-reported fair/poor health compared with those in excellent/very good health varied by plan, suggesting quality differences associated with health status and underscoring the importance of collecting quality information.

  7. Consumer-directed health plans: what happened?

    Science.gov (United States)

    Goldsmith, Jeff

    2007-08-01

    CDHPs can stabilize growth in health costs, but the health plan-subscriber relationship should be more transparent. CFOs should ensure that increased cost exposure in CDHPs is paired with broad, deep disease management and employee assistance support. Hospitals should plan for the likelihood that, one way or another, consumers will be paying more of their healthcare bill.

  8. Iran's Health Reform Plan: Measuring Changes in Equity Indices.

    Science.gov (United States)

    Assari Arani, Abbas; Atashbar, Tohid; Antoun, Joseph; Bossert, Thomas

    2018-03-01

    Two years after the implementation of the Health Sector Evolution Plan (HSEP), this study evaluated the effects of the plan on health equity indices. The main indices assessed by the study were the Out-of-Pocket (OOP) health expenditures, the Fairness in Financial Contribution (FFC) to the health system index, the index of households' Catastrophic Health Expenditure (CHE) and the headcount ratio of Impoverishing Health Expenditure (IHE). The per capita share of costs for total health services has been decreased. The lowered costs have been more felt in rural areas, generally due to sharp decrease in inpatient costs. Per capita pay for outpatient services is almost constant or has slightly increased. The reform plan has managed to improve households' Catastrophic Health Expenditure (CHE) index from an average of 2.9% before the implementation of the plan to 2.3% after the plan. The Fairness in Financial Contribution (FFC) to the health system index has worsened from 0.79 to 0.76, and the headcount ratio of Impoverishing Health Expenditure (IHE) index deteriorated after the implementation of plan from 0.34 to 0.50. Considerable improvement, in decreasing the burden of catastrophic hospital costs in low income strata which is about 26% relative to the time before the implementation of the plan can be regarded as the main achievement of the plan, whereas the worsening in the headcount ratio of IHE and FFC are the equity bottlenecks of the plan.

  9. 77 FR 38296 - Draft Public Health Action Plan-A National Public Health Action Plan for the Detection...

    Science.gov (United States)

    2012-06-27

    ... Prevention and Health Promotion, Division of Reproductive Health, Attn: National Public Health Action Plan... Disease Prevention and Health Promotion, Division of Reproductive Health, 4770 Buford Highway NE... topic's public health importance, existing challenges, and opportunities for action to decrease the...

  10. A framework for health care planning and control

    NARCIS (Netherlands)

    Hans, Elias W.; van Houdenhoven, Mark; Hulshof, P.J.H.

    Rising expenditures spur health care organizations to organize their processes more efficiently and effectively. Unfortunately, health care planning and control lags far behind manufacturing planning and control. Successful manufacturing planning and control concepts can not be directly copied,

  11. Chemical Risk Assessment: Traditional vs Public Health ...

    Science.gov (United States)

    Preventing adverse health impacts from exposures to environmental chemicals is fundamental to protecting individual and public health. When done efficiently and properly, chemical risk assessment enables risk management actions that minimize the incidence and impacts of environmentally-induced diseases related to chemical exposure. However, traditional chemical risk assessment is faced with multiple challenges with respect to predicting and preventing disease in human populations, and epidemiological studies increasingly report observations of adverse health effects at exposure levels predicted from animal studies to be safe for humans. This discordance reinforces concerns about the adequacy of contemporary risk assessment practices (Birnbaum, Burke, & Jones, 2016) for protecting public health. It is becoming clear that to protect public health more effectively, future risk assessments will need to use the full range of available data, draw on innovative methods to integrate diverse data streams, and consider health endpoints that also reflect the range of subtle effects and morbidities observed in human populations. Given these factors, there is a need to reframe chemical risk assessment to be more clearly aligned with the public health goal of minimizing environmental exposures associated with disease. Preventing adverse health impacts from exposures to environmental chemicals is fundamental to protecting individual and public health. Chemical risk assessments

  12. Provider-Sponsored Health Plans: Lessons Learned over Three Decades.

    Science.gov (United States)

    Breon, Richard C

    2016-01-01

    Healthcare's movement to value-based care is causing health systems across the country to consider whether owning or partnering with a health plan could benefit their organizations. Although organizations have different reasons for wanting to enter the insurance business, potential benefits include improving care quality, lowering costs, managing population health, expanding geographic reach, and diversifying the organization's revenue stream. However, the challenges and risks of owning a health plan are formidable: Assuming 100 percent financial risk for a patient population requires considerable financial resources, as well as competencies that are wholly different from those needed to run a hospital or physician group. For Spectrum Health, an integrated, not-for-profit health system based in Grand Rapids, Michigan, owning a health plan has been vital to fulfilling its mission of improving the health of the communities it serves, as well as its value proposition of providing highquality care at lower costs. This article weighs the pros and cons of operating a health plan; explores key business factors and required competencies that organizations need to consider when deciding whether to buy, build, or partner; examines the current environment for provider-sponsored health plans; and shares some of the lessons Spectrum Health has learned over three decades of running its health plan, Priority Health.

  13. Maternal health, war, and religious tradition: authoritative knowledge in Pujehun District, Sierra Leone.

    Science.gov (United States)

    Jambai, A; MacCormack, C

    1996-06-01

    In Sierra Leone constraints to ideal maternal health require a primary health care approach that includes collaboration with traditional midwives. They are authoritative figures embedded within local political structures and a powerful women's religion. The local causes of maternal risk are described, including civil war and refugee camp life. Traditional midwives provide vital services in the camp, are respected for their social status, and learn additional skills. Biomedical and traditional systems of authoritative knowledge, based on different kinds of legitimacy to heal, are in a complementary relationship.

  14. Joining up health and planning: how Joint Strategic Needs Assessment (JSNA) can inform health and wellbeing strategies and spatial planning.

    Science.gov (United States)

    Tomlinson, Paul; Hewitt, Stephen; Blackshaw, Neil

    2013-09-01

    There has been a welcome joining up of the rhetoric around health, the environment and land use or spatial planning in both the English public health white paper and the National Planning Policy Framework. However, this paper highlights a real concern that this is not being followed through into practical guidance needed by local authorities (LAs), health bodies and developers about how to deliver this at the local level. The role of Joint Strategic Needs Assessments (JSNAs) and Health and Wellbeing Strategies (HWSs) have the potential to provide a strong basis for integrated local policies for health improvement, to address the wider determinants of health and to reduce inequities. However, the draft JSNA guidance from the Department of Health falls short of providing a robust, comprehensive and practical guide to meeting these very significant challenges. The paper identifies some examples of good practice. It recommends that action should be taken to raise the standards of all JSNAs to meet the new challenges and that HWSs should be aligned spatially and temporally with local plans and other LA strategies. HWSs should also identify spatially targeted interventions that can be delivered through spatial planning or transport planning. Steps need to be taken to ensure that district councils are brought into the process.

  15. An analysis of application of health informatics in Traditional Medicine: A review of four Traditional Medicine Systems.

    Science.gov (United States)

    Raja Ikram, Raja Rina; Abd Ghani, Mohd Khanapi; Abdullah, Noraswaliza

    2015-11-01

    This paper shall first investigate the informatics areas and applications of the four Traditional Medicine systems - Traditional Chinese Medicine (TCM), Ayurveda, Traditional Arabic and Islamic Medicine and Traditional Malay Medicine. Then, this paper shall examine the national informatics infrastructure initiatives in the four respective countries that support the Traditional Medicine systems. Challenges of implementing informatics in Traditional Medicine Systems shall also be discussed. The literature was sourced from four databases: Ebsco Host, IEEE Explore, Proquest and Google scholar. The search term used was "Traditional Medicine", "informatics", "informatics infrastructure", "traditional Chinese medicine", "Ayurveda", "traditional Arabic and Islamic medicine", and "traditional malay medicine". A combination of the search terms above was also executed to enhance the searching process. A search was also conducted in Google to identify miscellaneous books, publications, and organization websites using the same terms. Amongst major advancements in TCM and Ayurveda are bioinformatics, development of Traditional Medicine databases for decision system support, data mining and image processing. Traditional Chinese Medicine differentiates itself from other Traditional Medicine systems with documented ISO Standards to support the standardization of TCM. Informatics applications in Traditional Arabic and Islamic Medicine are mostly ehealth applications that focus more on spiritual healing, Islamic obligations and prophetic traditions. Literature regarding development of health informatics to support Traditional Malay Medicine is still insufficient. Major informatics infrastructure that is common in China and India are automated insurance payment systems for Traditional Medicine treatment. National informatics infrastructure in Middle East and Malaysia mainly cater for modern medicine. Other infrastructure such as telemedicine and hospital information systems focus its

  16. The perfect storm of information: combining traditional and non-traditional data sources for public health situational awareness during hurricane response.

    Science.gov (United States)

    Bennett, Kelly J; Olsen, Jennifer M; Harris, Sara; Mekaru, Sumiko; Livinski, Alicia A; Brownstein, John S

    2013-12-16

    Hurricane Isaac made landfall in southeastern Louisiana in late August 2012, resulting in extensive storm surge and inland flooding. As the lead federal agency responsible for medical and public health response and recovery coordination, the Department of Health and Human Services (HHS) must have situational awareness to prepare for and address state and local requests for assistance following hurricanes. Both traditional and non-traditional data have been used to improve situational awareness in fields like disease surveillance and seismology. This study investigated whether non-traditional data (i.e., tweets and news reports) fill a void in traditional data reporting during hurricane response, as well as whether non-traditional data improve the timeliness for reporting identified HHS Essential Elements of Information (EEI). HHS EEIs provided the information collection guidance, and when the information indicated there was a potential public health threat, an event was identified and categorized within the larger scope of overall Hurricane Issac situational awareness. Tweets, news reports, press releases, and federal situation reports during Hurricane Isaac response were analyzed for information about EEIs. Data that pertained to the same EEI were linked together and given a unique event identification number to enable more detailed analysis of source content. Reports of sixteen unique events were examined for types of data sources reporting on the event and timeliness of the reports. Of these sixteen unique events identified, six were reported by only a single data source, four were reported by two data sources, four were reported by three data sources, and two were reported by four or more data sources. For five of the events where news tweets were one of multiple sources of information about an event, the tweet occurred prior to the news report, press release, local government\\emergency management tweet, and federal situation report. In all circumstances where

  17. [The Health Plan for Catalonia: an instrument to transform the health system].

    Science.gov (United States)

    Constante i Beitia, Carles

    2015-11-01

    The Department of Health of the Generalitat in Catalonia periodically draws up the Health Plan, which is the strategic document that brings together the reference framework for initiatives concerning public health in terms of the Catalan health administration. The 2011-2015 version of the Health Plan incorporates key care and system governance-related elements, which, in conjunction with health goals, make up the complete picture of what the health system in Catalonia should look like until 2015. The Plan was drawn up at a time when the environmental conditions were extremely particular, given the major economic crisis that began in 2007. This has meant that the system has been forced to address public health problems using a significant reduction in the economic resources available, while aiming to maintain the level of care provided, both quantitatively and qualitatively, and preserve the sustainability of the system whose defining traits are its universality, equity and the wide range of services on offer. The Health Plan focuses on three areas of action, 9 major courses of action and 32 strategic projects designed to respond to new social needs: addressing the most common health issues, comprehensive care for chronic patients and organizational modernization. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  18. Traditional health practitioners and the authority to issue medical ...

    African Journals Online (AJOL)

    to face in selecting the credible practitioners from the bogus ones for registration ... for registration. It is clear that the definition of a traditional health ... medical certificate and its validity can bring about came sharply to the fore in Kievits Kroon ...

  19. EM Health and Safety Plan Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    1994-12-01

    This document contains information about the Health and Safety Plan Guidelines. Topics discussed include: Regulatory framework; key personnel; hazard assessment; training requirements; personal protective equipment; extreme temperature disorders or conditions; medical surveillance; exposure monitoring/air sampling; site control; decontamination; emergency response/contingency plan; emergency action plan; confined space entry; and spill containment.

  20. Financial Performance of Health Plans in Medicaid Mana...

    Data.gov (United States)

    U.S. Department of Health & Human Services — This study assesses the financial performance of health plans that enroll Medicaid members across the key plan traits, specifically Medicaid dominant, publicly...

  1. Environmental health and health planning

    International Nuclear Information System (INIS)

    1975-07-01

    Areas of environmental concern are identified and recommendations for improving environmental health are proposed by the Environmental Health Task Force of the Western Massachusetts Health Planning Council. Environmental health concerns in Western Massachusetts are in the areas of: air pollution; dental health and the specific problem of water flouridation; housing; injury control, including accidental death and disability; land use, and the specific problem of critical receptors; noise pollution; occupational hazards, specifically occupational accidents; pesticides; radiological exposure, particularly medical X-ray exposure and nuclear exposure; rural health care; sanitation; solid waste; and water quality including private and public water supplies, road salting, and rural sewerages. Each area of concern and specific problem are broken down into sections: background information; comments which incorporate recommendations for general problem-solving activities; and resources, including lists of key organization, individuals, laws and regulations, and publications relevant to the area of concern. Recommendations are presented based on long-term and short-term environmental goals. An inventory of environmental health organizations in Western Massachusetts is included. Appendices contain the charge to the Task Force, a definition of environmental health, sources of drinking water, the sanitation and sanitary codes, and housing and sanitation standards. Portions of this document are not fully legible

  2. Housing, health and master planning: rules of engagement.

    Science.gov (United States)

    Harris, P; Haigh, F; Thornell, M; Molloy, L; Sainsbury, P

    2014-04-01

    Knowledge about health focussed policy collaboration to date has been either tactical or technical. This article focusses on both technical and tactical issues to describe the experience of cross-sectoral collaboration between health and housing stakeholders across the life of a housing master plan, including but not limited to a health impact assessment (HIA). A single explanatory case study of collaboration on a master plan to regenerate a deprived housing estate in Western Sydney was developed to explain why and how the collaboration worked or did not work. Data collection included stakeholder interviews, document review, and reflections by the health team. Following a realist approach, data was analysed against established public policy theory dimensions. Tactically we did not know what we were doing. Despite our technical knowledge and skills with health focussed processes, particularly HIA, we failed to appreciate complexities inherent in master planning. This limited our ability to provide information at the right points. Eventually however the HIA did provide substantive connections between the master plan and health. We use our analysis to develop technical and tactical rules of engagement for future cross-sectoral collaboration. This case study from the field provides insight for future health focussed policy collaboration. We demonstrate the technical and tactical requirements for future intersectoral policy and planning collaborations, including HIAs, with the housing sector on master planning. The experience also suggested how HIAs can be conducted flexibly alongside policy development rather than at a specific point after a policy is drafted. Copyright © 2014 The Royal Society for Public Health. All rights reserved.

  3. Health impact assessment in planning: Development of the design for health HIA tools

    International Nuclear Information System (INIS)

    Forsyth, Ann; Slotterback, Carissa Schively; Krizek, Kevin J.

    2010-01-01

    How can planners more systematically incorporate health concerns into practical planning processes? This paper describes a suite of health impact assessment tools (HIAs) developed specifically for planning practice. Taking an evidence-based approach the tools are designed to fit into existing planning activities. The tools include: a short audit tool, the Preliminary Checklist; a structured participatory workshop, the Rapid HIA; an intermediate health impact assessment, the Threshold Analysis; and a set of Plan Review Checklists. This description provides a basis for future work including assessing tool validity, refining specific tools, and creating alternatives.

  4. 76 FR 46677 - Requirements for Group Health Plans and Health Insurance Issuers Relating to Coverage of...

    Science.gov (United States)

    2011-08-03

    ... Requirements for Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services... regulations published July 19, 2010 with respect to group health plans and health insurance coverage offered... plans, and health insurance issuers providing group health insurance coverage. The text of those...

  5. How to inject consumerism into your existing health plans.

    Science.gov (United States)

    Havlin, Linda J; McAllister, Michael F; Slavney, David H

    2003-09-01

    Consumerism seeks to create a behavior change on the part of consumers so that they become accountable, knowledgeable and actively engaged in managing their health. It can be used in any existing health plan through targeted plan design changes and consumer education efforts. Employers have many options in addition to consumer-directed health plans (CDHPs).

  6. The ACTIVATE study: results from a group-randomized controlled trial comparing a traditional worksite health promotion program with an activated consumer program.

    Science.gov (United States)

    Terry, Paul E; Fowles, Jinnet Briggs; Xi, Min; Harvey, Lisa

    2011-01-01

    PURPOSE. This study compares a traditional worksite-based health promotion program with an activated consumer program and a control program DESIGN. Group randomized controlled trial with 18-month intervention. SETTING. Two large Midwestern companies. SUBJECTS. Three hundred and twenty employees (51% response). INTERVENTION. The traditional health promotion intervention offered population-level campaigns on physical activity, nutrition, and stress management. The activated consumer intervention included population-level campaigns for evaluating health information, choosing a health benefits plan, and understanding the risks of not taking medications as prescribed. The personal development intervention (control group) offered information on hobbies. The interventions also offered individual-level coaching for high risk individuals in both active intervention groups. MEASURES. Health risk status, general health status, consumer activation, productivity, and the ability to evaluate health information. ANALYSIS. Multivariate analyses controlled for baseline differences among the study groups. RESULTS. At the population level, compared with baseline performance, the traditional health promotion intervention improved health risk status, consumer activation, and the ability to recognize reliable health websites. Compared with baseline performance, the activated consumer intervention improved consumer activation, productivity, and the ability to recognize reliable health websites. At the population level, however, only the activated consumer intervention improved any outcome more than the control group did; that outcome was consumer activation. At the individual level for high risk individuals, both traditional health coaching and activated consumer coaching positively affected health risk status and consumer activation. In addition, both coaching interventions improved participant ability to recognize a reliable health website. Consumer activation coaching also

  7. Planning of general practitioners in the Netherlands: a simulation model.

    NARCIS (Netherlands)

    Greuningen, M. van; Batenburg, R.S.; Velden, L.F.J. van der

    2010-01-01

    Manpower planning can be an important instrument to control shortages (or oversupply) within the health care labour market. The Netherlands is one of the countries that have a relative long tradition of manpower planning in health care. In 1973 the government introduced the numerus clausus for the

  8. Initiatives: Nigeria. Traditional healers and PPFN in wedlock.

    Science.gov (United States)

    Adejo, A A

    1996-04-01

    The Planned Parenthood Federation of Nigeria (PPFN) runs a program to integrate modern contraception into the practice of traditional medicine. Under the project, traditional healers, largely male, are trained on the ideals of nonprescriptive contraceptives such as condoms, the oral contraceptive pill, and foaming tablets, and how to offer such services to their clients. They participate in a two-week, highly participatory training course which confers a comprehensive introduction to basic and integrated reproductive health care service delivery, simple human anatomy and physiology, and human reproduction. The benefits of modern contraception are reviewed along with community mobilization and counseling. Simple communication techniques such as songs, drama, and role play are discussed. Information on maternal and child health and child survival, basic hygiene, nutrition, and AIDS is also incorporated into the course. 136 traditional healers have thus far been trained in three local government areas (LGAs) of Lagos State and 150 in six other LGAs in Benue State. The project has resulted in strong referral linkages between traditional healers, modern practitioners, and PPFN.

  9. Participant compliance to a six‐month traditional and modified Daniel Fast

    Directory of Open Access Journals (Sweden)

    Richard Bloomer

    2014-09-01

    Full Text Available Background: We have previously reported multiple health benefits in individuals following the Christian-based fasting protocol known as the Daniel Fast (DF. However, our prior work has involved only short-term (21-day assessments. For dietary modification to have a profound impact on health, compliance to the dietary plan must be established for the long-term. Materials and Methods We determined the 6-month compliance to a traditional (vegan DF (n=12, as well as a modified DF (n=9; allowing for the inclusion of small amounts of meat and milk in healthy individuals. Participants completed diet records during the study period and also rated their overall compliance to the assigned dietary plan. Results Compliance to both dietary plans proved to be satisfactory (approximately 80% in the 6th month; 85% in the 3rd month and 95% during the 3rd week. It is noteworthy that it did not show any major differences between groups. Body weight, from baseline toward month 6, saw a decline in participants assigned to both the traditional DF (79.6±5.3 to 75.5±5.5 kg and the modified DF (80.4±8.0 to 74.3±6.5 kg. Conclusion These data indicated that both the traditional and modified DF, which involve ad libitum (Latin for “at liberty” feeding, are realistic for individuals to comply with over a period of several months. Such compliance is associated with a weight loss of approximately 5-8% of the body mass and considering the multi-faceted health benefits of this particular dietary approach, it may result in worthy improvements in overall health. Additional studies of the long-term health implications of this fasting method are also required.

  10. Empowering health personnel for decentralized health planning in India: The Public Health Resource Network

    Directory of Open Access Journals (Sweden)

    Prasad Vandana

    2009-07-01

    Full Text Available Abstract The Public Health Resource Network is an innovative distance-learning course in training, motivating, empowering and building a network of health personnel from government and civil society groups. Its aim is to build human resource capacity for strengthening decentralized health planning, especially at the district level, to improve accountability of health systems, elicit community participation for health, ensure equitable and accessible health facilities and to bring about convergence in programmes and services. The question confronting health systems in India is how best to reform, revitalize and resource primary health systems to deliver different levels of service aligned to local realities, ensuring universal coverage, equitable access, efficiency and effectiveness, through an empowered cadre of health personnel. To achieve these outcomes it is essential that health planning be decentralized. Districts vary widely according to the specific needs of their population, and even more so in terms of existing interventions and available resources. Strategies, therefore, have to be district-specific, not only because health needs vary, but also because people's perceptions and capacities to intervene and implement programmes vary. In centrally designed plans there is little scope for such adaptation and contextualization, and hence decentralized planning becomes crucial. To undertake these initiatives, there is a strong need for trained, motivated, empowered and networked health personnel. It is precisely at this level that a lack of technical knowledge and skills and the absence of a supportive network or adequate educational opportunities impede personnel from making improvements. The absence of in-service training and of training curricula that reflect field realities also adds to this, discouraging health workers from pursuing effective strategies. The Public Health Resource Network is thus an attempt to reach out to motivated

  11. Empowering health personnel for decentralized health planning in India: The Public Health Resource Network.

    Science.gov (United States)

    Kalita, Anuska; Zaidi, Sarover; Prasad, Vandana; Raman, V R

    2009-07-20

    The Public Health Resource Network is an innovative distance-learning course in training, motivating, empowering and building a network of health personnel from government and civil society groups. Its aim is to build human resource capacity for strengthening decentralized health planning, especially at the district level, to improve accountability of health systems, elicit community participation for health, ensure equitable and accessible health facilities and to bring about convergence in programmes and services. The question confronting health systems in India is how best to reform, revitalize and resource primary health systems to deliver different levels of service aligned to local realities, ensuring universal coverage, equitable access, efficiency and effectiveness, through an empowered cadre of health personnel. To achieve these outcomes it is essential that health planning be decentralized. Districts vary widely according to the specific needs of their population, and even more so in terms of existing interventions and available resources. Strategies, therefore, have to be district-specific, not only because health needs vary, but also because people's perceptions and capacities to intervene and implement programmes vary. In centrally designed plans there is little scope for such adaptation and contextualization, and hence decentralized planning becomes crucial. To undertake these initiatives, there is a strong need for trained, motivated, empowered and networked health personnel. It is precisely at this level that a lack of technical knowledge and skills and the absence of a supportive network or adequate educational opportunities impede personnel from making improvements. The absence of in-service training and of training curricula that reflect field realities also adds to this, discouraging health workers from pursuing effective strategies. The Public Health Resource Network is thus an attempt to reach out to motivated though often isolated health

  12. Reproductive health/family planning and the health of infants, girls and women.

    Science.gov (United States)

    Sadik, N

    1997-01-01

    The 1994 International Conference on Population and Development developed international consensus amongst health providers, policy makers, and group representing the whole of civil society regarding the concept of reproductive health and its definition. In line with this definition, reproductive health care is defined as the constellation of methods, techniques and services that contribute to reproductive health and well-being by preventing and solving reproductive health problems. Reproductive health care saves lives and prevents significant levels of morbidity through family planning programmes, antenatal, delivery and post-natal services, prevention and management programmes for reproductive tract infections (including sexually transmitted diseases and HIV/AIDS), prevention of abortion and management of its complications, cancers of the reproductive system, and harmful practices that impact on reproductive function. Reproductive health care needs are evident at all stages of the life cycle and account for a greater proportion of disability adjusted life years (DALYS) in girls and women than in boys and men. Reproductive health protects infant health by enabling birth spacing and birth limitation to be practiced through family planning. The prevention and early detection of reproductive tract infections, including sexually transmitted diseases and HIV, through the integration of preventive measures in family planning service delivery not only improves the quality of care provided but is also directly responsible for improvement in survival and health of infants. Addressing harmful practices such as son preference, sex selection, sexual violence and female genital mutilation complements the positive impact of planned and spaced children through family planning services on infant mortality and the reproductive health of young girls and women. They are also in addition to prenatal, delivery and postnatal services, positive determinants of low maternal mortality and

  13. Consumer experiences in a consumer-driven health plan.

    Science.gov (United States)

    Christianson, Jon B; Parente, Stephen T; Feldman, Roger

    2004-08-01

    To assess the experience of enrollees in a consumer-driven health plan (CDHP). Survey of University of Minnesota employees regarding their 2002 health benefits. Comparison of regression-adjusted mean values for CDHP and other plan enrollees: customer service, plan paperwork, overall satisfaction, and plan switching. For CDHP enrollees only, use of plan features, willingness to recommend the plan to others, and reports of particularly negative or positive experiences. There were significant differences in experiences of CDHP enrollees versus enrollees in other plans with customer service and paperwork, but similar levels of satisfaction (on a 10-point scale) with health plans. Eight percent of CDHP enrollees left their plan after one year, compared to 5 percent of enrollees leaving other plans. A minority of CDHP enrollees used online plan features, but enrollees generally were satisfied with the amount and quality of the information provided by the CDHP. Almost half reported a particularly positive experience, compared to a quarter reporting a particularly negative experience. Thirty percent said they would recommend the plan to others, while an additional 57 percent said they would recommend it depending on the situation. Much more work is needed to determine how consumer experience varies with the number and type of plan options available, the design of the CDHP, and the length of time in the CDHP. Research also is needed on the factors that affect consumer decisions to leave CDHPs.

  14. Risk sharing between competing health plans and sponsors

    NARCIS (Netherlands)

    E.M. van Barneveld (Erik); W.P.M.M. van de Ven (Wynand); R.C.J.A. van Vliet (René)

    2001-01-01

    textabstractIn many countries, competing health plans receive capitation payments from a sponsor, whether government or a private employer. All capitation payment methods are far from perfect and have raised concerns about risk selection. Paying health plans partly on the basis

  15. Approach to Health Supporting System Using Traditional Chinese Medicine

    Science.gov (United States)

    Watsuji, Tadashi; Shinohara, Shoji; Arita, Seizaburo

    The primary prevention of disease related to the lifestyle is an essential theme in medical research. Preventing before it arises is the important concept in traditional Chinese medicine (TCM). Since TCM, which emphasizes individual physical condition in medical treatment, has recently attracted considerable attention globally, objective diagnostic methods in TCM have been investigated in this work. Firstly, the fuzzy theory was applied to develop a tongue diagnosis supporting system based on the tongue diagnosis in TCM. Secondly, the usefulness of TCM health questionnaire was examined to identify individual physical condition. Our results suggest that the TCM health questionnaire is useful in the construction of a health supporting system based on TCM.

  16. 76 FR 37037 - Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and...

    Science.gov (United States)

    2011-06-24

    ... Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and Appeals and... interim final regulations published July 23, 2010 with respect to group health plans and health insurance..., group health plans, and health insurance issuers providing group health insurance coverage. The text of...

  17. Cyber and Traditional Bullying Victimization as a Risk Factor for Mental Health Problems and Suicidal Ideation in Adolescents

    Science.gov (United States)

    Bannink, Rienke; Broeren, Suzanne; van de Looij – Jansen, Petra M.; de Waart, Frouwkje G.; Raat, Hein

    2014-01-01

    Purpose To examine whether traditional and cyber bullying victimization were associated with adolescent's mental health problems and suicidal ideation at two-year follow-up. Gender differences were explored to determine whether bullying affects boys and girls differently. Methods A two-year longitudinal study was conducted among first-year secondary school students (N = 3181). Traditional and cyber bullying victimization were assessed at baseline, whereas mental health status and suicidal ideation were assessed at baseline and follow-up by means of self-report questionnaires. Logistic regression analyses were conducted to assess associations between these variables while controlling for baseline problems. Additionally, we tested whether gender differences in mental health and suicidal ideation were present for the two types of bullying. Results There was a significant interaction between gender and traditional bullying victimization and between gender and cyber bullying victimization on mental health problems. Among boys, traditional and cyber bullying victimization were not related to mental health problems after controlling for baseline mental health. Among girls, both traditional and cyber bullying victimization were associated with mental health problems after controlling for baseline mental health. No significant interaction between gender and traditional or cyber bullying victimization on suicidal ideation was found. Traditional bullying victimization was associated with suicidal ideation, whereas cyber bullying victimization was not associated with suicidal ideation after controlling for baseline suicidal ideation. Conclusions Traditional bullying victimization is associated with an increased risk of suicidal ideation, whereas traditional, as well as cyber bullying victimization is associated with an increased risk of mental health problems among girls. These findings stress the importance of programs aimed at reducing bullying behavior, especially

  18. Cyber and traditional bullying victimization as a risk factor for mental health problems and suicidal ideation in adolescents.

    Science.gov (United States)

    Bannink, Rienke; Broeren, Suzanne; van de Looij-Jansen, Petra M; de Waart, Frouwkje G; Raat, Hein

    2014-01-01

    To examine whether traditional and cyber bullying victimization were associated with adolescent's mental health problems and suicidal ideation at two-year follow-up. Gender differences were explored to determine whether bullying affects boys and girls differently. A two-year longitudinal study was conducted among first-year secondary school students (N = 3181). Traditional and cyber bullying victimization were assessed at baseline, whereas mental health status and suicidal ideation were assessed at baseline and follow-up by means of self-report questionnaires. Logistic regression analyses were conducted to assess associations between these variables while controlling for baseline problems. Additionally, we tested whether gender differences in mental health and suicidal ideation were present for the two types of bullying. There was a significant interaction between gender and traditional bullying victimization and between gender and cyber bullying victimization on mental health problems. Among boys, traditional and cyber bullying victimization were not related to mental health problems after controlling for baseline mental health. Among girls, both traditional and cyber bullying victimization were associated with mental health problems after controlling for baseline mental health. No significant interaction between gender and traditional or cyber bullying victimization on suicidal ideation was found. Traditional bullying victimization was associated with suicidal ideation, whereas cyber bullying victimization was not associated with suicidal ideation after controlling for baseline suicidal ideation. Traditional bullying victimization is associated with an increased risk of suicidal ideation, whereas traditional, as well as cyber bullying victimization is associated with an increased risk of mental health problems among girls. These findings stress the importance of programs aimed at reducing bullying behavior, especially because early-onset mental health problems

  19. Cyber and traditional bullying victimization as a risk factor for mental health problems and suicidal ideation in adolescents.

    Directory of Open Access Journals (Sweden)

    Rienke Bannink

    Full Text Available PURPOSE: To examine whether traditional and cyber bullying victimization were associated with adolescent's mental health problems and suicidal ideation at two-year follow-up. Gender differences were explored to determine whether bullying affects boys and girls differently. METHODS: A two-year longitudinal study was conducted among first-year secondary school students (N = 3181. Traditional and cyber bullying victimization were assessed at baseline, whereas mental health status and suicidal ideation were assessed at baseline and follow-up by means of self-report questionnaires. Logistic regression analyses were conducted to assess associations between these variables while controlling for baseline problems. Additionally, we tested whether gender differences in mental health and suicidal ideation were present for the two types of bullying. RESULTS: There was a significant interaction between gender and traditional bullying victimization and between gender and cyber bullying victimization on mental health problems. Among boys, traditional and cyber bullying victimization were not related to mental health problems after controlling for baseline mental health. Among girls, both traditional and cyber bullying victimization were associated with mental health problems after controlling for baseline mental health. No significant interaction between gender and traditional or cyber bullying victimization on suicidal ideation was found. Traditional bullying victimization was associated with suicidal ideation, whereas cyber bullying victimization was not associated with suicidal ideation after controlling for baseline suicidal ideation. CONCLUSIONS: Traditional bullying victimization is associated with an increased risk of suicidal ideation, whereas traditional, as well as cyber bullying victimization is associated with an increased risk of mental health problems among girls. These findings stress the importance of programs aimed at reducing bullying

  20. Organisational travel plans for improving health.

    Science.gov (United States)

    Hosking, Jamie; Macmillan, Alexandra; Connor, Jennie; Bullen, Chris; Ameratunga, Shanthi

    2010-03-17

    Dependence on car use has a number of broad health implications, including contributing to physical inactivity, road traffic injury, air pollution and social severance, as well as entrenching lifestyles that require environmentally unsustainable energy use. Travel plans are interventions that aim to reduce single-occupant car use and increase the use of alternatives such as walking, cycling and public transport, with a variety of behavioural and structural components. This review focuses on organisational travel plans for schools, tertiary institutes and workplaces. These plans are closely aligned in their aims and intervention design, having emerged from a shared theoretical base. To assess the effects of organisational travel plans on health, either directly measured, or through changes in travel mode. We searched the following electronic databases; Transport (1988 to June 2008), MEDLINE (1950 to June 2008), EMBASE (1947 to June 2008), CINAHL (1982 to June 2008), ERIC (1966 to June 2008), PSYCINFO (1806 to June 2008), Sociological Abstracts (1952 to June 2008), BUILD (1989 to 2002), Social Sciences Citation Index (1900 to June 2008), Science Citation Index (1900 to June 2008), Arts & Humanities Index (1975 to June 2008), Cochrane Database of Systematic Reviews (to August 2008), CENTRAL (to August 2008), Cochrane Injuries Group Register (to December 2009), C2-RIPE (to July 2008), C2-SPECTR (to July 2008), ProQuest Dissertations & Theses (1861 to June 2008). We also searched the reference lists of relevant articles, conference proceedings and Internet sources. We did not restrict the search by date, language or publication status. We included randomised controlled trials and controlled before-after studies of travel behaviour change programmes conducted in an organisational setting, where the measured outcome was change in travel mode or health. Both positive and negative health effects were included. Two authors independently assessed eligibility, assessed trial

  1. Traditional health practitioners and the authority to issue medical ...

    African Journals Online (AJOL)

    The Council, as a professional body established by Parliament, gives traditional health practitioners registered with it the authority to issue medical certificates in line with the provisions of the Basic Conditions of Employment Act. However, the Council does not seem to be in a position to perform this function yet. Moreover ...

  2. 76 FR 44491 - Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals...

    Science.gov (United States)

    2011-07-26

    ... 37208) entitled, ``Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims..., ``Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals and... external review processes for group health plans and health insurance issuers offering coverage in the...

  3. 75 FR 70159 - Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered...

    Science.gov (United States)

    2010-11-17

    ... Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered Health Plan... contracts of insurance. The temporary regulations provide guidance to employers, group health plans, and health insurance issuers providing group health insurance coverage. The IRS is issuing the temporary...

  4. The consideration of health in land use planning: Barriers and opportunities

    International Nuclear Information System (INIS)

    Burns, Jennifer; Bond, Alan

    2008-01-01

    This research investigates the consideration of human health effects within the plan-making process in the East of England. It is based primarily upon questionnaires and interviews with those involved in plan-making. The results indicate that, prior to the implementation of the Strategic Environmental Assessment (SEA) Directive, which established a statutory requirement for the consideration of significant effects on human health in European Union member states, very limited consideration has been given to human health in land use plans. The capacity of the planning system to affect human health is clearly understood by those responsible for their production, but they lack the expertise to consider the health implications of their plans. The SEA Directive, along with reforms to the planning system, does provide a framework for improving the consideration of health, but the capacity of the planning system to consider health must be improved as should dialogue with health practitioners, and the evidence base for health outcomes. Also, analytical and methodological complexity may hinder the ability of planners to consider health, indicating that greater application of the precautionary principle is required to deal with the present uncertainty over human health impacts resulting from the implementation of land use plans

  5. Incorporating Traditional Healing Into an Urban American Indian Health Organization: A Case Study of Community Member Perspectives

    Science.gov (United States)

    Hartmann, William E.; Gone, Joseph P.

    2013-01-01

    Facing severe mental health disparities rooted in a complex history of cultural oppression, members of many urban American Indian (AI) communities are reaching out for indigenous traditional healing to augment their use of standard Western mental health services. Because detailed descriptions of approaches for making traditional healing available for urban AI communities do not exist in the literature, this community-based project convened 4 focus groups consisting of 26 members of a midwestern urban AI community to better understand traditional healing practices of interest and how they might be integrated into the mental health and substance abuse treatment services in an Urban Indian Health Organization (UIHO). Qualitative content analysis of focus group transcripts revealed that ceremonial participation, traditional education, culture keepers, and community cohesion were thought to be key components of a successful traditional healing program. Potential incorporation of these components into an urban environment, however, yielded 4 marked tensions: traditional healing protocols versus the realities of impoverished urban living, multitribal representation in traditional healing services versus relational consistency with the culture keepers who would provide them, enthusiasm for traditional healing versus uncertainty about who is trustworthy, and the integrity of traditional healing versus the appeal of alternative medicine. Although these tensions would likely arise in most urban AI clinical contexts, the way in which each is resolved will likely depend on tailored community needs, conditions, and mental health objectives. PMID:22731113

  6. 75 FR 34571 - Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered...

    Science.gov (United States)

    2010-06-17

    ... Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered Health Plan... of Consumer Information and Insurance Oversight of the U.S. Department of Health and Human Services... health insurance coverage offered in connection with a group health plan under the Employee Retirement...

  7. 76 FR 37207 - Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals...

    Science.gov (United States)

    2011-06-24

    ... Department of Health and Human Services 45 CFR Part 147 Group Health Plans and Health Insurance Issuers... SERVICES [CMS-9993-IFC2] 45 CFR Part 147 RIN 0938-AQ66 Group Health Plans and Health Insurance Issuers... for group health plans and health insurance coverage in the group and individual markets under...

  8. Public Health Climate Change Adaptation Planning Using Stakeholder Feedback.

    Science.gov (United States)

    Eidson, Millicent; Clancy, Kathleen A; Birkhead, Guthrie S

    2016-01-01

    Public health climate change adaptation planning is an urgent priority requiring stakeholder feedback. The 10 Essential Public Health Services can be applied to adaptation activities. To develop a state health department climate and health adaptation plan as informed by stakeholder feedback. With Centers for Disease Control and Prevention (CDC) funding, the New York State Department of Health (NYSDOH) implemented a 2010-2013 climate and health planning process, including 7 surveys on perceptions and adaptation priorities. New York State Department of Health program managers participated in initial (n = 41, denominator unknown) and follow-up (72.2%) needs assessments. Surveillance system information was collected from 98.1% of surveillance system managers. For adaptation prioritization surveys, participants included 75.4% of NYSDOH leaders; 60.3% of local health departments (LHDs); and 53.7% of other stakeholders representing environmental, governmental, health, community, policy, academic, and business organizations. Interviews were also completed with 38.9% of other stakeholders. In 2011 surveys, 34.1% of state health program directors believed that climate change would impact their program priorities. However, 84.6% of state health surveillance system managers provided ideas for using databases for climate and health monitoring/surveillance. In 2012 surveys, 46.5% of state health leaders agreed they had sufficient information about climate and health compared to 17.1% of LHDs (P = .0046) and 40.9% of other stakeholders (nonsignificant difference). Significantly fewer (P climate and health into planning compared to state health leaders (55.8%) and other stakeholders (68.2%). Stakeholder groups agreed on the 4 highest priority adaptation categories including core public health activities such as surveillance, coordination/collaboration, education, and policy development. Feedback from diverse stakeholders was utilized by NYSDOH to develop its Climate and Health

  9. Building and measuring infrastructure and capacity for community health assessment and health improvement planning in Florida.

    Science.gov (United States)

    Abarca, Christine; Grigg, C Meade; Steele, Jo Ann; Osgood, Laurie; Keating, Heidi

    2009-01-01

    COMPASS (Comprehensive Assessment, Strategic Success) is the Florida Department of Health's community health assessment and health improvement planning initiative. Since 2002, COMPASS built state and county health department infrastructure to support a comprehensive, systematic, and integrated approach to community health assessment and planning. To assess the capacity of Florida's 67 county health departments (CHDs) to conduct community health assessment and planning and to identify training and technical assistance needs, COMPASS surveyed the CHDs using a Web-based instrument annually from 2004 through 2008. Response rate to the survey was 100 percent annually. In 2007, 96 percent of CHDs reported conducting assessment and planning within the past 3 years; 74 percent used the MAPP (Mobilizing for Action through Planning and Partnerships) framework. Progress was greater for the organizational and assessment phases of the MAPP-based work; only 10 CHDs had identified strategic priorities in 2007, and even fewer had implemented strategies for improving health. In 2007, the most frequently requested types of training were measuring success, developing goals and action plans, and using qualitative data; technical assistance was most frequently requested for program evaluation and writing community health status reports. Florida's CHDs have increased their capacity to conduct community health assessment and planning. Questions remain about sustaining these gains with limited resources.

  10. Responsive consumerism: empowerment in markets for health plans.

    Science.gov (United States)

    Elbel, Brian; Schlesinger, Mark

    2009-09-01

    American health policy is increasingly relying on consumerism to improve its performance. This article examines a neglected aspect of medical consumerism: the extent to which consumers respond to problems with their health plans. Using a telephone survey of five thousand consumers conducted in 2002, this article assesses how frequently consumers voice formal grievances or exit from their health plan in response to problems of differing severity. This article also examines the potential impact of this responsiveness on both individuals and the market. In addition, using cross-group comparisons of means and regressions, it looks at how the responses of "empowered" consumers compared with those who are "less empowered." The vast majority of consumers do not formally voice their complaints or exit health plans, even in response to problems with significant consequences. "Empowered" consumers are only minimally more likely to formally voice and no more likely to leave their plan. Moreover, given the greater prevalence of trivial problems, consumers are much more likely to complain or leave their plans because of problems that are not severe. Greater empowerment does not alleviate this. While much of the attention on consumerism has focused on prospective choice, understanding how consumers respond to problems is equally, if not more, important. Relying on consumers' responses as a means to protect individual consumers or influence the market for health plans is unlikely to be successful in its current form.

  11. The contribution of traditional healers' clinics to public health care system in Addis Ababa, Ethiopia: a cross-sectional study.

    Science.gov (United States)

    Birhan, Wubet; Giday, Mirutse; Teklehaymanot, Tilahun

    2011-12-02

    Ethiopian people have been using traditional medicine since time immemorial with 80% of its population dependent on traditional medicines. However, the documentation of traditional healers' clinics contribution to modern public health system in cosmopolitan cities is scanty. Studies conducted so far are limited and focused on the perceptions and practices of modern and traditional health practitioners about traditional medicine. Thus, a cross sectional study was conducted from February to May 2010 to assess the contribution of traditional healers' clinics to public health care system in Addis Ababa. Ten traditional healers who were willing to participate in the study and 306 patients who were visiting these traditional healers' clinics were interviewed using two types of semi-structured questionnaires. Data were summarized using percentages, tables and bar chart. The diseases mostly treated by traditional healers were wound, inflammation, herpes zoster, hemorrhoids, fracture, paralysis, back-pain, liver diseases, cancer and eczema. This study showed that traditional healers' clinics considerably contribute to public health care in Addis Ababa. Fifty two percent of patients reported that traditional healers' clinics were their first choice when they faced health problems. The reasons for visiting these clinics were 175 (57.2%) efficacy, 109 (35.6%) dissatisfaction with modern medicine, 10 (3.3%) dissatisfaction with modern medicine and efficacy, 6 (2.0%) cost and 6 (2.0%) dissatisfaction and cost. Females (55.2%), young age (20-40 years, 65.0%), never married (56.9%), orthodox (73.9%), Amhara (52.3%), educational status above grade 12 (34.6%) and government employees (29.4%) were frequent visitors. Healers reported that there was no form of cooperation with modern health professionals. The reasons were lack of motivation to collaborate and communicate with modern health service workers. Family based apprenticeship was the sources of knowledge for majority of the

  12. Planning a change project in mental health nursing.

    Science.gov (United States)

    Thorpe, Rebecca

    2015-09-02

    This article outlines a plan for a change project to improve the quality of physical health care on mental health wards. The plan was designed to improve the monitoring and recording of respiratory rates on mental health wards, through the implementation of a training programme for staff. A root cause analysis was used to explore the reasons for the low incidence of respiratory rate measurement on mental health wards, and the results of this establish the basis of the proposed change project and its aims and objectives. The article describes how the project could be implemented using a change management model, as well as how its effects could be measured and evaluated. Potential barriers to the planned change project are discussed, including the human dimensions of change. The article suggests methods to overcome such barriers, discusses the value of leadership as an important factor, and examines the principles of clinical governance in the context of the planned change project.

  13. FAMILY HEALTH STRATEGY OF PARTICIPATION IN MUNICIPAL HEALTH PLAN CONSTRUCTION: AN EXPERIENCE REPOR

    Directory of Open Access Journals (Sweden)

    Adilson Ribeiro dos Santos

    2015-08-01

    Full Text Available The Municipal Health Plan is an important planning tool in the management at the Unified Health System and at the same time, a mechanism for popular participation. This study aims to report the experience of the Municipal Health Plan’s workshop conducted by a Family Health Program team in a municipality in the south of Bahia Construção do Plano Municipal de Saúde. in the year 2014. This is an experience report that consolidates itself as a descriptive research tool that presents a reflection about an action that addresses a situation experienced in the professional interest of the scientific community. The workshop included the team and community members’ participation. The population's health problems follow a national trend, highlighting problems like diabetes, hypertension, worms, abuse of alcohol and other drugs inaddition to viruses. The health system problems reveal the weaknesses in local management of the Unified Health System by the insufficiency and/or lack of resources such as drugs, tests, equipment maintenance and others. Therefore, we emphasize the importance of the Municipal Health Plan as a management tool of the Unified Health System that allows closeness between users, workers and managers, as well as being a space for policy vocalization, contributing to the real effectiveness of the Unified Health System, based on participatory planning in accordance with the needs of users.

  14. 75 FR 27121 - Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Dependent...

    Science.gov (United States)

    2010-05-13

    ... 45 CFR Parts 144, 146, and 147 Group Health Plans and Health Insurance Issuers Relating to Dependent... 144, 146, and 147 RIN 0991-AB66 Interim Final Rules for Group Health Plans and Health Insurance... requirements for group health plans and health insurance issuers in the group and individual markets under...

  15. The Hemophilia Games: An Experiment in Health Education Planning.

    Science.gov (United States)

    National Heart and Lung Inst. (DHEW/PHS), Bethesda, MD.

    The Hemophilia Health Education Planning Project was designed to (1) create a set of tools useful in hemophilia planning and education, and (2) create a planning model for other diseases with similar factors. The project used the game-simulations technique which was felt to be particularly applicable to hemophilia health problems, since as a…

  16. Federal Employees Health Benefits Program (FEHBP) Plan Information

    Data.gov (United States)

    Office of Personnel Management — A list of all Federal Employees Health Benefits Program (FEHBP) plans available in each state, as well as links to the plan brochures, changes for each plan from the...

  17. Heard and valued: the development of a model to meaningfully engage marginalized populations in health services planning.

    Science.gov (United States)

    Snow, M Elizabeth; Tweedie, Katherine; Pederson, Ann

    2018-03-15

    Recently, patient engagement has been identified as a promising strategy for supporting healthcare planning. However, the context and structure of universalistic, "one-size-fits-all" approaches often used for patient engagement may not enable diverse patients to participate in decision-making about programs intended to meet their needs. Specifically, standard patient engagement approaches are gender-blind and might not facilitate the engagement of those marginalized by, for example, substance use, low income, experiences of violence, homelessness, and/or mental health challenges-highly gendered health and social experiences. The project's purpose was to develop a heuristic model to assist planners to engage patients who are not traditionally included in healthcare planning. Using a qualitative research approach, we reviewed literature and conducted interviews with patients and healthcare planners regarding engaging marginalized populations in health services planning. From these inputs, we created a model and planning manual to assist healthcare planners to engage marginalized patients in health services planning, which we piloted in two clinical programs undergoing health services design. The findings from the pilots were used to refine the model. The analysis of the interviews and literature identified power and gender as barriers to participation, and generated suggestions to support diverse populations both to attend patient engagement events and to participate meaningfully. Engaging marginalized populations cannot be reduced to a single defined process, but instead needs to be understood as an iterative process of fitting engagement methods to a particular situation. Underlying this process are principles for meaningfully engaging marginalized people in healthcare planning. A one-size-fits-all approach to patient engagement is not appropriate given patients' diverse barriers to meaningful participation in healthcare planning. Instead, planners need a

  18. Findings from the 2009 EBRI/MGA Consumer Engagement in Health Care Survey.

    Science.gov (United States)

    Fronstin, Paul

    2009-12-01

    FIFTH ANNUAL SURVEY: This Issue Brief presents findings from the 2009 EBRI/MGA Consumer Engagement in Health Care Survey, which provides nationally representative data regarding the growth of consumer-driven health plans (CDHPs) and high-deductible health plans (HDHPs), and the impact of these plans and consumer engagement more generally on the behavior and attitudes of adults with private health insurance coverage. Findings from this survey are compared with four earlier annual surveys. ENROLLMENT LOW BUT GROWING: In 2009, 4 percent of the population was enrolled in a CDHP, up from 3 percent in 2008. Enrollment in HDHPs increased from 11 percent in 2008 to 13 percent in 2009. The 4 percent of the population with a CDHP represents 5 million adults ages 21-64 with private insurance, while the 13 percent with a HDHP represents 16.2 million people. Among the 16.2 million individuals with an HDHP, 38 percent (or 6.2 million) reported that they were eligible for a health savings account (HSA) but did not have such an account. Overall, 11.2 million adults ages 21-64 with private insurance, representing 8.9 percent of that market, were either in a CDHP or were in an HDHP that was eligible for an HSA, but had not opened the account. MORE COST-CONSCIOUS BEHAVIOR: Individuals in CDHPs were more likely than those with traditional coverage to exhibit a number of cost-conscious behaviors. They were more likely to say that they had checked whether the plan would cover care; asked for a generic drug instead of a brand name; talked to their doctor about prescription drug options, other treatments, and costs; asked their doctor to recommend a less costly prescription drug; developed a budget to manage health care expenses; checked prices before getting care; and used an online cost-tracking tool. CDHP MORE ENGAGED IN WELLNESS PROGRAMS: CDHP enrollees were more likely than traditional plan enrollees to report that they had the opportunity to fill out a health risk assessment

  19. Safety and health five-year plan, Fiscal years 1995--1999

    International Nuclear Information System (INIS)

    1994-10-01

    This report describes efforts by the Department of Energy (DOE) to size and allocate funding to safety and health activities that protect workers and the public from harm. Although it is well recognized that virtually every aspect of an operation has health and safety implications, this effort is directed at identifying planned efforts specifically directed at health and safety. The initial effort, to compile information for the period covering FY 1994--1998, served two primary needs: (1) to document what was actually taking place in the DOE Complex, from a budget and resource utilization standpoint (how the complex was reacting to the calls for greater protection for workers and the public); and (2) to embark on an effort to utilize forward-looking management plans to allocate resources to meet safety and health needs (to begin to be proactive). It was recognized that it would take several years to achieve full acceptance and implementation of a single, DOE-wide approach toward planning for safety and health, and to develop plans that emphasized the benefits from both risk management and accident prevention strategies. This report, describing safety and health plans and budgets for FY 1995, reflects the increasing acceptance of risk-based strategies in the development of safety and health plans. More operations are using the prioritization methodology recommended for the safety and health planning process, and more operations have begun to review planned expenditures of resources to better assure that resources are allocated to the highest risk reduction activities

  20. THE ACCEPTANCE OF HEALTH RELATED INNOVATIONS IN TRADITIONAL MEAT PRODUCTS BY CROATIAN CONSUMERS

    Directory of Open Access Journals (Sweden)

    Danijel Karolyi

    2015-09-01

    Full Text Available The aim of this study was to examine Croatian consumers’ acceptance of health related innovations in traditional meat products. A face-to-face survey was conducted with a sample of 151 visitors of a specialized fair of traditional food products in Zagreb in 2013. The respondents were asked to indicate their attitudes on a fivepoint scale, where 1 meant rejection or no impact and 5 meant full acceptance or high impact. Results (mean±SD showed the highest level of acceptance for innovations related to better control of smoking conditions (3.3± 1.14 and reduction of salt content (3.1±1.15, followed by reduced fat content (3.0±1.14 and controlled fermentation (2.9±1.12. The perceived negative impact of innovations on traditional character of meat products was highest for fat (3.4±0.99 and salt (3.4±1.03 reduction and lowest for controlled fermentation (3.2±1.04 and smoking conditions (3.2±1.05. With regards to respondents’ socio-demographic features a nonparametric test statistic (Mann-Whitney U revealed a higher acceptance of fat reduction and higher willingness to increase a consumption of healthier traditional meat products among females, while age, education level and income had no influence on the investigated parameters. In addition, some health related innovations; e.g. fat reduction and controlled fermentation were generally less acceptable among respondents with a high consumption frequency of traditional meat products. The results of this preliminary study indicated controlled smoking conditions as the best accepted health related innovation by Croatian consumers with the least negative impact on perceived traditional character of product. In general terms, women were more likely to accept some of the investigated innovations and consequently to increase their consumption of innovate products. However, the most regular consumers of traditional meat products were less open towards innovations which may pose a challenge to

  1. The contribution of traditional healers' clinics to public health care system in Addis Ababa, Ethiopia: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Birhan Wubet

    2011-12-01

    Full Text Available Abstract Background Ethiopian people have been using traditional medicine since time immemorial with 80% of its population dependent on traditional medicines. However, the documentation of traditional healers' clinics contribution to modern public health system in cosmopolitan cities is scanty. Studies conducted so far are limited and focused on the perceptions and practices of modern and traditional health practitioners about traditional medicine. Thus, a cross sectional study was conducted from February to May 2010 to assess the contribution of traditional healers' clinics to public health care system in Addis Ababa. Materials and methods Ten traditional healers who were willing to participate in the study and 306 patients who were visiting these traditional healers' clinics were interviewed using two types of semi-structured questionnaires. Data were summarized using percentages, tables and bar chart. Results The diseases mostly treated by traditional healers were wound, inflammation, herpes zoster, hemorrhoids, fracture, paralysis, back-pain, liver diseases, cancer and eczema. This study showed that traditional healers' clinics considerably contribute to public health care in Addis Ababa. Fifty two percent of patients reported that traditional healers' clinics were their first choice when they faced health problems. The reasons for visiting these clinics were 175 (57.2% efficacy, 109 (35.6% dissatisfaction with modern medicine, 10 (3.3% dissatisfaction with modern medicine and efficacy, 6 (2.0% cost and 6 (2.0% dissatisfaction and cost. Females (55.2%, young age (20-40 years, 65.0%, never married (56.9%, orthodox (73.9%, Amhara (52.3%, educational status above grade 12 (34.6% and government employees (29.4% were frequent visitors. Healers reported that there was no form of cooperation with modern health professionals. The reasons were lack of motivation to collaborate and communicate with modern health service workers. Family based

  2. Quality improvement initiatives: the missed opportunity for health plans.

    Science.gov (United States)

    Fernandez-Lopez, Sara; Lennert, Barbara

    2009-11-01

    The increase in healthcare cost without direct improvements in health outcomes, coupled with a desire to expand access to the large uninsured population, has underscored the importance of quality initiatives and organizations that provide more affordable healthcare by maximizing value. To determine the knowledge of managed care organizations about quality organizations and initiatives and to identify potential opportunities in which pharmaceutical companies could collaborate with health plans in the development and implementation of quality initiatives. We conducted a survey of 36 pharmacy directors and 15 medical directors of different plans during a Managed Care Network meeting in 2008. The represented plans cover almost 74 million lives in commercial, Medicare, and Medicaid programs, or a combination of them. The responses show limited knowledge among pharmacy and medical directors about current quality organizations and initiatives, except for quality organizations that provide health plan quality accreditation. The results also reveal an opportunity for pharmaceutical companies to collaborate with private health plans in the development of quality initiatives, especially those related to drug utilization, such as patient adherence and education and correct drug utilization. Our survey shows clearly that today's focus for managed care organizations is mostly limited to the organizations that provide health plan quality accreditation, with less focus on other organizations.

  3. Some factors affecting acceptance of family planning in Manus.

    Science.gov (United States)

    Avue, B; Freeman, P

    1991-12-01

    This paper examines selected factors affecting the acceptance and delivery of modern family planning from health centres in Manus. A survey was carried out of mothers attending Maternal and Child Health clinics and a written questionnaire was given to health workers. The survey of mothers demonstrated the importance of the husband's approval for contraceptive practice and showed that knowledge about traditional methods of family planning is widespread. The health workers' questionnaire demonstrated a high level of dissatisfaction with the current family planning program delivered by health clinics: 45% found the program ineffective; 68% wrote that health workers' attitudes discouraged mothers from attending for family planning. The perceived and actual benefits and costs of children and the role of men should be assessed locally before planning future family planning programs. Widespread retraining and motivating of health workers is essential if improved coverage is to be achieved through health services. The efficacy of alternative methods of delivery of family planning such as local community-based and social marketing programs should also be investigated.

  4. Innovating Chinese Herbal Medicine: From Traditional Health Practice to Scientific Drug Discovery

    Directory of Open Access Journals (Sweden)

    Shuo Gu

    2017-06-01

    Full Text Available As one of the major contemporary alternative medicines, traditional Chinese medicine (TCM continues its influence in Chinese communities and has begun to attract the academic attention in the world of western medicine. This paper aims to examine Chinese herbal medicine (CHM, the essential branch of TCM, from both narrative and scientific perspectives. CHM is a traditional health practice originated from Chinese philosophy and religion, holding the belief of holism and balance in the body. With the development of orthodox medicine and science during the last centuries, CHM also seized the opportunity to change from traditional health practice to scientific drug discovery illustrated in the famous story of the herb-derived drug artemisinin. However, hindered by its culture and founding principles, CHM faces the questions of the research paradigm posed by the convention of science. To address these questions, we discussed two essential questions concerning the relationship of CHM and science, and then upheld the paradigm of methodological reductionism in scientific research. Finally, the contemporary narrative of CHM in the 21st century was discussed in the hope to preserve this medical tradition in tandem with scientific research.

  5. Innovating Chinese Herbal Medicine: From Traditional Health Practice to Scientific Drug Discovery.

    Science.gov (United States)

    Gu, Shuo; Pei, Jianfeng

    2017-01-01

    As one of the major contemporary alternative medicines, traditional Chinese medicine (TCM) continues its influence in Chinese communities and has begun to attract the academic attention in the world of western medicine. This paper aims to examine Chinese herbal medicine (CHM), the essential branch of TCM, from both narrative and scientific perspectives. CHM is a traditional health practice originated from Chinese philosophy and religion, holding the belief of holism and balance in the body. With the development of orthodox medicine and science during the last centuries, CHM also seized the opportunity to change from traditional health practice to scientific drug discovery illustrated in the famous story of the herb-derived drug artemisinin. However, hindered by its culture and founding principles, CHM faces the questions of the research paradigm posed by the convention of science. To address these questions, we discussed two essential questions concerning the relationship of CHM and science, and then upheld the paradigm of methodological reductionism in scientific research. Finally, the contemporary narrative of CHM in the 21st century was discussed in the hope to preserve this medical tradition in tandem with scientific research.

  6. Federal, provincial and territorial public health response plan for biological events.

    Science.gov (United States)

    McNeill, R; Topping, J

    2018-01-04

    The Federal/Provincial/Territorial (FPT) Public Health Response Plan for Biological Events was developed for the Public Health Network Council (PHNC). This plan outlines how the national response to public health events caused by biological agents will be conducted and coordinated, with a focus on implementation of responses led by senior-level FPT public health decision-makers. The plan was developed by an expert task group and was approved by PHNC in October, 2017. The plan describes roles, responsibilities and authorities of FPT governments for public health and emergency management, a concept of operations outlining four scalable response levels and a governance structure that aims to facilitate an efficient, timely, evidence-informed and consistent approach across jurisdictions. Improving effective engagement amongst public health, health care delivery and health emergency management authorities is a key objective of the plan.

  7. Health care in a community of followers of traditional African-Brazilian religions.

    Science.gov (United States)

    Alves, Miriam Cristiane; Seminotti, Nedio

    2009-08-01

    To understand the concept of health and the source of psychological distress among followers of a traditional African-Brazilian religion. Qualitative study performed in a community of followers of a traditional African-Brazilian religion, in the city of Porto Alegre, Southern Brazil, between 2007 and 2008. The priest/Babalorixá and six followers of this community participated in the study. Open interviews, which were recorded and subsequently transcribed, were conducted to collect data and construct the corpus of analysis. Report categorization, based on the complex systemic approach, enabled the construction of two main themes: 1) religious community and concept of health, and 2) origin of psychological distress and cultural identity. In this religious community, traditional health therapies, such as the use of herbs, baths, diets and/or initiation rites, were associated with conventional therapies proposed by the Sistema Unico de Saúde (SUS - Unified Health System). Bonds with and belonging to a territory, the relationships among individuals, and the relationship among their spiritual, psychological and physical dimensions are considered in their concepts of psychological distress and health. The way to understand and act in the world, as experienced in this community, with its myths, rites, beliefs and values, constitutes a set of legitimate types of knowledge in its context, which oftentimes opposes and goes beyond professionals' technical-scientific knowledge and truths. This community is a space marked by welcoming, counseling and treatment of followers, where the physical, psychological and spiritual dimensions are integrated in these practices. As regards the black population health, psychological distress results from their having been uprooted from African black cultures.

  8. Health and safety plan for operations performed for the Environmental Restoration Program

    Energy Technology Data Exchange (ETDEWEB)

    Trippet, W.A. II (IT Corp., (United States)); Reneau, M.; Morton, S.L. (EG and G Idaho, Inc., Idaho Falls, ID (United States))

    1992-04-01

    This document constitutes the generic health and safety plan for the Environmental Restoration Program (ERP). It addresses the health and safety requirements of the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA); Occupational Safety and Health Administration (OSHA) 29 CFR 1910.120 standard; and EG G Idaho, Inc. This plan is a guide to individuals who must complete a health and safety plan for a task performed for the EPR. It contains a task specific addendum that, when completed, specifically addresses task specific health and safety issues. This health and safety plan reduces the time it takes to write a task specific health and safety plan by providing discussions of requirements, guidance on where specific information is located, and specific topics in the Addendum that must be discussed at a task level. This format encourages a complete task specific health and safety plan and a standard for all health and safety plans written for ERP.

  9. Health and safety plan for operations performed for the Environmental Restoration Program

    International Nuclear Information System (INIS)

    Trippet, W.A. II; Reneau, M.; Morton, S.L.

    1992-04-01

    This document constitutes the generic health and safety plan for the Environmental Restoration Program (ERP). It addresses the health and safety requirements of the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA); Occupational Safety and Health Administration (OSHA) 29 CFR 1910.120 standard; and EG ampersand G Idaho, Inc. This plan is a guide to individuals who must complete a health and safety plan for a task performed for the EPR. It contains a task specific addendum that, when completed, specifically addresses task specific health and safety issues. This health and safety plan reduces the time it takes to write a task specific health and safety plan by providing discussions of requirements, guidance on where specific information is located, and specific topics in the Addendum that must be discussed at a task level. This format encourages a complete task specific health and safety plan and a standard for all health and safety plans written for ERP

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

    Science.gov (United States)

    Pfeiffer, Constanze; Mwaipopo, Rosemarie

    2013-02-28

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

  11. Findings from the 2012 EBRI/MGA Consumer Engagement in Health Care Survey.

    Science.gov (United States)

    Fronstin, Paul

    2012-12-01

    The 2012 EBRI/MGA Consumer Engagement in Health Care Survey finds continued slow growth in consumer-driven health plans: 10 percent of the population was enrolled in a CDHP, up from 7 percent in 2011. Enrollment in HDHPs remained at 16 percent. Overall, 18.6 million adults ages 21-64 with private insurance, representing 15.4 percent of that market, were either in a CDHP or were in an HDHP that was eligible for an HSA. When their children were counted, about 25 million individuals with private insurance, representing about 14.6 percent of the market, were either in a CDHP or an HSA-eligible plan. This study finds evidence that adults in a CDHP and those in an HDHP were more likely than those in a traditional plan to exhibit a number of cost-conscious behaviors. While CDHP enrollees, HDHP enrollees, and traditional-plan enrollees were about equally likely to report that they made use of quality information provided by their health plan, CDHP enrollees were more likely to use cost information and to try to find information about their doctors' costs and quality from sources other than the health plan. CDHP enrollees were more likely than traditional-plan enrollees to take advantage of various wellness programs, such as health-risk assessments, health-promotion programs, and biometric screenings. In addition, financial incentives mattered more to CDHP enrollees than to traditional-plan enrollees. It is clear that the underlying characteristics of the populations enrolled in these plans are different: Adults in a CDHP were significantly more likely to report being in excellent or very good health. Adults in a CDHP and those in a HDHP were significantly less likely to smoke than were adults in a traditional plan, and they were significantly more likely to exercise. CDHP and HDHP enrollees were also more likely than traditional-plan enrollees to be highly educated. As the CDHP and HDHP markets continue to expand and more enrollees are enrolled for longer periods of time

  12. Assessing environmental assets for health promotion program planning: a practical framework for health promotion practitioners.

    Science.gov (United States)

    Springer, Andrew E; Evans, Alexandra E

    2016-01-01

    Conducting a health needs assessment is an important if not essential first step for health promotion planning. This paper explores how health needs assessments may be further strengthened for health promotion planning via an assessment of environmental assets rooted in the multiple environments (policy, information, social and physical environments) that shape health and behavior. Guided by a behavioral-ecological perspective- one that seeks to identify environmental assets that can influence health behavior, and an implementation science perspective- one that seeks to interweave health promotion strategies into existing environmental assets, we present a basic framework for assessing environmental assets and review examples from the literature to illustrate the incorporation of environmental assets into health program design. Health promotion practitioners and researchers implicitly identify and apply environmental assets in the design and implementation of health promotion interventions;this paper provides foundation for greater intentionality in assessing environmental assets for health promotion planning.

  13. 76 FR 13197 - National Institute of Environmental Health Sciences Strategic Planning

    Science.gov (United States)

    2011-03-10

    ... parties. The goal of this strategic planning process is to define an overarching Vision Statement... this planning process, visit the NIEHS Strategic Planning Web site at Request for Visionary Ideas The... Environmental Health Sciences Strategic Planning AGENCY: National Institutes of Health (NIH), National Institute...

  14. Refugees in Conflict: Creating a Bridge Between Traditional and Conventional Health Belief Models.

    Science.gov (United States)

    Ben-Arye, Eran; Bonucci, Massimo; Daher, Michel; Kebudi, Rejin; Saad, Bashar; Breitkreuz, Thomas; Rassouli, Maryam; Rossi, Elio; Gafer, Nahla; Nimri, Omar; Hablas, Mohamed; Kienle, Gunver Sophia; Samuels, Noah; Silbermann, Michael

    2018-06-01

    The recent wave of migration from Middle Eastern countries to Europe presents significant challenges to the European health profession. These include the inevitable communication gap created by differences in health care beliefs between European oncologists, health care practitioners, and refugee patients. This article presents the conclusions of a workshop attended by a group of clinicians and researchers affiliated with the Middle East Cancer Consortium, as well as four European-based health-related organizations. Workshop participants included leading clinicians and medical educators from the field of integrative medicine and supportive cancer care from Italy, Germany, Turkey, Israel, Palestine, Iran, Lebanon, Jordan, Egypt, and Sudan. The workshop illustrated the need for creating a dialogue between European health care professionals and the refugee population in order to overcome the communication barriers to create healing process. The affinity for complementary and traditional medicine (CTM) among many refugee populations was also addressed, directing participants to the mediating role that integrative medicine serves between CTM and conventional medicine health belief models. This is especially relevant to the use of herbal medicine among oncology patients, for whom an open and nonjudgmental (yet evidence-based) dialogue is of utmost importance. The workshop concluded with a recommendation for the creation of a comprehensive health care model, to include bio-psycho-social and cultural-spiritual elements, addressing both acute and chronic medical conditions. These models need to be codesigned by European and Middle Eastern clinicians and researchers, internalizing a culturally sensitive approach and ethical commitment to the refugee population, as well as indigenous groups originating from Middle Eastern and north African countries. European oncologists face a communication gap with refugee patients who have recently immigrated from Middle Eastern and

  15. Health Seeking Behavior and Family Planning Services Accessibility in Indonesia

    Directory of Open Access Journals (Sweden)

    Niniek Lely Pratiwi

    2014-11-01

    Full Text Available Background: The MDG target to increase maternal health will be achieved when 50% of maternal deaths can be prevented through improvment the coverage of K1, K4, to make sure that midwife stay in the village improve the delivery by health workers in health facilities, increase coverage long-term contraceptive methods participant as well as family and community empowerment in health. Methods: This study is a further analysis of Riskesdas in 2010 to assess how big the accessibility of services in family planning in Indonesia. Results: Women of 3–4 children in rural greater and prevalence (27.1% compared to women who live in urban areas (25.0%. The main reason of not using contraception mostly because they want to have children 27.0% in urban, 28.2% rural whereas, the second reason is the fear of side effects 23.1% in urban, 16.5% rural. There is 10% of respondent did not use contraceptives, because they did not need it. Health seeking behavior of pregnant women with family planning work status has a significant relationship (prevalence ratio 1.073. The jobless mothers has better access to family planning services compared to working mother. Conclusions: Accessibility of family planning services is inadequate, because not all rural ‘Poskesdes’ equipped with infrastructure and family planning devices, a lack of knowledge of family planning in rural areas. Health seeking behavior of family planning services is mostly to the midwives, the scond is to community health centers and than polindes, ‘poskesdes’ as the ranks third.

  16. Developing a mental health care plan in a low resource setting: the theory of change approach.

    Science.gov (United States)

    Hailemariam, Maji; Fekadu, Abebaw; Selamu, Medhin; Alem, Atalay; Medhin, Girmay; Giorgis, Tedla Wolde; DeSilva, Mary; Breuer, Erica

    2015-09-28

    Scaling up mental healthcare through integration into primary care remains the main strategy to address the extensive unmet mental health need in low-income countries. For integrated care to achieve its goal, a clear understanding of the organisational processes that can promote and hinder the integration and delivery of mental health care is essential. Theory of Change (ToC), a method employed in the planning, implementation and evaluation of complex community initiatives, is an innovative approach that has the potential to assist in the development of a comprehensive mental health care plan (MHCP), which can inform the delivery of integrated care. We used the ToC approach to develop a MHCP in a rural district in Ethiopia. The work was part of a cross-country study, the Programme for Improving Mental Health Care (PRIME) which focuses on developing evidence on the integration of mental health in to primary care. An iterative ToC development process was undertaken involving multiple workshops with stakeholders from diverse backgrounds that included representatives from the community, faith and traditional healers, community associations, non-governmental organisations, Zonal, Regional and Federal level government offices, higher education institutions, social work and mental health specialists (psychiatrists and psychiatric nurses). The objective of this study is to report the process of implementing the ToC approach in developing mental health care plan. A total of 46 persons participated in four ToC workshops. Four critical path dimensions were identified: community, health facility, administrative and higher level care organisation. The ToC participants were actively engaged in the process and the ToC encouraged strong commitment among participants. Key opportunities and barriers to implementation and how to overcome these were suggested. During the workshops, a map incorporating the key agreed outcomes and outcome indicators was developed and finalized later

  17. Why HIV positive patients on antiretroviral treatment and/or cotrimoxazole prophylaxis use traditional medicine: perceptions of health workers, traditional healers and patients: a study in two provinces of South Africa.

    Science.gov (United States)

    Puoane, T R; Hughes, G D; Uwimana, J; Johnson, Q; Folk, W R

    2012-01-01

    The study explored the perceptions, knowledge and attitudes of patients, health workers and traditional healers about the use of traditional medicine and Anti Retroviral Therapy (ART). The study explored the perceptions, knowledge and attitudes of patients, health workers and traditional healers about the use of traditional medicine and Anti Retroviral Therapy (ART), using an exploratory qualitative design in two provinces of South Africa: an urban township health facility in the Western Cape, and a rural district hospital in KwaZulu-Natal (KZN) with antennal HIV rate of 32% and 28%'respectively. In-depth interviews were conducted with 14 participants: six HIV patients on ART and using Traditional Medicine(TM), two doctors, two nurses and four traditional healers. Two focus group discussions -one at each site - were held with community health workers who work with HIV-positive patients (Western Cape [5] and in KZN [4]). Patient said to have used Traditional Healing Practices (THP) before they were diagnosed with HIV, and some who have been diagnosed with HIV continue using TM in conjunction with ART and/or Cotrimoxazole prophylaxis. Patients preferred not to disclose THP to health professionals because of lack of support and understanding. Patients utilize THP because of family expectations, privacy and confidentiality, especially when they have not disclosed their HIV status. Healthcare professionals had strong negative opinions about THP, especially for HIV-positive patients. Traditional healers supported the patient's rationale for THP use. This study revealed a need to better understand factors involved in patients' choosing to use THP concurrently with ART.

  18. Parents' Traditional Cultural Values and Mexican-Origin Young Adults' Routine Health and Dental Care.

    Science.gov (United States)

    Updegraff, Kimberly A; Kuo, Sally I-Chun; McHale, Susan M; Umaña-Taylor, Adriana J; Wheeler, Lorey A

    2017-05-01

    To investigate the prospective associations between Mexican-origin mothers' and fathers' traditional cultural values and young adults' health and dental care utilization and to test the moderating role of youth gender. Mexican-origin parents and youth (N = 246 families) participated in home interviews and provided self-reports of parents' cultural values (time 1) and young adults' health status and routine health and dental care (time 2; 5 years later). Logistic regressions tested parents' traditional cultural values as predictors of routine health and dental care, accounting for parent nativity, parent acculturation, family socioeconomic status, youth gender, youth age, and youth physical health status. We also tested whether youth gender moderated the associations between parents' cultural values and young adults' routine care. Young adults whose mothers endorsed strong familism values when they were in mid-to-late adolescence were more likely to report at least one routine physician visit in the past year as young adults (odds ratio [OR] = 3.47, 95% confidence interval [CI]: 1.23-9.83, p = .019). Furthermore, for females only, mothers' more traditional gender role attitudes predicted reduced odds of receiving routine health (OR = .22; 95% CI: .08-.64, p = .005) and dental care (OR = .26; 95% CI: .09-.75, p culturally specific mechanisms to identify targets for addressing ethnic/racial disparities in health care utilization among Mexican-origin young adults, during a period of increased risk for health-compromising behaviors and reduced access to care. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  19. Innovating Chinese Herbal Medicine: From Traditional Health Practice to Scientific Drug Discovery

    OpenAIRE

    Gu, Shuo; Pei, Jianfeng

    2017-01-01

    As one of the major contemporary alternative medicines, traditional Chinese medicine (TCM) continues its influence in Chinese communities and has begun to attract the academic attention in the world of western medicine. This paper aims to examine Chinese herbal medicine (CHM), the essential branch of TCM, from both narrative and scientific perspectives. CHM is a traditional health practice originated from Chinese philosophy and religion, holding the belief of holism and balance in the body. W...

  20. Health Careers Planning Guide--Illinois. Second Edition.

    Science.gov (United States)

    Illinois Univ., Champaign.

    This notebook of career counseling materials is a compilation of career information on nursing and the allied health fields. The first section provides general information useful in choosing a health career on such topics as career planning, career mobility, employment prospects, financial aid, terminology in health job titles, and an annotated…

  1. Knowledge and practice of traditional healers in oral health in the Bui Division, Cameroon

    Directory of Open Access Journals (Sweden)

    Naidoo Sudeshni

    2011-01-01

    Full Text Available Abstract Background The majority of Cameroonians depend on traditional medicines for their health care needs and about seven per cent of the average household health budget is spent on traditional medicines irrespective of their incomes. The aim of the present study was to determine the oral care knowledge and practices of Traditional Healers (TH on oral health delivery in the urban and rural areas of Bui Division of Cameroon and the objectives to determine the cost of treatment and reasons why people visit TH. Methods The present study was cross sectional and utilized semi-structured questionnaires to collect data. Results The sample consisted of 21 TH and 52 clients of TH. Sixty two percent of the TH's were above 40 years and 90% male. The mean age was 46 years (range 20-77 years. Twenty four percent of the TH practiced as herbalists and the remainder both divination and herbalism. Sixty seven percent of people in the Bui Division, who patronize TH for their oral health needs, fall within the 20-40 year age group. There is little collaboration between the oral health workers and TH and only 6% of all patients seen by TH are referred to the dentist. Socio-cultural and economic factors affect the oral health care seeking behavior of patients in this area and only 6.5% of patients visit dental clinics. Reasons for not attending dental clinics included high cost, poor accessibility, superstition and fear. TH's are not experienced in the treatment of pulpitis - the majority of patients who presented with toothache had temporary or no relief, but despite this 67% reported being satisfied with their treatment. Sixty nine percent of the patients visited TH because of low cost - the average cost of treatment with TH (approximately $5 is very low, as compared to conventional treatment ($50. Conclusions Traditional healers are willing to co-operate with oral health workers in improving oral health. Since they have a vital role to play in health care

  2. Knowledge and practice of traditional healers in oral health in the Bui Division, Cameroon.

    Science.gov (United States)

    Agbor, Ashu M; Naidoo, Sudeshni

    2011-01-15

    The majority of Cameroonians depend on traditional medicines for their health care needs and about seven per cent of the average household health budget is spent on traditional medicines irrespective of their incomes. The aim of the present study was to determine the oral care knowledge and practices of Traditional Healers (TH) on oral health delivery in the urban and rural areas of Bui Division of Cameroon and the objectives to determine the cost of treatment and reasons why people visit TH. The present study was cross sectional and utilized semi-structured questionnaires to collect data. The sample consisted of 21 TH and 52 clients of TH. Sixty two percent of the TH's were above 40 years and 90% male. The mean age was 46 years (range 20-77 years). Twenty four percent of the TH practiced as herbalists and the remainder both divination and herbalism. Sixty seven percent of people in the Bui Division, who patronize TH for their oral health needs, fall within the 20-40 year age group. There is little collaboration between the oral health workers and TH and only 6% of all patients seen by TH are referred to the dentist. Socio-cultural and economic factors affect the oral health care seeking behavior of patients in this area and only 6.5% of patients visit dental clinics. Reasons for not attending dental clinics included high cost, poor accessibility, superstition and fear. TH's are not experienced in the treatment of pulpitis - the majority of patients who presented with toothache had temporary or no relief, but despite this 67% reported being satisfied with their treatment. Sixty nine percent of the patients visited TH because of low cost - the average cost of treatment with TH (approximately $5) is very low, as compared to conventional treatment ($50). Traditional healers are willing to co-operate with oral health workers in improving oral health. Since they have a vital role to play in health care seeking attitudes in this community and barriers affecting the oral

  3. Mental Health Services Utilization and Expenditures Among Children Enrolled in Employer-Sponsored Health Plans.

    Science.gov (United States)

    Walter, Angela Wangari; Yuan, Yiyang; Cabral, Howard J

    2017-05-01

    Mental illness in children increases the risk of developing mental health disorders in adulthood, and reduces physical and emotional well-being across the life course. The Mental Health Parity and Addiction Equity Act (MHPAEA, 2008) aimed to improve access to mental health treatment by requiring employer-sponsored health plans to include insurance coverage for behavioral health services. Investigators used IBM Watson/Truven Analytics MarketScan claims data (2007-2013) to examine: (1) the distribution of mental illness; (2) trends in utilization and out-of-pocket expenditures; and (3) the overall effect of the MHPAEA on mental health services utilization and out-of-pocket expenditures among privately-insured children aged 3 to 17 with mental health disorders. Multivariate Poisson regression and linear regression modeling techniques were used. Mental health services use for outpatient behavioral health therapy (BHT) was higher in the years after the implementation of the MHPAEA (2010-2013). Specifically, before the MHPAEA implementation, the annual total visits for BHT provided by mental health physicians were 17.1% lower and 2.5% lower for BHT by mental health professionals, compared to years when MHPAEA was in effect. Children covered by consumer-driven and high-deductible plans had significantly higher out-of-pocket expenditures for BHT compared to those enrolled PPOs. Our findings demonstrate increased mental health services use and higher out-of-pocket costs per outpatient visit after implementation of the MHPAEA. As consumer-driven and high-deductible health plans continue to grow, enrollees need to be cognizant of the impact of health insurance benefit designs on health services offered in these plans. Copyright © 2017 by the American Academy of Pediatrics.

  4. Health transformation plan: Goals achievement in Nemazee hospital

    Directory of Open Access Journals (Sweden)

    Ali Akbar Ahmadi

    2016-01-01

    Full Text Available Introduction: The main purpose of this study was to assess fulfillment of goals about “Health Transformation Plan (HTP of Ministry of Health, Treatment and Medical Education” from the perspective of managers, which is as one of the most important management challenges in the Health System Reform Plan. These goals included six packages determined by the Ministry of Health, Treatment and Medical Education, the fulfillment of each of which one was evaluated separately as sub-goals in the current study. Finally, the rank of each package in comparison to other packages was determined and presented, using means rank test (Friedman test. Method: This study was conducted using a questionnaire in which comments of the senior and middle managers of Nemazee hospital were collected as the research data. Due to the fact that about one year has passed since the beginning of implementation of HTP and since there were no documented methods or questionnaires, the researcher designed a self-made questionnaire. The basis of designing the questionnaire was the set of guidelines developed for Health System Reform Plan. These guidelines include goals that a hospital should achieve during implementation of Health System Reform Plan. After sharing these goals with senior and middle managers of Nemazee hospital (as the place of research, they were converted to a questionnaire including 20 questions. The questionnaire included the goals that must be achieved in Nemazee hospital of Shiraz during the implementation of the plan. After designing the questionnaire, a preliminary test was taken to assess the reliability. Results: Cronbach’s alpha coefficient (0.88 showed a high rate of reliability in the above questionnaire. After the final data collection, the questionnaire was tested in a sample of 100 senior and middle managers; the results showed that about six packages were specified by the Ministry of Health, Treatment and Medical Education. The majority of

  5. 75 FR 41726 - Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Coverage of...

    Science.gov (United States)

    2010-07-19

    ... Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under the Patient... and health insurance coverage in the group and individual markets under provisions of the Patient... plans and group health insurance issuers for plan years beginning on or after September 23, 2010. These...

  6. 75 FR 34537 - Interim Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a...

    Science.gov (United States)

    2010-06-17

    ... 45 CFR Part 147 Group Health Plans and Health Insurance Coverage Relating to Status as a... for Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Health Plan... and Insurance Oversight, Department of Health and Human Services. ACTION: Interim final rules with...

  7. Strategic planning--a plan for excellence for South Haven Health System.

    Science.gov (United States)

    Urbanski, Joanne; Baskel, Maureen; Martelli, Mary

    2011-01-01

    South Haven Health System has developed an innovative approach to strategic planning. The key to success of this process has been the multidisciplinary involvement of all stakeholders from the first planning session through the final formation of a strategic plan with measurable objectives for each goal. The process utilizes a Conversation Café method for identifying opportunities and establishing goals, Strategic Oversight Teams to address each goal and a Champion for implementation of each objective. Progress is measured quarterly by Strategic Oversight Team report cards. Transparency of communication within the organization and the sharing of information move the plan forward. The feedback from participant evaluations has been overwhelmingly positive. They are involved and excited.

  8. Scenario planning.

    Science.gov (United States)

    Enzmann, Dieter R; Beauchamp, Norman J; Norbash, Alexander

    2011-03-01

    In facing future developments in health care, scenario planning offers a complementary approach to traditional strategic planning. Whereas traditional strategic planning typically consists of predicting the future at a single point on a chosen time horizon and mapping the preferred plans to address such a future, scenario planning creates stories about multiple likely potential futures on a given time horizon and maps the preferred plans to address the multiple described potential futures. Each scenario is purposefully different and specifically not a consensus worst-case, average, or best-case forecast; nor is scenario planning a process in probabilistic prediction. Scenario planning focuses on high-impact, uncertain driving forces that in the authors' example affect the field of radiology. Uncertainty is the key concept as these forces are mapped onto axes of uncertainty, the poles of which have opposed effects on radiology. One chosen axis was "market focus," with poles of centralized health care (government control) vs a decentralized private market. Another axis was "radiology's business model," with one pole being a unified, single specialty vs a splintered, disaggregated subspecialty. The third axis was "technology and science," with one pole representing technology enabling to radiology vs technology threatening to radiology. Selected poles of these axes were then combined to create 3 scenarios. One scenario, termed "entrepreneurialism," consisted of a decentralized private market, a disaggregated business model, and threatening technology and science. A second scenario, termed "socialized medicine," had a centralized market focus, a unified specialty business model, and enabling technology and science. A third scenario, termed "freefall," had a centralized market focus, a disaggregated business model, and threatening technology and science. These scenarios provide a range of futures that ultimately allow the identification of defined "signposts" that can

  9. Health policies planning: methodological standards, boundaries and possibilities

    Directory of Open Access Journals (Sweden)

    Cassius Guimarães Chai

    2016-12-01

    Full Text Available Before the health right recognition and expansion brought about by the Federal Constitution of 1988,the impact on public accounts and the need to rationalize the system, now bound to the universalisation matrix, place “planning” as fundamental for the operationalization of actions and services of health accessing. The objective of this article is to carry out an integrative literature review in order to know the factors related to the methodological frameworks, challenges and possibilities for structuring a Municipal Health Plan (Administration. The following databases were searched: Lilacs, Library Digital Thesis and Dissertation (BDTD, in Google Scholar, the Coordination of Improvement of Higher Education Personnel (CAPES Thesis Bank. For the composition of the sample, the following descriptors were associated: Health Policy, Decentralization and Municipalization with Health Planning. In addition, papers were selected among dissertations, theses and scientific articles, as well as institutional handbooks of the Ministry of Health-MS Publics of PlanejaSUS, adopting scientific works published between 2005 and 2015 as a time cut. The results found synthesize the scenario of the intersectoral and tripartite arrangement of health management, contributing to a critical and evaluative exercise of experience, challenges and possibility Of advances in the understanding of the importance of SUS municipal planning.

  10. Qualitative Study of correspondence between Patient Perception of Service Advertisement and Service Provided from Traditional Health Facilities

    Directory of Open Access Journals (Sweden)

    Lusi Kristiana

    2015-01-01

    Full Text Available background: Attractive adses of traditional health services often promises such as certainty of healing, treatment without side effect, experience personnel, exclusive recipes, and testimony of patients who recovered. Ads that this unsubstantiated allegedly played a role in the tendency of people turn to traditional medicine. The aim of the study is to describe the perception of patients about the correspondence between the advertisement and the services provided qualitatively. Methods: The study was conducted in Surabaya for 5 months in 2012. Informants were selected purposively. results: The result shows that most of the information about traditional health services obtained from either advertisement local and national television. Health complaints predominanly degenerative diseases, and most have been treated to modern medicine but because they do not heal, switch to traditional medicine. conclusion: Informants judge ad featuring attractive because advanced equipment, herbal remedies as well as testimonials of patients who have recovered. Much of the promise of the ads is not evident when patients seek treatment, so they seek other traditional treatments. Most of them are less satisfied, but there is a fraction that satisfied because being cured. Traditional health services responsiveness associated with the non-medical aspects assessed either by informants. recomendation:Competent authorities should enforce and socialize media literacy to encourage community.

  11. 75 FR 37242 - Requirements for Group Health Plans and Health Insurance Issuers Under the Patient Protection and...

    Science.gov (United States)

    2010-06-28

    ... Requirements for Group Health Plans and Health Insurance Issuers Under the Patient Protection and Affordable... Labor and the Office of Consumer Information and Insurance Oversight of the U.S. Department of Health... guidance to employers, group health plans, and health insurance issuers providing group health insurance...

  12. 26 CFR 54.9831-1 - Special rules relating to group health plans.

    Science.gov (United States)

    2010-04-01

    ... this section. In addition, benefits provided under a health flexible spending arrangement are excepted... of a group health plan. For purposes of this paragraph (c)(3), benefits are not an integral part of a group health plan (whether the benefits are provided through the same plan or a separate plan) only if...

  13. Centering Pregnancy and Traditional Prenatal Care: A Comparison of Health Practices

    OpenAIRE

    Shakespear, Kaylynn

    2008-01-01

    Centering Pregnancy is an alternative method of providing prenatal care with increased education and social support with health assessment in a group setting. This study, a cross-sectional, correlational, convenience-sample design, sought to determine the difference between women who receive prenatal care in Centering Pregnancy prenatal care and those in traditional prenatal care in regards to health behaviors. Adult pregnant women (n = 125) were surveyed from at least 28 weeks gestation. The...

  14. [Inclusion of traditional birth attendants in the public health care system in Brazil: reflecting on challenges].

    Science.gov (United States)

    Gusman, Christine Ranier; Viana, Ana Paula de Andrade Lima; Miranda, Margarida Araújo Barbosa; Pedrosa, Mayane Vilela; Villela, Wilza Vieira

    2015-05-01

    The present article describes an experience with traditional birth attendants carried out in the state of Tocantins, Brazil, between 2010 and 2014. The experience was part of a diagnostic project to survey home deliveries in the state of Tocantins and set up a registry of traditional birth attendants for the Health Ministry's Working with Traditional Birth Attendants Program (PTPT). The project aimed to articulate the home deliveries performed by traditional birth attendants to the local health care systems (SUS). Sixty-seven active traditional birth attendants were identified in the state of Tocantins, and 41 (39 indigenous) participated in workshops. During these workshops, they discussed their realities, difficulties, and solutions in the context of daily adversities. Birth attendants were also trained in the use of biomedical tools and neonatal resuscitation. Based on these experiences, the question came up regarding the true effectiveness of the strategy to include traditional birth attendants in the SUS. The present article discusses this theme with support from the relevant literature. The dearth of systematic studies focusing on the impact of PTPT actions on the routine of traditional birth attendants, including perinatal outcomes and remodeling of health practices in rural, riverfront, former slave, forest, and indigenous communities, translates into a major gap in terms of the knowledge regarding the effectiveness of such initiatives.

  15. The Islamic dialogue with African traditional religion: divination and health care.

    Science.gov (United States)

    Kirby, J P

    1993-02-01

    In rural Africa delivering better health care is more complicated than simply offering good medical services; it must also take into account peoples' religious orientation and beliefs. Here the non-material causes of illness are at least as important as the biological or material and, in many places, one can only determine the exact nature of the problem and its corresponding remedy after the fact, through a process involving divination and sacrifice. In northern Ghana, by adapting to traditional methods of divination, Islam is gradually introducing a future perspective and expanding the possibilities of preventative action. By so doing it is bringing about a religio-epistemological transformation that is, among other things, helping people to understand and make better use of Western bio-medicine and primary health care programs. The author argues for a similar adaptation and dialogue between African traditional beliefs and Western medical institutions.

  16. Parents’ Traditional Cultural Values and Mexican-Origin Young Adults’ Routine Health and Dental Care

    Science.gov (United States)

    Updegraff, Kimberly A.; Kuo, Sally I-Chun; McHale, Susan M.; Umaña-Taylor, Adriana J.; Wheeler, Lorey A.

    2017-01-01

    Purpose To investigate the prospective associations between Mexican-origin mothers’ and fathers’ traditional cultural values and young adults’ health and dental care utilization and to test the moderating role of youth gender. Methods Mexican-origin parents and youth (N = 246 families) participated in home interviews and provided self-reports of parents’ cultural values (time 1) and young adults’ health status and routine health and dental care (time 2; 5 years later). Logistic regressions tested parents’ traditional cultural values as predictors of routine health and dental care, accounting for parent nativity, parent acculturation, family socioeconomic status, youth gender, youth age, and youth physical health status. We also tested whether youth gender moderated the associations between parents’ cultural values and young adults’ routine care. Results Young adults whose mothers endorsed strong familism values when they were in mid-to-late adolescence were more likely to report at least one routine physician visit in the past year as young adults (odds ratio [OR] = 3.47, 95% confidence interval [CI]: 1.23–9.83, p = .019). Furthermore, for females only, mothers’ more traditional gender role attitudes predicted reduced odds of receiving routine health (OR = .22; 95% CI: .08–.64, p = .005) and dental care (OR = .26; 95% CI: .09–.75, p = .012) in young adulthood. Conclusions Our findings highlight the importance of examining intragroup variability in culturally specific mechanisms to identify targets for addressing ethnic/racial disparities in health care utilization among Mexican-origin young adults, during a period of increased risk for health-compromising behaviors and reduced access to care. PMID:27988108

  17. 45 CFR 162.925 - Additional requirements for health plans.

    Science.gov (United States)

    2010-10-01

    ... clearinghouse to receive, process, or transmit a standard transaction may not charge fees or costs in excess of... RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS General Provisions for Transactions § 162.925 Additional... transaction as a standard transaction, the health plan must do so. (2) A health plan may not delay or reject a...

  18. Integrating authorities and disciplines into the preparedness-planning process: a study of mental health, public health, and emergency management.

    Science.gov (United States)

    Robertson, Madeline; Pfefferbaum, Betty; Codispoti, Catherine R; Montgomery, Juliann M

    2007-01-01

    The process of integrating all necessary authorities and disciplines into an organized preparedness plan is complex, and the inclusion of disaster mental health poses specific challenges. The goals of this project were (1) to identify whether state mental health preparedness was included in state public health and emergency management preparedness plans, (2) to document barriers to entry and strategies reportedly used by state authorities in efforts to incorporate reasonable mental health preparedness into existing public health and emergency management preparedness planning, (3) to employ a theory for organizational change to organize and synthesize this information, and (4) to stimulate further discussion and research supporting coordinated preparedness efforts at the state level, particularly those inclusive of mental health. To accomplish these goals we (1) counted the number of state public health preparedness and emergency management plans that either included, mentioned, or omitted a mental health preparedness plan; (2) interviewed key officials from nine representative states for their reports on strategies used in seeking greater inclusion of mental health preparedness in public health and emergency management preparedness planning; and (3) synthesized these results to contribute to the national dialogue on coordinating disaster preparedness, particularly with respect to mental health preparedness. We found that 15 out of 29 publicly available public health preparedness plans (52 percent) included mental health preparedness, and eight of 43 publicly available emergency management plans (18 percent) incorporated mental health. Interviewees reported numerous barriers and strategies, which we cataloged according to a well-accepted eight-step plan for transforming organizations.

  19. Identification of traditional foods with public health potential for complementary feeding in Western Kenya

    DEFF Research Database (Denmark)

    Kinyuru, John N,; Konyole, Silvenus O.; Kenji, Glaston M.

    2012-01-01

    The diversity of traditional foods in Kisumu West District of Western Kenya was assessed with an aim to identify the foods with a potential for complementary feeding. Leaves were the most consumed plant part amongst vegetables, while a few fruits were consumed together with their seeds. Amaranthus...... with nutritional and health benefits as perceived by the locals. Traditional food processing methods such as boiling, fermentation and sun drying were identified. Thus exploitation of the species possessing nutrient, health and processing benefits needs to be explored in complementary feeding....

  20. Global mental health, autonomy and medical paternalism: reconstructing the 'French ethical tradition' in psychiatry.

    Science.gov (United States)

    Pires Marques, Tiago

    2017-09-01

    In the last few decades, the definition of deontological ethics, a well-identified ethical territory in psychiatry, has been the object of increasing concerns. This has been the case in France, where claims of a specific ethical tradition in psychiatry have accompanied the institutionalization of psychiatric ethics and the perceived globalization of an Anglo-American model of mental health care. This study traces the history of the 'French ethical tradition in psychiatry' and its relationship with establishing institutional spaces for ethical decision-making. The 'ethical tradition' thus conceived proves to be functional in terms of preserving the threatened identity of French psychiatry. Nevertheless, this movement also pinpoints impasses that transcend the French context and may provide valuable resources for ethical reflections on mental health on a global scale.

  1. 75 FR 43329 - Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Internal...

    Science.gov (United States)

    2010-07-23

    ... 45 CFR Part 147 Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to... Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and... of Labor; Office of Consumer Information and Insurance Oversight, Department of Health and Human...

  2. 75 FR 27141 - Group Health Plans and Health Insurance Issuers Providing Dependent Coverage of Children to Age...

    Science.gov (United States)

    2010-05-13

    ... Group Health Plans and Health Insurance Issuers Providing Dependent Coverage of Children to Age 26 Under... Information and Insurance Oversight of the U.S. Department of Health and Human Services are issuing substantially similar interim final regulations with respect to group health plans and health insurance coverage...

  3. 76 FR 46621 - Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under...

    Science.gov (United States)

    2011-08-03

    ... to the interim final regulations implementing the rules for group health plans and health insurance... dates. These interim final regulations generally apply to group health plans and group health insurance... from HHS on private health insurance for consumers can be found on the Centers for Medicare & Medicaid...

  4. 75 FR 41787 - Requirement for Group Health Plans and Health Insurance Issuers To Provide Coverage of Preventive...

    Science.gov (United States)

    2010-07-19

    ... Requirement for Group Health Plans and Health Insurance Issuers To Provide Coverage of Preventive Services... Insurance Oversight of the U.S. Department of Health and Human Services are issuing substantially similar interim final regulations with respect to group health plans and health insurance coverage offered in...

  5. Incorporating Traditional Healing into an Urban American Indian Health Organization: A Case Study of Community Member Perspectives

    Science.gov (United States)

    Hartmann, William E.; Gone, Joseph P.

    2012-01-01

    Facing severe mental health disparities rooted in a complex history of cultural oppression, members of many urban American Indian (AI) communities are reaching out for indigenous traditional healing to augment their use of standard Western mental health services. Because detailed descriptions of approaches for making traditional healing available…

  6. Breaking The Traditional Communication Flow: Exploration of Social Media Opinion Leaders in Health

    Directory of Open Access Journals (Sweden)

    Mohamad Emma

    2017-01-01

    Full Text Available Opinion leaders play an important role in mitigating health issues and are able to influence attitudes and health behaviors to a certain extent. However, in the world we are living today, individual health decision making no longer rely fully on doctor’s advice, but often persuaded by people or organisations deemed reliable and trustworthy. Interestingly, one does not have to have a medical degree to be seen as “reliable” or “trustworthy” in giving out medical advices. Computer-mediated-communication changes the way opinion leaders emerge in virtual communities, specifically in the context of health. Through increased access to both traditional and online media, people have a fair access to communication technology and therefore, our definition of opinion leaders have shifted from how we used to understand it through Lazarsfeld’s two-steps flow theory. In fact, the way opinion leaders operate via social media platform is very different from how it used to be through the traditional mass media. This paper will discuss on the characteristics of new media opinion leaders, particularly in the context of health, in hopes to learn new ways to promote health in future communication campaigns.

  7. Traditional, complementary, and alternative medicine approaches to mental health care and psychological wellbeing in India and China.

    Science.gov (United States)

    Thirthalli, Jagadisha; Zhou, Liang; Kumar, Kishore; Gao, Jie; Vaid, Henna; Liu, Huiming; Hankey, Alex; Wang, Guojun; Gangadhar, Bangalore N; Nie, Jing-Bao; Nichter, Mark

    2016-07-01

    India and China face the same challenge of having too few trained psychiatric personnel to manage effectively the substantial burden of mental illness within their population. At the same time, both countries have many practitioners of traditional, complementary, and alternative medicine who are a potential resource for delivery of mental health care. In our paper, part of The Lancet and Lancet Psychiatry's Series about the China-India Mental Health Alliance, we describe and compare types of traditional, complementary, and alternative medicine in India and China. Further, we provide a systematic overview of evidence assessing the effectiveness of these alternative approaches for mental illness and discuss challenges in research. We suggest how practitioners of traditional, complementary, and alternative medicine and mental health professionals might forge collaborative relationships to provide more accessible, affordable, and acceptable mental health care in India and China. A substantial proportion of individuals with mental illness use traditional, complementary, and alternative medicine, either exclusively or with biomedicine, for reasons ranging from faith and cultural congruence to accessibility, cost, and belief that these approaches are safe. Systematic reviews of the effectiveness of traditional, complementary, and alternative medicine find several approaches to be promising for treatment of mental illness, but most clinical trials included in these systematic reviews have methodological limitations. Contemporary methods to establish efficacy and safety-typically through randomised controlled trials-need to be complemented by other means. The community of practice built on collaborative relationships between practitioners of traditional, complementary, and alternative medicine and providers of mental health care holds promise in bridging the treatment gap in mental health care in India and China. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. [World plan for reproductive autonomy and health].

    Science.gov (United States)

    Ospina, P

    1994-06-01

    The principal objective of the Third International Conference on Population and Development to be held in Cairo in 1994 is to achieve consensus on a Plan of Action to reinforce reproductive rights of individuals, who bear ultimate responsibility for slowing population growth. The Plan of Action should be adopted by all the peoples of the world in order to stabilize population growth during the next twenty years by means of programs to provide family planning and reproductive health services. The preliminary conference document incorporated recommendations and proposals of two preparatory committees, five regional conferences, six expert meetings, 109 countries, and over 400 nongovernmental organizations from around the world. At current rates of growth, the world's 5.7 billion inhabitants will increase to 9.1 billion by the year 2025, vastly increasing pressure on already limited resources and ecosystems. The central theme of the first World Population Conference in Bucharest in 1974 was the close relationship between population growth and socioeconomic development. The 1974 World Population Plan of Action stressed development of strategies to achieve a better quality of life and rapid socioeconomic development. Recommendations of the 1984 World Population Conference in Mexico remained centered on implementation of the Bucharest Plan of Action with a few additions. Although progress has been achieved in meeting the goals of the Bucharest Plan of Action, growth rates of some developing countries have actually increased. Poverty, unemployment, illiteracy, and discrimination against women are still obstacles to socioeconomic development, and contraceptive usage has not reached optimal levels. Urban migration remains excessive. Progress for many countries over the past decade has been directly related to increasing the access of women to health care and family planning. Themes related to women's status and rights will be incorporated in the 1994 Cairo Conference. The

  9. 75 FR 43109 - Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and...

    Science.gov (United States)

    2010-07-23

    ... Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and Appeals and... the Office of Consumer Information and Insurance Oversight of the U.S. Department of Health and Human... health insurance coverage offered in connection with a group health plan under the Employee Retirement...

  10. Policy Watch: The Federal Employees Health Benefits Plan

    OpenAIRE

    Roger Feldman; Kenneth E. Thorpe; Bradley Gray

    2002-01-01

    This short feature describes the Federal Employees Health Benefits Plan (FEHBP), which provides health insurance benefits to active and retired federal employees and their dependents. The article discusses the FEHBP as a touchstone for research on employment-based health insurance and as a touchstone for health policy reform.

  11. [Philanthropic hospitals and the operation of provider-owned health plans in Brazil].

    Science.gov (United States)

    Lima, Sheyla Maria Lemos; Portela, Margareth C; Ugá, Maria Alicia Dominguez; Barbosa, Pedro Ribeiro; Gerschman, Silvia; Vasconcellos, Miguel Murat

    2007-02-01

    To describe the management performance of philanthropic hospitals that operate their own health plans, in comparison with philanthropic hospitals as a whole in Brazil. The managerial structures of philanthropic hospitals that operated their own health plans were compared with those seen in a representative group from the philanthropic hospital sector, in six dimensions: management and planning, economics and finance, human resources, technical services, logistics services and information technology. Data from a random sample of 69 hospitals within the philanthropic hospital sector and 94 philanthropic hospitals that operate their own health plans were evaluated. In both cases, only the hospitals with less than 599 beds were included. The results identified for the hospitals that operate their own health plans were more positive in all the managerial dimensions compared. In particular, the economics and finance and information technology dimensions were highlighted, for which more than 50% of the hospitals that operated their own health plans presented almost all the conditions considered. The philanthropic hospital sector is important in providing services to the Brazilian Health System (SUS). The challenges in maintaining and developing these hospitals impose the need to find alternatives. Stimulation of a public-private partnership in this segment, by means of operating provider-owned health plans or providing services to other health plans that work together with SUS, is a field that deserves more in-depth analysis.

  12. 77 FR 42462 - Hawaii State Plan for Occupational Safety and Health; Proposed Modification of 18(e) Plan Approval

    Science.gov (United States)

    2012-07-19

    ... DEPARTMENT OF LABOR Occupational Safety and Health Administration 29 CFR Part 1952 [Docket ID. OSHA 2012-0029] RIN 1218-AC78 Hawaii State Plan for Occupational Safety and Health; Proposed Modification of 18(e) Plan Approval AGENCY: Occupational Safety and Health Administration (OSHA), Department of...

  13. Indicators for planning of health services: assessing impacts of social and health care factors on population health.

    Science.gov (United States)

    Wan, T T; Broida, J H

    1983-01-01

    Community health planning requires identification of the level of access to care and factors which affect the differentials in use of health services. In formulating strategies or alternatives for planning, some assessment of the current level or patterns of health services must be made. It is this element of the planning process that is addressed in this paper. In this study sixty-five specifically designated areas (medical market areas) in the Province of Quebec, Canada were selected. The analysis was performed using data obtained from a large scale study of physicians' responses to the introduction of universal medical care insurance in Quebec. Our analysis offered an opportunity to observe the impact of Medicare on access to care for those thought to be underserved.

  14. Nonprofit to for-profit conversions by hospitals, health insurers, and health plans.

    Science.gov (United States)

    Needleman, J

    1999-01-01

    Conversion of hospitals, health insurers, and health plans from nonprofit to for-profit ownership has become a focus of national debate. The author examines why nonprofit ownership has been dominant in the US health system and assesses the strength of the argument that nonprofits provide community benefits that would be threatened by for-profit conversion. The author concludes that many of the specific community benefits offered by nonprofits, such as care for the poor, could be maintained or replaced by adequate funding of public programs and that quality and fairness in treatment can be better assured through clear standards of care and adequate monitoring systems. As health care becomes increasingly commercialized, the most difficult parts of nonprofits' historic mission to preserve are the community orientation, leadership role, and innovation that nonprofit hospitals and health plans have provided out of their commitment to a community beyond those to whom they sell services.

  15. Is health workforce planning recognising the dynamic interplay between health literacy at an individual, organisation and system level?

    Science.gov (United States)

    Naccarella, Lucio; Wraight, Brenda; Gorman, Des

    2016-02-01

    The growing demands on the health system to adapt to constant change has led to investment in health workforce planning agencies and approaches. Health workforce planning approaches focusing on identifying, predicting and modelling workforce supply and demand are criticised as being simplistic and not contributing to system-level resiliency. Alternative evidence- and needs-based health workforce planning approaches are being suggested. However, to contribute to system-level resiliency, workforce planning approaches need to also adopt system-based approaches. The increased complexity and fragmentation of the healthcare system, especially for patients with complex and chronic conditions, has also led to a focus on health literacy not simply as an individual trait, but also as a dynamic product of the interaction between individual (patients, workforce)-, organisational- and system-level health literacy. Although it is absolutely essential that patients have a level of health literacy that enables them to navigate and make decisions, so too the health workforce, organisations and indeed the system also needs to be health literate. Herein we explore whether health workforce planning is recognising the dynamic interplay between health literacy at an individual, organisation and system level, and the potential for strengthening resiliency across all those levels.

  16. 77 FR 8725 - Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under...

    Science.gov (United States)

    2012-02-15

    ... regulations authorizing the exemption of group health plans and group health insurance coverage sponsored by... plans and group health insurance issuers on April 16, 2012. FOR FURTHER INFORMATION CONTACT: Amy Turner... addition, information from HHS on private health insurance for consumers can be found on the CMS Web site...

  17. Animal Health and Welfare Planning in Organic Dairy Cattle Farms

    DEFF Research Database (Denmark)

    Vaarst, Mette; Winckler, Christoph; Roderick, Stephen

    2011-01-01

    Continuous development is needed within the farm to reach the goal of good animal health and welfare in organic livestock farming. The very different conditions between countries call for models that are relevant for different farming types and can be integrated into local practice and be relevant...... for each type of farming context. This article reviews frameworks, principles and practices for animal health and welfare planning which are relevant for organic livestock farming. This review is based on preliminary analyses carried out within a European project (acronym ANIPLAN) with participants from...... as well as animal health and welfare professionals (veterinarians and advisors) is paramount. This paper provides an overview of some current animal health and welfare planning initiatives and explains the principles of animal health and welfare planning which are being implemented in ANIPLAN partner...

  18. Traditional birth attendants in Malawi

    Directory of Open Access Journals (Sweden)

    J. J. M. Smit

    1994-03-01

    Full Text Available Traditional Birth Attendants (TBAs and traditional healers form an important link in the chain of health personnel providing primary health care in Malawi. In spite of the establishment of hospitals and health centres, it is to these traditional healers and TBAs that the majority of people turn in times of sickness and child-birth. Approximately 60 percent of all deliveries in Malawi occur in the villages. It is therefore important that due regard be paid to the activities of these traditional practitioners in order to ensure the achievement of the goal - "Health for all by the year 2000". The training of TBAs is seen as part of the Maternal and Child Health Services in the country.

  19. Traditional birth attendants in Malawi

    Directory of Open Access Journals (Sweden)

    J. J. M. Smit

    1994-05-01

    Full Text Available Traditional Birth Attendants (TBAs and traditional healers form an important link in the chain of health personnel providing primary health care in Malawi. In spite of the establishment of hospitals and health centres, it is to these traditional healers and TBAs that the majority of people turn in times of sickness and child-birth. Approximately 60 percent of all deliveries in Malawi occur in the villages. It is therefore important that due regard be paid to the activities of these traditional practitioners in order to ensure the achievement of the goal - "Health for all by the year 2000". The training of TBAs is seen as part of the Maternal and Child Health Services in the country.

  20. Assessing Health Promotion Interventions: Limitations of Traditional Research Methods in Community-Based Studies.

    Science.gov (United States)

    Dressel, Anne; Schneider, Robert; DeNomie, Melissa; Kusch, Jennifer; Welch, Whitney; Sosa, Mirtha; Yeldell, Sally; Maida, Tatiana; Wineberg, Jessica; Holt, Keith; Bernstein, Rebecca

    2017-09-01

    Most low-income Americans fail to meet physical activity recommendations. Inactivity and poor diet contribute to obesity, a risk factor for multiple chronic diseases. Health promotion activities have the potential to improve health outcomes for low-income populations. Measuring the effectiveness of these activities, however, can be challenging in community settings. A "Biking for Health" study tested the impact of a bicycling intervention on overweight or obese low-income Latino and African American adults to reduce barriers to cycling and increase physical activity and fitness. A randomized controlled trial was conducted in Milwaukee, Wisconsin, in summer 2015. A 12-week bicycling intervention was implemented at two sites with low-income, overweight, or obese Latino and African American adults. We found that randomized controlled trial methodology was suboptimal for use in this small pilot study and that it negatively affected participation. More discussion is needed about the effectiveness of using traditional research methods in community settings to assess the effectiveness of health promotion interventions. Modifications or alternative methods may yield better results. The aim of this article is to discuss the effectiveness and feasibility of using traditional research methods to assess health promotion interventions in community-based settings.

  1. How institutional forces, ideas and actors shaped population health planning in Australian regional primary health care organisations.

    Science.gov (United States)

    Javanparast, Sara; Freeman, Toby; Baum, Fran; Labonté, Ronald; Ziersch, Anna; Mackean, Tamara; Reed, Richard; Sanders, David

    2018-03-20

    Worldwide, there are competing norms driving health system changes and reorganisation. One such norm is that of health systems' responsibilities for population health as distinct from a focus on clinical services. In this paper we report on a case study of population health planning in Australian primary health care (PHC) organisations (Medicare Locals, 2011-2015). Drawing on institutional theory, we describe how institutional forces, ideas and actors shaped such planning. We reviewed the planning documents of the 61 Medicare Locals and rated population health activities in each Medicare Local. We also conducted an online survey and 50 interviews with Medicare Local senior staff, and an interview and focus group with Federal Department of Health staff. Despite policy emphasis on population health, Medicare Locals reported higher levels of effort and capacity in providing clinical services. Health promotion and social determinants of health activities were undertaken on an ad hoc basis. Regulatory conditions imposed by the federal government including funding priorities and time schedules, were the predominant forces constraining population health planning. In some Medicare Locals, this was in conflict with the normative values and what Medicare Locals felt ought to be done. The alignment between the governmental and the cultural-cognitive forces of a narrow biomedical approach privileged clinical practice and ascribed less legitimacy to action on social determinants of health. Our study also shed light on the range of PHC actors and how their agency influenced Medicare Locals' performance in population health. The presence of senior staff or community boards with a strong commitment to population health were important in directing action towards population health and equity. There are numerous institutional, normative and cultural factors influencing population health planning. The experience of Australian Medicare Locals highlights the difficulties of planning in

  2. Discourse versus practice: are traditional practices and beliefs in pregnancy and childbirth included or excluded in the Ecuadorian health care system?

    Science.gov (United States)

    Gallegos, Carlos Andres; Waters, William F; Kuhlmann, Anne Sebert

    2017-03-01

    Traditional beliefs, knowledge and practices are formally integrated into the Ecuadorian health system. We sought to understand whether they are integrated in practice. Qualitative data were collected in two rural parishes in the central highlands of Ecuador through four focus group discussions (30 participants), eight key informant interviews, three participatory exercises (24 participants), structured observations of health facilities and analysis of official documents. We found different levels of integration, coexistence, tolerance, and intolerance of traditional health beliefs and practices in health facilities. One parish has undergone dramatic social and cultural transformation, and the role of traditional birth attendants is limited. In the other parish, traditional indigenous norms and values persist, and traditional birth attendants are sought during pregnancy and childbirth. The degree to which traditional birth attendants, indigenous women and their families are included or excluded from public health services depends largely on decisions taken by local health professionals. Formal policies in Ecuador stipulate that health care should be intercultural, but the role of traditional birth attendants is not necessarily incorporated in practice. The integration of culturally-informed beliefs and practices is critical for providing appropriate health services to members of vulnerable populations. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Results from a national survey on chronic care management by health plans.

    Science.gov (United States)

    Mattke, Soeren; Higgins, Aparna; Brook, Robert

    2015-05-01

    The growing burden of chronic disease necessitates innovative approaches to help patients and to ensure the sustainability of our healthcare system. Health plans have introduced chronic care management models, but systematic data on the type and prevalence of different approaches are lacking. Our goal was to conduct a systematic examination of chronic care management programs offered by health plans in the commercial market (ie, in products sold to employers and individuals. We undertook a national survey of a representative sample of health plans (70 plans, 36% response rate) and 6 case studies on health plans' programs to improve chronic care in the commercial market. The data underwent descriptive and bivariate analyses. All plans, regardless of size, location, and ownership, offer chronic care management programs, which identify eligible members from claims data and match them to interventions based on overall risk and specific care gaps. Plans then report information on care gaps to providers and offer self-management support to their members. While internal evaluations suggest that the interventions improve care and reduce cost, plans report difficulties in engaging members and providers. To overcome those obstacles, plans are integrating their programs into provider work flow, collaborating with providers on care redesign and leveraging patient support technologies. Our study shows that chronic care management programs have become a standard component of the overall approach used by health plans to manage the health of their members.

  4. Traditional Medicine in Developing Countries

    DEFF Research Database (Denmark)

    Thorsen, Rikke Stamp

    or spiritual healer and self-treatment with herbal medicine or medicinal plants. Reliance on traditional medicine varies between countries and rural and urban areas, but is reported to be as high as 80% in some developing countries. Increased realization of the continued importance of traditional medicine has......People use traditional medicine to meet their health care needs in developing countries and medical pluralism persists worldwide despite increased access to allopathic medicine. Traditional medicine includes a variety of treatment opportunities, among others, consultation with a traditional healer...... led to the formulation of policies on the integration of traditional medicine into public health care. Local level integration is already taking place as people use multiple treatments when experiencing illness. Research on local level use of traditional medicine for health care, in particular the use...

  5. Health Care Waste Segregation Behavior among Health Workers in Uganda: An Application of the Theory of Planned Behavior.

    Science.gov (United States)

    Akulume, Martha; Kiwanuka, Suzanne N

    2016-01-01

    Objective . The goal of this study was to assess the appropriateness of the theory of planned behavior in predicting health care waste segregation behaviors and to examine the factors that influence waste segregation behaviors. Methodology . One hundred and sixty-three health workers completed a self-administered questionnaire in a cross-sectional survey that examined the theory of planned behavior constructs (attitudes, subjective norms, perceived behavioral control, and intention) and external variables (sociodemographic factors, personal characteristics, organizational characteristics, professional characteristics, and moral obligation). Results . For their most recent client 21.5% of the health workers reported that they most definitely segregated health care waste while 5.5% did not segregate. All the theory of planned behavior constructs were significant predictors of health workers' segregation behavior, but intention emerged as the strongest and most significant ( r = 0.524, P theory of planned behavior model explained 52.5% of the variance in health workers' segregation behavior. When external variables were added, the new model explained 66.7% of the variance in behavior. Conclusion . Generally, health workers' health care waste segregation behavior was high. The theory of planned behavior significantly predicted health workers' health care waste segregation behaviors.

  6. Curricula for Health Planning, Policy, and Marketing: Conference Papers 1981-82.

    Science.gov (United States)

    Bergwall, David F., Ed.

    Papers from a 1981 conference on curriculum for health planning, policy, and marketing and from a 1982 conference on curriculum for strategic planning are presented. Responses to the papers and summaries of the proceedings are also presented. Titles and authors are as follows: "A Curriculum in Community Health Planning: An Approach for Today…

  7. A tool for enhancing strategic health planning: a modeled use of the International Classification of Functioning, Disability and Health.

    Science.gov (United States)

    Sinclair, Lisa Bundara; Fox, Michael H; Betts, Donald R

    2013-01-01

    This article describes use of the International Classification of Functioning, Disability and Health (ICF) as a tool for strategic planning. The ICF is the international classification system for factors that influence health, including Body Structures, Body Functions, Activities and Participation and Environmental Factors. An overview of strategic planning and the ICF are provided. Selected ICF concepts and nomenclature are used to demonstrate its utility in helping develop a classic planning framework, objectives, measures and actions. Some issues and resolutions for applying the ICF are described. Applying the ICF for strategic health planning is an innovative approach that fosters the inclusion of social ecological health determinants and broad populations. If employed from the onset of planning, the ICF can help public health organizations systematically conceptualize, organize and communicate a strategic health plan. Published 2012. This article is a US Government work and is in the public domain in the USA.

  8. Introducing risk adjustment and free health plan choice in employer-based health insurance: Evidence from Germany.

    Science.gov (United States)

    Pilny, Adam; Wübker, Ansgar; Ziebarth, Nicolas R

    2017-12-01

    To equalize differences in health plan premiums due to differences in risk pools, the German legislature introduced a simple Risk Adjustment Scheme (RAS) based on age, gender and disability status in 1994. In addition, effective 1996, consumers gained the freedom to choose among hundreds of existing health plans, across employers and state-borders. This paper (a) estimates RAS pass-through rates on premiums, financial reserves, and expenditures and assesses the overall RAS impact on market price dispersion. Moreover, it (b) characterizes health plan switchers and investigates their annual and cumulative switching rates over time. Our main findings are based on representative enrollee panel data linked to administrative RAS and health plan data. We show that sickness funds with bad risk pools and high pre-RAS premiums lowered their total premiums by 42 cents per additional euro allocated by the RAS. Consequently, post-RAS, health plan prices converged but not fully. Because switchers are more likely to be white collar, young and healthy, the new consumer choice resulted in more risk segregation and the amount of money redistributed by the RAS increased over time. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Eliminating traditional reference services in an academic health sciences library: a case study

    Science.gov (United States)

    Schulte, Stephanie J

    2011-01-01

    Question: How were traditional librarian reference desk services successfully eliminated at one health sciences library? Setting: The analysis was done at an academic health sciences library at a major research university. Method: A gap analysis was performed, evaluating changes in the first eleven months through analysis of reference transaction and instructional session data. Main Results: Substantial increases were seen in the overall number of specialized reference transactions and those conducted by librarians lasting more than thirty minutes. The number of reference transactions overall increased after implementing the new model. Several new small-scale instructional initiatives began, though perhaps not directly related to the new model. Conclusion: Traditional reference desk services were eliminated at one academic health sciences library without negative impact on reference and instructional statistics. Eliminating ties to the confines of the physical library due to staffing reference desk hours removed one significant barrier to a more proactive liaison program. PMID:22022221

  10. Improving Urban Water Environment in Eastern China by Blending Traditional with Modern Landscape Planning.

    Science.gov (United States)

    Cao, Jiajie; Yu, Junjun; Tian, Yuan; Zhao, Cai; Wang, Hao

    2017-01-01

    As a fundamental part of greenspace, urban water landscape contributes greatly to the ecological system and at the same time supplies a leisure area for residents. The paper did an analysis on the number of aquatic plant communities, the form of water spaces, and water quality condition by investigating 135 quadrats (90 at amphibious boundary and the land, 45 in the water) in 45 transects of 15 urban and suburban parks. We found that water spaces had monotonous forms with low biodiversity and poor water quality. In addition, urban water landscapes hardly provided ecological functions given excessive construction. Accordingly, a proposition to connect tradition with modernism in the improvement and innovation of urban water landscape planning was put forward, and further, the way to achieve it was explored. By taking Qinhu Wetland Park as a case, the principles and specific planning methods on macro- and microperspectives were discussed to guide the development of urban landscape in eastern China.

  11. Improving Urban Water Environment in Eastern China by Blending Traditional with Modern Landscape Planning

    Directory of Open Access Journals (Sweden)

    Jiajie Cao

    2017-01-01

    Full Text Available As a fundamental part of greenspace, urban water landscape contributes greatly to the ecological system and at the same time supplies a leisure area for residents. The paper did an analysis on the number of aquatic plant communities, the form of water spaces, and water quality condition by investigating 135 quadrats (90 at amphibious boundary and the land, 45 in the water in 45 transects of 15 urban and suburban parks. We found that water spaces had monotonous forms with low biodiversity and poor water quality. In addition, urban water landscapes hardly provided ecological functions given excessive construction. Accordingly, a proposition to connect tradition with modernism in the improvement and innovation of urban water landscape planning was put forward, and further, the way to achieve it was explored. By taking Qinhu Wetland Park as a case, the principles and specific planning methods on macro- and microperspectives were discussed to guide the development of urban landscape in eastern China.

  12. Predictors of health plan satisfaction among employees in an academic setting.

    Science.gov (United States)

    Dembe, Allard E; Lu, Bo; Sieck, Cynthia J

    2010-01-01

    This study's goal was to identify the strongest predictors of satisfaction with a health plan offered to employees at a large university in the Midwestern United States. Survey responses from 1533 employees were analyzed (response rate of 51.2%). Unadjusted odds ratios (ORs) were calculated to identify factors that were statistically associated with plan satisfaction. Multivariate logistic regression analyses followed by likelihood ratio testing were conducted to assess the predictive value of particular variables. The strongest predictors of satisfaction with the health plan were the perceived quality of the plan's wellness and prevention services (OR = 3.69), having a personal doctor or nurse (OR = 2.70), being satisfied with the cost of the health plan (OR = 2.18), and having claims handled correctly (OR = 1.90). The factors that have the greatest individual effect on these findings were the quality of the plan's prevention and wellness services and how effectively the plan communicated how much particular services or visits would cost.

  13. Animal health and welfare planning improves udder health and cleanliness but not leg health in Austrian dairy herds.

    Science.gov (United States)

    Tremetsberger, Lukas; Leeb, Christine; Winckler, Christoph

    2015-10-01

    Animal health and welfare planning is considered an important tool for herd management; however, its effectiveness is less well known. The aim of this study was to conduct animal health and welfare planning on 34 Austrian dairy farms and to evaluate changes in health and welfare after 1 yr. After an initial assessment using the Welfare Quality protocol (Welfare Quality Consortium, Lelystad, the Netherlands), results were reported back to the farmers. Health and welfare area(s) in which both the farmer and the researcher regarded improvement as important were discussed. Management practices and husbandry measures were chosen according to the respective farm situation. One year after interventions had been initiated, farms were reassessed, and the degree of implementation of improvement measures was recorded. The average implementation rate was 57% and thus relatively high when compared with other studies. High degrees of implementation were achieved related to cleanliness and udder health, at 77 and 63%, respectively. Intervention measures addressing udder health were mostly easy to incorporate in the daily routine and led to a reduced somatic cell score, whereas this score increased in herds without implementation of measures. The decrease in cows with dirty teats was more pronounced when measures were implemented compared with control farms. The implementation rate regarding leg health (46%) was comparably low in the present study, and leg health did not improve even when measures were implemented. Lying comfort, social behavior, and human-animal relationship did not require interventions and were therefore seldom chosen by farmers as part of health and welfare plans. In conclusion, the structured, participatory process of animal health and welfare planning appears to be a promising way to improve at least some animal health and welfare issues. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  14. Hawaii State Plan for Occupational Safety and Health. Final rule.

    Science.gov (United States)

    2012-09-21

    This document announces the Occupational Safety and Health Administration's (OSHA) decision to modify the Hawaii State Plan's ``final approval'' determination under Section 18(e) of the Occupational Safety and Health Act (the Act) and to transition to ``initial approval'' status. OSHA is reinstating concurrent federal enforcement authority over occupational safety and health issues in the private sector, which have been solely covered by the Hawaii State Plan since 1984.

  15. Traditional and ayurvedic foods of Indian origin

    Directory of Open Access Journals (Sweden)

    Preetam Sarkar

    2015-09-01

    Full Text Available The Ayurveda contains a wealth of knowledge on health sciences. Accordingly traditional foods and their dietary guidelines are prescribed in Ayurveda. There is so much similarity in ayurvedic dietetics and traditional foods that many of the traditional health foods in India can be called ayurvedic foods. This review article introduces the concepts of ayurvedic health foods in India and describes several traditional heath foods across various regions of India. Recommended dietary guidelines according to age and health condition of the consumer, and seasonal considerations are presented for each of the traditional health foods of India. In the era of globalization of the population and international food trading, health conscious citizens around the globe will benefit from the wealth of knowledge on traditional Indian and ayurvedic health foods of Indian origin.

  16. The North Carolina State Health Plan for Teachers and State Employees: Strategies in Creating Financial Stability While Improving Member Health.

    Science.gov (United States)

    Jones, Dee; Horner, Beth

    2018-01-01

    The North Carolina State Health Plan provides health care coverage to more than 700,000 members, including teachers, state employees, retirees, current and former lawmakers, state university and community college personnel, and their dependents. The State Health Plan is a division of the North Carolina Department of State Treasurer, self-insured, and exempt from the Employee Retirement Income Security Act as a government-sponsored plan. With health care costs rising at rates greater than funding, the Plan must take measures to stem cost growth while ensuring access to quality health care. The Plan anticipates focusing on strategic initiatives that drive results and cost savings while improving member health to protect the Plan's financial future. ©2018 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

  17. [Planning a Health Residence for Prison Security Measures, Tuscany (Italy)].

    Science.gov (United States)

    Porfido, Eugenio; Colombai, Renato; Scarpa, Franco; Totaro, Michele; Tani, Luca; Baldini, Claudio; Baggiani, Angelo

    2016-01-01

    Health Residences for Prison Security Measures are facilities hosting psychotic persons who have committed crimes and providing them with personalized rehabilitation and treatment plans to promote their reinstatement in society. The aim of this study was to describe the criteria for planning and designing a prison health residence in the Tuscany region (Italy), to be managed by the regional healthcare service, in line with current regulations, with dedicated staff for providing specific treatment plans and programmes.

  18. Action planning as predictor of health protective and health risk behavior: an investigation of fruit and snack consumption.

    Science.gov (United States)

    van Osch, Liesbeth; Beenackers, Mariëlle; Reubsaet, Astrid; Lechner, Lilian; Candel, Math; de Vries, Hein

    2009-10-13

    Large discrepancies between people's intention to eat a healthy diet and actual dietary behavior indicate that motivation is not a sufficient instigator for healthy behavior. Research efforts to decrease this 'intention - behavior gap' have centered on aspects of self-regulation, most importantly self-regulatory planning. Most studies on the impact of self-regulatory planning in health and dietary behavior focus on the promotion of health protective behaviors. This study investigates and compares the predictive value of action planning in health protective behavior and the restriction of health risk behavior. Two longitudinal observational studies were performed simultaneously, one focusing on fruit consumption (N = 572) and one on high-caloric snack consumption (N = 585) in Dutch adults. Structural equation modeling was used to investigate and compare the predictive value of action planning in both behaviors, correcting for demographics and the influence of motivational factors and past behavior. The nature of the influence of action planning was investigated by testing mediating and moderating effects. Action planning was a significant predictor of fruit consumption and restricted snack consumption beyond the influence of motivational factors and past behavior. The strength of the predictive value of action planning did not differ between the two behaviors. Evidence for mediation of the intention - behavior relationship was found for both behaviors. Positive moderating effects of action planning were demonstrated for fruit consumption, indicating that individuals who report high levels of action planning are significantly more likely to translate their intentions into actual behavior. The results indicate that the planning of specific preparatory actions predicts the performance of healthy dietary behavior and support the application of self-regulatory planning in both health protective and health risk behaviors. Future interventions in dietary modification may

  19. Framing health for land-use planning legislation: A qualitative descriptive content analysis.

    Science.gov (United States)

    Harris, Patrick; Kent, Jennifer; Sainsbury, Peter; Thow, Anne Marie

    2016-01-01

    Framing health as a relevant policy issue for other sectors is not well understood. A recent review of the New South Wales (Australia) land-use planning system resulted in the drafting of legislation with an internationally unprecedented focus on human health. We apply a political science approach to investigate the question 'how and to what extent were health and wider issues framed in submissions to the review?' We investigated a range of stakeholder submissions including health focussed agencies (n = 31), purposively identified key stakeholders with influence on the review (n = 24), and a random sample of other agencies and individuals (n = 47). Using qualitative descriptive analysis we inductively coded for the term 'health' and sub-categories. We deductively coded for 'wider concerns' using a locally endorsed 'Healthy Urban Development Checklist'. Additional inductive analysis uncovered further 'wider concerns'. Health was explicitly identified as a relevant issue for planning policy only in submissions by health-focussed agencies. This framing concerned the new planning system promoting and protecting health as well as connecting health to wider planning concerns including economic issues, transport, public open space and, to a slightly lesser extent, environmental sustainability. Key stakeholder and other agency submissions focussed on these and other wider planning concerns but did not mention health in detail. Health agency submissions did not emphasise infrastructure, density or housing as explicitly as others. Framing health as a relevant policy issue has the potential to influence legislative change governing the business of other sectors. Without submissions from health agencies arguing the importance of having health as an objective in the proposed legislation it is unlikely health considerations would have gained prominence in the draft bill. The findings have implications for health agency engagement with legislative change processes and beyond in

  20. Health Care Waste Segregation Behavior among Health Workers in Uganda: An Application of the Theory of Planned Behavior

    Directory of Open Access Journals (Sweden)

    Martha Akulume

    2016-01-01

    Full Text Available Objective. The goal of this study was to assess the appropriateness of the theory of planned behavior in predicting health care waste segregation behaviors and to examine the factors that influence waste segregation behaviors. Methodology. One hundred and sixty-three health workers completed a self-administered questionnaire in a cross-sectional survey that examined the theory of planned behavior constructs (attitudes, subjective norms, perceived behavioral control, and intention and external variables (sociodemographic factors, personal characteristics, organizational characteristics, professional characteristics, and moral obligation. Results. For their most recent client 21.5% of the health workers reported that they most definitely segregated health care waste while 5.5% did not segregate. All the theory of planned behavior constructs were significant predictors of health workers’ segregation behavior, but intention emerged as the strongest and most significant (r=0.524, P<0.001. The theory of planned behavior model explained 52.5% of the variance in health workers’ segregation behavior. When external variables were added, the new model explained 66.7% of the variance in behavior. Conclusion. Generally, health workers’ health care waste segregation behavior was high. The theory of planned behavior significantly predicted health workers’ health care waste segregation behaviors.

  1. Can health feasibly be considered as part of the planning process in Scotland?

    International Nuclear Information System (INIS)

    Higgins, Martin; Douglas, Margaret; Muirie, Jill

    2005-01-01

    The planning system is significant because of its capacity to determine the quality of the built environment as well as the health, well-being and quality of life of the individuals and communities therein. Development planning is especially important because of the long-term impact of the decisions. This paper was developed in response to increasing recognition amongst HIA practitioners in Scotland of the importance of planning for health. It focuses on the relationship between the planning system in Scotland, specifically the Development Planning element of it, and population health and considers how the health impact assessment (HIA) approach can facilitate and support joint working with planners. In particular, consideration is given to the potential impact of the introduction of Strategic Environmental Assessment (SEA) on the linkages between health, HIA and planning

  2. To rub shoulders with the traditional health practitioner or not, that is the question for the medical doctor in the New South Africa

    Directory of Open Access Journals (Sweden)

    Gabriel Louw

    2017-03-01

    Full Text Available Background The South African medical doctor has been well established over the years as the keeper of the holy medical grails. Entrance for newcomers to the medical domain has not been and is still not easy. The hostility towards the allied professions in the 1950s and later in the 1980s provides evidence of this. Certain prerequisites for entrance were set and jealously guarded by the medical fraternity. The Traditional Health Practitioners Act, (Act No 22, 2007 is another such a challenge. This time it is not an outsider fraternity that is fighting alone for its own recognition. They are backed by a government and political force to get the traditional health practitioner (previously known as the traditional healer statutorily recognized. Aims The study aimed to reflect on the future professional relationship between the medical doctor and the traditional health practitioner in South Africa. Methods This is an exploratory and descriptive study that makes use of an historical approach by means of investigation and a literature review. The emphasis is on using current documentation like articles, books and newspapers as primary sources to reflect on the future professional relationship between the medical doctor and the traditional health practitioner in South Africa. The findings are offered in narrative form. Results It is clear that the Traditional Health Practitioners Act No 22 (2007 will put enormous pressure on the medical doctor, not only to relinquish some of his healthcare empowerment, but also to see and to accept the traditional health practitioner as a new, respectable health copractitioner and colleague. Facts hereto reveal that there are in terms of training, health ethics, practice approaches, attitudes and views, basically not a single point of similarity or agreement between the medical doctor and the traditional health practitioner whatsoever. Notwithstanding these enormous differences, the existence of the Traditional Health

  3. A comparison of health behaviors of women in centering pregnancy and traditional prenatal care.

    Science.gov (United States)

    Shakespear, Kaylynn; Waite, Phillip J; Gast, Julie

    2010-03-01

    Researchers sought to determine the difference in health behaviors between women who receive prenatal care via the Centering Pregnancy approach and those involved in traditional prenatal care. Using a cross-sectional design, adult pregnant women (n = 125) were surveyed from at least 28 weeks gestation to delivery. The sample was comprised of primarily white low income women. Using multiple linear regression it was determined that women in Centering Pregnancy had significantly lower index health behavior scores compared with the traditional care group showing that those in Centering Pregnancy reported engaging in fewer health promoting behaviors. Furthermore, no differences were observed for smoking or weight gain behaviors between groups. Additionally, those in Centering Pregnancy reported a lower perceived value of prenatal care. The results of this study suggest that Centering Pregnancy is not adequately aiding its patients in adopting healthy behaviors during pregnancy.

  4. Health Plans Can't Ignore The Customer Experience Any Longer.

    Science.gov (United States)

    Swanson, Erik

    2017-10-01

    With regulations limiting differentiation between products, health plans must rethink consumer experience to meet expectations of today's consumers, who seek convenience, quality, and speed from their health care organizations. Many plans understand they need to connect more effectively with their end customers, but technological, cultural, and other obstacles are in the way.

  5. Core competency model for the family planning public health nurse.

    Science.gov (United States)

    Hewitt, Caroline M; Roye, Carol; Gebbie, Kristine M

    2014-01-01

    A core competency model for family planning public health nurses has been developed, using a three stage Delphi Method with an expert panel of 40 family planning senior administrators, community/public health nursing faculty and seasoned family planning public health nurses. The initial survey was developed from the 2011 Title X Family Planning program priorities. The 32-item survey was distributed electronically via SurveyMonkey(®). Panelist attrition was low, and participation robust resulting in the final 28-item model, suggesting that the Delphi Method was a successful technique through which to achieve consensus. Competencies with at least 75% consensus were included in the model and those competencies were primarily related to education/counseling and administration of medications and contraceptives. The competencies identified have implications for education/training, certification and workplace performance. © 2014 Wiley Periodicals, Inc.

  6. School-Sponsored Health Insurance: Planning for a New Reality

    Science.gov (United States)

    Liang, Bryan A.

    2010-01-01

    Health care reform efforts in both the Clinton and Obama administrations have attempted to address college and university health. Yet, although the world of health care delivery has almost universally evolved to managed care, school health programs have not. In general, school-sponsored health plans do little to improve access and have adopted…

  7. Developing a Spanish-language consumer report for CAHPS health plan surveys.

    Science.gov (United States)

    Derose, Kathryn Pitkin; Kanouse, David E; Weidmer, Beverly; Weech-Maldonado, Robert; García, Rosa Elena; Hays, Ron D

    2007-11-01

    A Spanish-language consumer report on health plan quality was developed for the Consumer Assessments of Healthcare Providers and Systems (CAHPS) project. Multiple translations, a committee review, and a readability assessment were performed to produce a draft Spanish report. The report was revised on the basis of a series of cognitive interviews with 24 Latinos. The median age of participants was 41 years, and the median number of years in the United States was 9; 67% were female, and 63% had less than a high school education. In general, participants understood the report and said they would use it to choose a health plan. Less-educated respondents had difficulty understanding the segmented bar graphs that showed the proportion of health plan members' responses. A summary chart comparing all health plans on all dimensions was easier to comprehend when differences were represented by word icons rather than by stars. Concepts and terms about health care quality translated well from English to Spanish. Simplifying graphical information involves losing some detail but makes information more usable. Summary charts facilitate comparisons across plans, but differences relative to a mean are difficult for both Spanish- and English-speaking consumers to understand.

  8. Robustness in practice--the regional planning of health services.

    Science.gov (United States)

    Best, G; Parston, G; Rosenhead, J

    1986-05-01

    Earlier work has criticized the dominant tendencies in operational research contributions to health services planning as characterized by optimization, implausible demands for data, depoliticization, hierarchy and inflexibility. This paper describes an effort which avoids at least some of these pitfalls. The project was to construct a planning system for a regional health council in Ontario, Canada, which would take account of the possible alternative future states of the health-care system's environment and would aim to keep options for future development open. The planning system devised is described in the paper. It is based on robustness analysis, which evaluates alternative initial action sets in terms of the useful flexibility they preserve. Other features include the explicit incorporation of pressures for change generated outside the health-care system, and a satisficing approach to the identification of both initial action sets and alternative future configurations of the health-care system. It was found possible to borrow and radically 're-use' techniques or formulations from the mainstream of O.R. contributions. Thus the 'reference projection' method was used to identify inadequacies in performance which future health-care system configurations must repair. And Delphi analysis, normally a method for generating consensus, was used in conjunction with cluster analysis of responses to generate meaningfully different alternative futures.

  9. Choosing a health plan: are Dutch consumers loyal to their health insurer?

    NARCIS (Netherlands)

    Hendriks, M.; Groenewegen, P.P.; Delnoij, D.M.J.

    2006-01-01

    In 2006, a number of far-reaching reforms have been implemented in the Dutch health insurance system. Giving Dutch consumers the freedom to change health plans every year increases consumer mobility. The idea is that especially consumers who are dissatisfied with their insurer will decide to switch

  10. Health Manpower Planning and Employment Policies for Turkey

    Directory of Open Access Journals (Sweden)

    Bulent Kilic

    2007-12-01

    Full Text Available Health manpower planning in health care should be done strategically while considering the following factors: health care needs and demands for community, health care organizations' objectives, goals and resources, goal of a high quality health workforce of sufficient size which has been appropriately distributed, their full employment realized within the appropriate time frame. A good health manpower planning consists of eight components: quantity (size, quality (skill, distribution, timing, employment, necessity, goals and resources. According to the calculations in this article, it must be 1515 people per general practitioner (GP and 1333 people per midwife. There must be 44.755 GP and 50.866 midwife for primary level in Turkey. However there are 51.530 GP and 41.513 midwife in Turkey in 2002. In this situation there is no more need for GP but there is a big need for 10.000 midwife as totally and actually 30.000 midwife for working at health centres for Turkey. As a result, this article discusses the shortcomings of Health Ministry's employment policies in Turkey. It is suggested that in the short run concepts such as physician unemployment, under-employment and flexible work hours will become frequently discussed in Turkey health care public discourse. [TAF Prev Med Bull 2007; 6(6.000: 501-514

  11. Health Manpower Planning and Employment Policies for Turkey

    Directory of Open Access Journals (Sweden)

    Bulent Kilic

    2007-12-01

    Full Text Available Health manpower planning in health care should be done strategically while considering the following factors: health care needs and demands for community, health care organizations' objectives, goals and resources, goal of a high quality health workforce of sufficient size which has been appropriately distributed, their full employment realized within the appropriate time frame. A good health manpower planning consists of eight components: quantity (size, quality (skill, distribution, timing, employment, necessity, goals and resources. According to the calculations in this article, it must be 1515 people per general practitioner (GP and 1333 people per midwife. There must be 44.755 GP and 50.866 midwife for primary level in Turkey. However there are 51.530 GP and 41.513 midwife in Turkey in 2002. In this situation there is no more need for GP but there is a big need for 10.000 midwife as totally and actually 30.000 midwife for working at health centres for Turkey. As a result, this article discusses the shortcomings of Health Ministry's employment policies in Turkey. It is suggested that in the short run concepts such as physician unemployment, under-employment and flexible work hours will become frequently discussed in Turkey health care public discourse. [TAF Prev Med Bull. 2007; 6(6: 501-514

  12. Joint Venture Health Plans May Give ACOs a Run for Their Money.

    Science.gov (United States)

    Reinke, Thomas

    2016-12-01

    Joint venture plans are starting to demonstrate their ability to implement clinical management and financial management reforms. A JV health plan replaces the offloading of financial risk by health plans to ill-equipped providers with an executive-level cost management committee stated jointly by the hospital and payer.

  13. Tank farm health and safety plan. Revision 2

    International Nuclear Information System (INIS)

    Mickle, G.D.

    1995-01-01

    This Tank Farm Health and Safety Plan (HASP) for the conduct of all operations and work activities at the Hanford Site 200 Area Tank Farms is provided in order to minimize health and safety risks to workers and other onsite personnel. The HASP accomplishes this objective by establishing requirements, providing general guidelines, and conveying farm and facility-specific hazard communication information. The HASP, in conjunction with the job-specific information required by the HASP, is provided also as a reference for use during the planning of work activities at the tank farms. This HASP applies to Westinghouse Hanford Company (WHC), other prime contractors to the U.S. Department of Energy (DOE), and subcontractors to WHC who may be involved in tank farm work activities. This plan is intended to be both a requirements document and a useful reference to aid tank farm workers in understanding the safety and health issues that are encountered in routine and nonroutine work activities. The HASP defines the health and safety responsibilities of personnel working at the tank farms. It has been prepared in recognition of and is consistent with National Institute of Safety and Health (NIOSH), and Occupational Safety and Health Administration (OSHA)/Unlimited State Coast Guard (USCG)/U.S. Environmental Protection Agency (EPA), Occupational Safety and Health Guidance Manual for Hazardous Waste Site Activities (NIOSH 1985); WHC-CM-4-3, Industrial Safety Manual, Volume 4, open-quotes Health and Safety Programs for Hazardous Waste Operations;close quotes 29 CFR 1910.120, Hazardous Waste Operations and Emergency Response; WHC-CM-1-1, Management Policies; and WHC-CM-1-3, Management Requirements and Procedures. When differences in governing regulations or policies exist, the more stringent requirements shall apply until the discrepancy can be resolved

  14. Tank farm health and safety plan. Revision 2

    Energy Technology Data Exchange (ETDEWEB)

    Mickle, G.D.

    1995-03-29

    This Tank Farm Health and Safety Plan (HASP) for the conduct of all operations and work activities at the Hanford Site 200 Area Tank Farms is provided in order to minimize health and safety risks to workers and other onsite personnel. The HASP accomplishes this objective by establishing requirements, providing general guidelines, and conveying farm and facility-specific hazard communication information. The HASP, in conjunction with the job-specific information required by the HASP, is provided also as a reference for use during the planning of work activities at the tank farms. This HASP applies to Westinghouse Hanford Company (WHC), other prime contractors to the U.S. Department of Energy (DOE), and subcontractors to WHC who may be involved in tank farm work activities. This plan is intended to be both a requirements document and a useful reference to aid tank farm workers in understanding the safety and health issues that are encountered in routine and nonroutine work activities. The HASP defines the health and safety responsibilities of personnel working at the tank farms. It has been prepared in recognition of and is consistent with National Institute of Safety and Health (NIOSH), and Occupational Safety and Health Administration (OSHA)/Unlimited State Coast Guard (USCG)/U.S. Environmental Protection Agency (EPA), Occupational Safety and Health Guidance Manual for Hazardous Waste Site Activities (NIOSH 1985); WHC-CM-4-3, Industrial Safety Manual, Volume 4, {open_quotes}Health and Safety Programs for Hazardous Waste Operations;{close_quotes} 29 CFR 1910.120, Hazardous Waste Operations and Emergency Response; WHC-CM-1-1, Management Policies; and WHC-CM-1-3, Management Requirements and Procedures. When differences in governing regulations or policies exist, the more stringent requirements shall apply until the discrepancy can be resolved.

  15. Family Planning in the Context of Latin America's Universal Health Coverage Agenda.

    Science.gov (United States)

    Fagan, Thomas; Dutta, Arin; Rosen, James; Olivetti, Agathe; Klein, Kate

    2017-09-27

    Countries in Latin America and the Caribbean (LAC) have substantially improved access to family planning over the past 50 years. Many have also recently adopted explicit declarations of universal rights to health and universal health coverage (UHC) and have begun implementing UHC-oriented health financing schemes. These schemes will have important implications for the sustainability and further growth of family planning programs throughout the region. We examined the status of contraceptive methods in major health delivery and financing schemes in 9 LAC countries. Using a set of 37 indicators on family planning coverage, family planning financing, health financing, and family planning inclusion in UHC-oriented schemes, we conducted a desk review of secondary sources, including population surveys, health financing assessments, insurance enrollment reports, and unit cost estimates, and interviewed in-country experts. Findings: Although the modern contraceptive prevalence rate (mCPR) has continued to increase in the majority of LAC countries, substantial disparities in access for marginalized groups remain. On average, mCPR is 20% lower among indigenous women than the general population, 5% lower among uninsured women than insured, and 7% lower among the poorest women than the wealthiest. Among the poorest quintile of women, insured women had an mCPR 16.5 percentage points higher than that of uninsured women, suggesting that expansion of insurance coverage is associated with increased family planning access and use. In the high- and upper-middle-income countries we reviewed, all modern contraceptive methods are typically available through the social health insurance schemes that cover a majority of the population. However, in low- and lower-middle-income countries, despite free provision of most family planning services in public health facilities, stock-outs and implicit rationing present substantial barriers that prevent clients from accessing their preferred method

  16. Action planning as predictor of health protective and health risk behavior: an investigation of fruit and snack consumption

    Directory of Open Access Journals (Sweden)

    Candel Math

    2009-10-01

    Full Text Available Abstract Background Large discrepancies between people's intention to eat a healthy diet and actual dietary behavior indicate that motivation is not a sufficient instigator for healthy behavior. Research efforts to decrease this 'intention - behavior gap' have centered on aspects of self-regulation, most importantly self-regulatory planning. Most studies on the impact of self-regulatory planning in health and dietary behavior focus on the promotion of health protective behaviors. This study investigates and compares the predictive value of action planning in health protective behavior and the restriction of health risk behavior. Methods Two longitudinal observational studies were performed simultaneously, one focusing on fruit consumption (N = 572 and one on high-caloric snack consumption (N = 585 in Dutch adults. Structural equation modeling was used to investigate and compare the predictive value of action planning in both behaviors, correcting for demographics and the influence of motivational factors and past behavior. The nature of the influence of action planning was investigated by testing mediating and moderating effects. Results Action planning was a significant predictor of fruit consumption and restricted snack consumption beyond the influence of motivational factors and past behavior. The strength of the predictive value of action planning did not differ between the two behaviors. Evidence for mediation of the intention - behavior relationship was found for both behaviors. Positive moderating effects of action planning were demonstrated for fruit consumption, indicating that individuals who report high levels of action planning are significantly more likely to translate their intentions into actual behavior. Conclusion The results indicate that the planning of specific preparatory actions predicts the performance of healthy dietary behavior and support the application of self-regulatory planning in both health protective and health

  17. Health plans and selection: formal risk adjustment vs. market design and contracts.

    Science.gov (United States)

    Frank, R G; Rosenthal, M B

    2001-01-01

    In this paper, we explore the demand for risk adjustment by health plans that contract with private employers by considering the conditions under which plans might value risk adjustment. Three factors reduce the value of risk adjustment from the plans' point of view. First, only a relatively small segment of privately insured Americans face a choice of competing health plans. Second, health plans share much of their insurance risk with payers, providers, and reinsurers. Third, de facto experience rating that occurs during the premium negotiation process and management of coverage appear to substitute for risk adjustment. While the current environment has not generated much demand for risk adjustment, we reflect on its future potential.

  18. [Quality planning of Family Health Units using Quality Function Deployment (QFD)].

    Science.gov (United States)

    Volpato, Luciana Fernandes; Meneghim, Marcelo de Castro; Pereira, Antonio Carlos; Ambrosano, Gláucia Maria Bovi

    2010-08-01

    Quality is an indispensible requirement in the health field, and its pursuit is necessary in order to meet demands by a population that is aware of its rights, as part of the essence of good work relations, and to decrease technological costs. Quality thus involves all parties to the process (users and professionals), and is no longer merely an attribute of the health service. This study aimed to verify the possibility of quality planning in the Family Health Units, using Quality Function Deployment (QFD). QFD plans quality according to user satisfaction, involving staff professionals and identifying new approaches to improve work processes. Development of the array, called the House of Quality, is this method's most important characteristics. The results show a similarity between the quality demanded by users and the quality planned by professionals. The current study showed that QFD is an efficient tool for quality planning in public health services.

  19. The clientele of traditional birth homes in rural southeastern Nigeria.

    Science.gov (United States)

    Izugbara, C Otutubikey; Ukwayi, J Kinuabeye

    2003-03-01

    Although it is widely documented that traditional birth homes (TBHs) do more than deliver babies, little is known about the other functions in addition to child delivery, which TBHs perform. Drawing on in-depth individual interviews with 13 traditional birth attendants (TBAs) and 147 users of TBHs, we profile the characteristics and health conditions of the clientele of TBHs in four rural communities in southeastern Nigeria. We found that TBHs provide their clients, who are mainly less educated women and girls, health services that range from child delivery, child sex selection, and abortion to family planning and cures for vaginal bleeding. Women are attracted to TBHs because the services are low cost, the women require privacy about their conditions, the TBHs are close by, and the women are confident in the abilities of TBHs. Rural women are bound by poverty, culture, and local values in their choices of services. We assert that health interventions to local people will need to be couched within frameworks that are responsive to their socioeconomic and cultural sensitivities if they are to deliver their expected impact.

  20. [General aspects of planning and care in mental health].

    Science.gov (United States)

    Saforcada, E

    1976-09-01

    This paper reviews some general concepts on Planning, especially in public and welfare sectors, stressing those concerning the major flaws in the argentine system of mental health. The author considers the definition of planning levels, and sets forth three: general plan, program and project. The correlative implementation is also considered. The importance of feed-back from adequate evaluation is stressed, emphasizing three aspects: a) evaluation of dynamics, rate and extent of decrease, increase or stagnation; b) assessment of efficacity of factors involved; c) control and stabilization of goals already attained. The necessity to develop a human ecology, encompassing socio-cultural and psycho-social factors is stressed, together with fostering theoretical research and the use of its results by implementation agents. Several differences among prevailing mental health actions are pointed out which allow a distinction between two typical models: clinical and sanitarist. The main differences between them lye on: standard location of working sites, nature of basic actions, field of action, hypothesis for working, including ethiological and ecological assumptions, theoretical and methodological framework. A series of criteria for evaluating sanitary techniques and strategies are set forth, among which: operative procedures, length of treatments, degree of therapeutic concentration, and general pragmatic criteria. The indicators reviewed are: degree of efficacity, covering, degree of perseverance in treatments, cultural barriers between patient and therapist, delegation of functions into special, first-rate sanitary agents, needs for the training of mental health workers. An attempt is made at developping general evaluation criteria for mental health planning, and several indicators are proposed, among which: a) cost/efficacity ratio, including in costs the use of economical, human and physical resources; b) preventive capacities of the community; c) capacities for the

  1. Health workforce governance and integration: the fit between planning and system.

    NARCIS (Netherlands)

    Batenburg, R.

    2014-01-01

    Background: The EU Joint Action on Health Workforce Planning and Forecasting has taken up the challenge to let countries share and exchange practices in health workforce planning. It appears however, that not many countries actually apply (needs-based forecasting) models to support this. But does

  2. Reflections on the use of the World Health Organization’s (WHO OneHealth Tool: Implications for health planning in low and middle income countries (LMICs [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    John Q. Wong

    2018-02-01

    Full Text Available The World Health Organization (WHO launched the OneHealth Tool (OHT to help low and middle income countries to develop their capacities for sector-wide priority setting. In 2016, we sought to use the OHT to aid the Philippine Health Insurance Corporation (PHIC, the national health insurer of the Philippines, in decisions to expand benefit packages using cost-effectiveness analyses. With technical support from the WHO, we convened health planning officers from the Philippine Department of Health (DOH and the Philippine Health Insurance Corporation (PHIC conduct generalized cost-effective analyses (GCEA of selected un-financed noncommunicable disease interventions using OHT. We collected epidemiological and cost data through health facility surveys, review of literature such as cost libraries and clinical practice guidelines, and expert consultations. Although we were unable to use GCEA results directly to set policy, we learnt important policy lessons which we outline here that might help inform other countries looking to inform service coverage decisions. Additionally, the entire process and GCEA visualizations helped high-level policymakers in the health sector, who have traditionally relied on ad hoc decision making, to realize the need for a systematic and transparent priority-setting process that can continuously provide the evidence needed to inform service coverage decisions.

  3. Hospital and Health Plan Partnerships: The Affordable Care Act's Impact on Promoting Health and Wellness

    Science.gov (United States)

    Vu, Michelle; White, Annesha; Kelley, Virginia P.; Hopper, Jennifer Kuca; Liu, Cathy

    2016-01-01

    Background The Affordable Care Act (ACA) healthcare reforms, centered on achieving the Centers for Medicare & Medicaid Services (CMS) Triple Aim goals of improving patient care quality and satisfaction, improving population health, and reducing costs, have led to increasing partnerships between hospitals and insurance companies and the implementation of employee wellness programs. Hospitals and insurance companies have opted to partner to distribute the risk and resources and increase coordination of care. Objective To examine the ACA's impact on the health and wellness programs that have resulted from the joint ventures of hospitals and health plans based on the published literature. Method We conducted a review of the literature to identify successful mergers and best practices of health and wellness programs. Articles published between January 2007 and January 2015 were compiled from various search engines, using the search terms “corporate,” “health and wellness program,” “health plan,” “insurance plan,” “hospital,” “joint venture,” and “vertical merger.” Publications that described consolidations or wellness programs not tied to health insurance plans were excluded. Noteworthy characteristics of these programs were summarized and tabulated. Results A total of 44 eligible articles were included in the analysis. The findings showed that despite rising healthcare costs, joint ventures prevent hospitals from trading-off quality and services for cost reductions. Administrators believed that partnering would allow the companies to meet ACA standards for improving clinical outcomes at reduced costs. Before the implementation of the ACA, some employers had wellness programs, but these were not standardized and did not need to produce measurable results. The ACA encouraged improvement of employee wellness programs by providing funding for expanded health services and by mandating quality care. Successful workplace health and wellness

  4. Traditional Birth Attendants: A Field Guide to Their Training, Evaluation, and Articulation with Health Services. World Health Organization Offset Publication No. 44.

    Science.gov (United States)

    World Health Organization, Geneva (Switzerland).

    Guidelines for the planning, implementation, and evaluation of nationwide programs for the training and utilization of traditional birth attendants (TBAs) are presented. The guide begins with a chart outlining the steps in the development and evaluation of TBA programs. The next section discusses the formulation of basic policies regarding the…

  5. Quality of Family Planning Services in Primary Health Centers of ...

    African Journals Online (AJOL)

    Background: Good quality of care in family planning (FP) services help individuals and couples to meet their reproductive health needs safely and effectively. Therefore, assessment and improvement of the quality of family planning services could enhance family planning services utilization. This study was thus conducted ...

  6. The Search Conference as a Method in Planning Community Health Promotion Actions

    Science.gov (United States)

    Magnus, Eva; Knudtsen, Margunn Skjei; Wist, Guri; Weiss, Daniel; Lillefjell, Monica

    2016-01-01

    Aims: The aim of this article is to describe and discuss how the search conference can be used as a method for planning health promotion actions in local communities. Design and methods: The article draws on experiences with using the method for an innovative project in health promotion in three Norwegian municipalities. The method is described both in general and how it was specifically adopted for the project. Results and conclusions: The search conference as a method was used to develop evidence-based health promotion action plans. With its use of both bottom-up and top-down approaches, this method is a relevant strategy for involving a community in the planning stages of health promotion actions in line with political expectations of participation, ownership, and evidence-based initiatives. Significance for public health This article describe and discuss how the Search conference can be used as a method when working with knowledge based health promotion actions in local communities. The article describe the sequences of the conference and shows how this have been adapted when planning and prioritizing health promotion actions in three Norwegian municipalities. The significance of the article is that it shows how central elements in the planning of health promotion actions, as participation and involvements as well as evidence was a fundamental thinking in how the conference were accomplished. The article continue discussing how the method function as both a top-down and a bottom-up strategy, and in what way working evidence based can be in conflict with a bottom-up strategy. The experiences described can be used as guidance planning knowledge based health promotion actions in communities. PMID:27747199

  7. Health workforce development planning in the Sultanate of Oman: a case study

    Directory of Open Access Journals (Sweden)

    Ghosh Basu

    2009-06-01

    Full Text Available Abstract Introduction Oman's recent experience in health workforce development may be viewed against the backdrop of the situation just three or four decades ago, when it had just a few physicians and nurses (mostly expatriate. All workforce categories in Oman have grown substantially over the last two decades. Increased self-reliance was achieved despite substantial growth in workforce stocks. Stocks of physicians and nurses grew significantly during 1985–2007. This development was the outcome of well-considered national policies and plans. This case outlines how Oman is continuing to turn around its excessive dependence on expatriate workforce through strategic workforce development planning. Case description The Sultanate's early development initiatives focused on building a strong health care infrastructure by importing workforce. However, the policy-makers stressed national workforce development for a sustainable future. Beginning with the formulation of a strategic health workforce development plan in 1991, the stage was set for adopting workforce planning as an essential strategy for sustainable health development and workforce self-reliance. Oman continued to develop its educational infrastructure, and began to produce as much workforce as possible, in order to meet health care demands and achieve workforce self-reliance. Other policy initiatives with a beneficial impact on Oman's workforce development scenario were: regionalization of nursing institutes, active collaboration with universities and overseas specialty boards, qualitative improvement of the education system, development of a strong continuing professional development system, efforts to improve workforce management, planned change management and needs-based micro/macro-level studies. Strong political will and bold policy initiatives, dedicated workforce planning and educational endeavours have all contributed to help Oman to develop its health workforce stocks and gain

  8. Health workforce development planning in the Sultanate of Oman: a case study.

    Science.gov (United States)

    Ghosh, Basu

    2009-06-11

    Oman's recent experience in health workforce development may be viewed against the backdrop of the situation just three or four decades ago, when it had just a few physicians and nurses (mostly expatriate). All workforce categories in Oman have grown substantially over the last two decades. Increased self-reliance was achieved despite substantial growth in workforce stocks. Stocks of physicians and nurses grew significantly during 1985-2007. This development was the outcome of well-considered national policies and plans. This case outlines how Oman is continuing to turn around its excessive dependence on expatriate workforce through strategic workforce development planning. The Sultanate's early development initiatives focused on building a strong health care infrastructure by importing workforce. However, the policy-makers stressed national workforce development for a sustainable future. Beginning with the formulation of a strategic health workforce development plan in 1991, the stage was set for adopting workforce planning as an essential strategy for sustainable health development and workforce self-reliance. Oman continued to develop its educational infrastructure, and began to produce as much workforce as possible, in order to meet health care demands and achieve workforce self-reliance. Other policy initiatives with a beneficial impact on Oman's workforce development scenario were: regionalization of nursing institutes, active collaboration with universities and overseas specialty boards, qualitative improvement of the education system, development of a strong continuing professional development system, efforts to improve workforce management, planned change management and needs-based micro/macro-level studies. Strong political will and bold policy initiatives, dedicated workforce planning and educational endeavours have all contributed to help Oman to develop its health workforce stocks and gain self-reliance. Oman has successfully innovated workforce

  9. State landscape in public health planning and quality improvement: results of the ASTHO survey.

    Science.gov (United States)

    Madamala, Kusuma; Sellers, Katie; Pearsol, Jim; Dickey, Michael; Jarris, Paul E

    2010-01-01

    Limited data exist on state public health agencies and their use of planning and quality improvement (QI) initiatives. Using the 2007 Association of State and Territorial Health Officials (ASTHO) State Public Health Survey, this article describes how state public health agencies perform tasks related to planning, performance management (PM), and QI. While 82 percent of respondents report having a QI process in place, only 9.8 percent have it fully implemented departmentwide. Seventy-six percent reported having a PM process in place, with 16 percent (n = 8) having it fully implemented departmentwide. A state health improvement plan was used by 80.4 percent of respondents, with 56.9 percent of respondents completing the plan more than 3 years ago. More than two-thirds (68.2%) of the respondents developed the plan by using results of their state health assessment. Analysis of state health department level planning, PM, and QI initiatives can inform states' efforts to ready themselves to meet the proposed national voluntary accreditation standards of the Public Health Accreditation Board.

  10. Traditional alcohol production and use in three provinces in Vietnam: an ethnographic exploration of health benefits and risks.

    Science.gov (United States)

    Luu, Bich Ngoc; Nguyen, Thi Thieng; Newman, Ian M

    2014-07-18

    Gaps exist in knowledge about the production and use of traditional alcohols, particularly in Asia. This study adds new information about the nature, production and sale of traditional distilled spirit alcohol in Vietnam. This was an ethnographic study of traditional distilled spirit alcohol production in rural areas of three provinces in Vietnam. Researchers interviewed more than 300 individuals and recorded responses to general open-ended questions about local alcohol production. Interviews were recorded, transcribed, and studied to discern what information about traditional alcohol was important to the speakers. Methods of production followed long-held traditions. Participants listed both personal and community benefits (economic, health, and social) from traditional alcohol making. Older people favoured traditional alcohol, while younger people favoured brand-name beer. Typically people consumed 2-4 drinks daily, mainly at meal times. People consumed more alcohol at special events and festivals. Distribution patterns ranged from low-risk distribution to family and neighbours to high-risk distribution by an agent who might combine alcohol from several producers, which increases the opportunity for dilution and adulteration. The most commonly listed health risks associated with locally-made alcohol were local air pollution and water pollution; participants also mentioned traffic crashes and bad public behaviour. Depending on the location, community leaders reported that production may be relatively stable or it may be declining. Traditional alcohol manufacture, sale, and use in Vietnam is a long-standing practice and low- to moderate-risk to health. There do not appear to be instances of accidental or intentional contamination. Urbanization seems to be affecting the market share of traditional alcohol as urbanized youth turn to branded products, mainly beer, making traditional alcohol making and consumption an activity mainly linked to older people in rural areas

  11. A spatial national health facility database for public health sector planning in Kenya in 2008

    Directory of Open Access Journals (Sweden)

    Gething Peter W

    2009-03-01

    Full Text Available Abstract Background Efforts to tackle the enormous burden of ill-health in low-income countries are hampered by weak health information infrastructures that do not support appropriate planning and resource allocation. For health information systems to function well, a reliable inventory of health service providers is critical. The spatial referencing of service providers to allow their representation in a geographic information system is vital if the full planning potential of such data is to be realized. Methods A disparate series of contemporary lists of health service providers were used to update a public health facility database of Kenya last compiled in 2003. These new lists were derived primarily through the national distribution of antimalarial and antiretroviral commodities since 2006. A combination of methods, including global positioning systems, was used to map service providers. These spatially-referenced data were combined with high-resolution population maps to analyze disparity in geographic access to public health care. Findings The updated 2008 database contained 5,334 public health facilities (67% ministry of health; 28% mission and nongovernmental organizations; 2% local authorities; and 3% employers and other ministries. This represented an overall increase of 1,862 facilities compared to 2003. Most of the additional facilities belonged to the ministry of health (79% and the majority were dispensaries (91%. 93% of the health facilities were spatially referenced, 38% using global positioning systems compared to 21% in 2003. 89% of the population was within 5 km Euclidean distance to a public health facility in 2008 compared to 71% in 2003. Over 80% of the population outside 5 km of public health service providers was in the sparsely settled pastoralist areas of the country. Conclusion We have shown that, with concerted effort, a relatively complete inventory of mapped health services is possible with enormous potential for

  12. A spatial national health facility database for public health sector planning in Kenya in 2008.

    Science.gov (United States)

    Noor, Abdisalan M; Alegana, Victor A; Gething, Peter W; Snow, Robert W

    2009-03-06

    Efforts to tackle the enormous burden of ill-health in low-income countries are hampered by weak health information infrastructures that do not support appropriate planning and resource allocation. For health information systems to function well, a reliable inventory of health service providers is critical. The spatial referencing of service providers to allow their representation in a geographic information system is vital if the full planning potential of such data is to be realized. A disparate series of contemporary lists of health service providers were used to update a public health facility database of Kenya last compiled in 2003. These new lists were derived primarily through the national distribution of antimalarial and antiretroviral commodities since 2006. A combination of methods, including global positioning systems, was used to map service providers. These spatially-referenced data were combined with high-resolution population maps to analyze disparity in geographic access to public health care. The updated 2008 database contained 5,334 public health facilities (67% ministry of health; 28% mission and nongovernmental organizations; 2% local authorities; and 3% employers and other ministries). This represented an overall increase of 1,862 facilities compared to 2003. Most of the additional facilities belonged to the ministry of health (79%) and the majority were dispensaries (91%). 93% of the health facilities were spatially referenced, 38% using global positioning systems compared to 21% in 2003. 89% of the population was within 5 km Euclidean distance to a public health facility in 2008 compared to 71% in 2003. Over 80% of the population outside 5 km of public health service providers was in the sparsely settled pastoralist areas of the country. We have shown that, with concerted effort, a relatively complete inventory of mapped health services is possible with enormous potential for improving planning. Expansion in public health care in Kenya has

  13. Patterns of service use in two types of managed behavioral health care plans.

    Science.gov (United States)

    Merrick, Elizabeth L; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M; Azzone, Vanessa; McCann, Bernard; Ritter, Grant; Zolotusky, Galima; McGuire, Thomas G; Reif, Sharon

    2010-01-01

    The study examined service use patterns by level of care in two managed care plans offered by a national managed behavioral health care organization (MBHO): an employee assistance program (EAP) combined with a standard behavioral health plan (integrated plan) and a standard behavioral health plan. The cross-sectional analysis used 2004 administrative data from the MBHO. Utilization of 11 specific service categories was compared. The weighted sample reflected exact matching on sociodemographic characteristics (unweighted N=710,014; weighted N=286,750). A larger proportion of enrollees in the integrated plan than in the standard plan used outpatient mental health and substance abuse office visits (including EAP visits) (p<.01) and substance abuse intensive outpatient or day treatment (p<.05), and the proportion using residential substance abuse rehabilitation was lower (p<.05). The integrated and standard products had distinct utilization patterns in this large MBHO. In particular, greater use of certain outpatient services was observed in the integrated plan.

  14. Do employers know the quality of health care benefits they provide? Use of HEDIS depression scores for health plans.

    Science.gov (United States)

    Robst, John; Rost, Kathryn; Marshall, Donna

    2013-11-01

    OBJECTIVE Dissemination of health quality measures is a necessary ingredient of efforts to harness market-based forces, such as value-based purchasing by employers, to improve health care quality. This study examined reporting of Healthcare Effectiveness Data and Information Set (HEDIS) measures for depression to firms interested in improving depression care. METHODS During surveys conducted between 2009 and 2011, a sample of 325 employers that were interested in improving depression treatment were asked whether their primary health plan reports HEDIS scores for depression to the National Committee for Quality Assurance (NCQA) and if so, whether they knew the scores. Data about HEDIS reporting by the health plans were collected from the NCQA. RESULTS HEDIS depression scores were reported by the primary health plans of 154 (47%) employers, but only 7% of employers knew their plan's HEDIS scores. Because larger employers were more likely to report knowing the scores, 53% of all employees worked for employers who reported knowing the scores. A number of structural, health benefit, and need characteristics predicted knowledge of HEDIS depression scores by employers. CONCLUSIONS The study demonstrated that motivated employers did not know their depression HEDIS scores even when their plan publicly reported them. Measures of health care quality are not reaching the buyers of insurance products; however, larger employers were more likely to know the HEDIS scores for their health plan, suggesting that value-based purchasing may have some ability to affect health care quality.

  15. Mitigating global warming: traditional versus alternative approaches in a planning versus a market context

    Energy Technology Data Exchange (ETDEWEB)

    Olerup, Brita [Royal Inst. of Technology, Dept. of Industrial Economics and Management, Stockholm (Sweden)

    2002-06-01

    Economic efficiency tends to be an important argument when different means of environmental control are assessed and suggested. Considering that the most cost-efficient means are not the ones most frequently chosen and used, some other qualities seem to play an equally important role. I use findings from organisational theory and negotiation theory to better understand what is concealed in the black-box of decision-making and implementation. My empirical material consists of case studies of four different means of environmental control used in Sweden during the 1990s to mitigate the threat of global warming. These are an environmental tax, a licensing trial, municipal energy planning, and technology procurement. Each represents a particular discipline (economic, legal, physical planning, or technological) in which a context (planning or market) and an approach (traditional relay race or alternative process-oriented) are combined. Although each means has its particular niche, some qualities stand out as superior. Such means need to be divisible in space as well as in time. It is then easier to get started. Since it is just as easy to deviate from, rather than adhere to, the predetermined course after a while, some incentive must be given to the person in charge of implementation. In other words, the classic proverb of using sticks and carrots is still valid although it is not always taken to heart and practised. (Author)

  16. The joint action on health workforce planning and forecasting: results of a European programme to improve health workforce policies.

    NARCIS (Netherlands)

    Kroezen, M.; Hoegaerden, M. van; Batenburg, R.

    2017-01-01

    Health workforce (HWF) planning and forecasting is faced with a number of challenges, most notably a lack of consistent terminology, a lack of data, limited model-, demand-based- and future-based planning, and limited inter-country collaboration. The Joint Action on Health Workforce Planning and

  17. Assessing the Financial Condition of Provider-Sponsored Health Plans.

    Science.gov (United States)

    McCue, Michael J

    2015-06-01

    The aim of this study was to assess the performance of health plans sponsored by provider organizations, with respect to plans generating strong positive cash flow relative to plans generating weaker cash flow. A secondary aim was to assess their capital adequacy. The study identified 24 provider-sponsored health plans (PSHPs) with an average positive cash flow margin from 2011 through 2013 at or above the top 75th percentile, defined as "strong cash flow PSHPs:" This group was compared with 72 PSHPs below the 75th percentile, defined as "weak cash flow PSHPs:" Atlantic Information Services Directory of Health Plans was used to identify the PSHPs. Financial ratios were computed from 2013 National Association of Insurance Commissioners Financial Filings. The study conducted a t test mean comparison between strong and weak cash flow PSHPs across an array of financial performance and capital adequacy measures. In 2013, the strong cash flow PSHPs averaged a cash-flow margin ratio of 6.6%. Weak cash flow PSHPs averaged a cash-flow margin of -0.4%. The net worth capital position of both groups was more than 4.5 times authorized capital. The operational analysis shows that strong cash-flow margin PSHPs are managing their medical costs to achieve this position. Although their medical loss ratio increased by almost 300 basis points from 2011 to 2013, it was still statistically significantly lower than the weaker cash flow PSHP group (P<.001). In terms of capital adequacy, both strong and weak cash-flow margin PSHP groups possessed sufficient capital to ensure the viability of these plans.

  18. 42 CFR 417.801 - Agreements between CMS and health care prepayment plans.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Agreements between CMS and health care prepayment... CMS and health care prepayment plans. (a) General requirement. (1) In order to participate and receive... written agreement with CMS. (2) An existing group practice prepayment plan (GPPP) that continues as an...

  19. UMTRA Project: Environment, Safety, and Health Plan

    International Nuclear Information System (INIS)

    1995-02-01

    The US Department of Energy has prepared this UMTRA Project Environment, Safety, and Health (ES and H) Plan to establish the policy, implementing requirements, and guidance for the UMTRA Project. The requirements and guidance identified in this plan are designed to provide technical direction to UMTRA Project contractors to assist in the development and implementation of their ES and H plans and programs for UMTRA Project work activities. Specific requirements set forth in this UMTRA Project ES and H Plan are intended to provide uniformity to the UMTRA Project's ES and H programs for processing sites, disposal sites, and vicinity properties. In all cases, this UMTRA Project ES and H Plan is intended to be consistent with applicable standards and regulations and to provide guidance that is generic in nature and will allow for contractors' evaluation of site or contract-specific ES and H conditions. This plan specifies the basic ES and H requirements applicable to UMTRA Project ES and H programs and delineates responsibilities for carrying out this plan. DOE and contractor ES and H personnel are expected to exercise professional judgment and apply a graded approach when interpreting these guidelines, based on the risk of operations

  20. [Clinical orientation and thought on several problems in post-marketed reassessment of traditional Chinese medicine].

    Science.gov (United States)

    Wang, Xin; Su, Xia; Yu, Jie; Xie, Yanming; Wang, Yongyan

    2011-10-01

    The post-marketed reassessment is an important link to ensure the safety and effectiveness of traditional chinese medicine. It is also the expansion and stretch of new drug evaluation. Through the systematic, standard, rigorous post-marketed reassessment, the enterprise can full access to drugs after listing the efficacy and safety information, evaluate the interests and risk of the drug and provide the scientific basis for the drug use. It can also provide timely, scientific technology basis for government health decisions, the enterprise marketing decision and public health security. This paper mainly discussed the thought on clinical orientation of traditional chinese medicine in the post-marketed reassessment and how to reach the goal through systematic consideration and overall plan.

  1. Special Report: Banjul Islam Conference endorses family planning.

    Science.gov (United States)

    1979-11-01

    44 participants from 12 West African nations met in Banjul, the Gambia, from October 22-26, 1979 and unanimously agreed that family planning is in conformity with Islam. They called for greater involvement of local Muslim leaders in African countries to encourage family planning for the promotion of maternal and child health. The Conference was sponsored by IPPF Africa Region and attended by representatives of Muslim associations, health and family planning workers, teachers, government officials, and experts on Muslim law from Cameroon, The Gambia, Ghana, Guinea, Liberia, Mali, Morocco, Nigeria, Senegal, Sierra Leone, Upper Volta, and Zaire. The Conference members acknowledged that while the Koran, the Sunna, and the concensus of most Islam scholars is that family planning is acceptable within marriage, most traditional religious leaders are ignorant of the fact. Muslim women should be encouraged to take an interest in family planning. Other recommendations were educating Muslims on nutrition, sanitation, and health; to collect views of African Muslim leaders and publicize them; and, to persuade Ministries of Education to include family relations and parenthood in school curricula.

  2. [Diffusion of clinical governance among the Italian Local Health Units (LHUs). Analysis of the Health Surveys, the Firm Acts and the Health Plans].

    Science.gov (United States)

    de Belvis, A G; Biasco, A; Pelone, F; Romaniello, A; De Micco, F; Volpe, M; Ricciardi, W

    2009-01-01

    The objective of our research is to report on the diffusion of Clinical Governance, as introduced with the National Health Plan 2006-2008, by analysing the planning instruments set up by each Region (Regional Health Plans and Emergency Plans in regions with budget deficit), the organizational frameworks (Atti Aziendali, firm acts), and the surveys on performance and quality of healthcare among the Italian Local Health Units (Health Surveys). Our research was realized on September-December 2007 and consisted of the collection of all retrieved documents available on the web and on the online public access catalog (OPAC SBN) of the National Library Service. Futhermore, each document has been classified and analysed according to Chambers' Clinical Governance definition. A descriptive statistical and inferential analysis by applying the Chi-2 Test was performed to test the correlation between the diffusion of such a classified documents and the geographical partition of each LHU. Our results show a scarce diffusion of Firm acts (43%) and Health Surveys (24.9% of the total). Any remind to Clinical Governance instruments and methods inside each document resulted even poorer among both the organizational and performance surveys and the regional health planning frameworks, respectively.

  3. The Global Mental Health movement and its impact on traditional healing in India: A case study of the Balaji temple in Rajasthan.

    Science.gov (United States)

    Sood, Anubha

    2016-12-01

    This article considers the impact of the global mental health discourse on India's traditional healing systems. Folk mental health traditions, based in religious lifeways and etiologies of supernatural affliction, are overwhelmingly sought by Indians in times of mental ill-health. This is despite the fact that the postcolonial Indian state has historically considered the popularity of these indigenous treatments regressive, and claimed Western psychiatry as the only mental health system befitting the country's aspirations as a modern nation-state. In the last decade however, as global mental health concerns for scaling up psychiatric interventions and instituting bioethical practices in mental health services begin to shape India's mental health policy formulations, the state's disapproving stance towards traditional healing has turned to vehement condemnation. In present-day India, traditional treatments are denounced for being antithetical to global mental health tenets and harmful for the population, while biomedical psychiatry is espoused as the only legitimate form of mental health care. Based on ethnographic research in the Hindu healing temple of Balaji, Rajasthan, and analysis of India's mental health policy environment, I demonstrate how the tenor of the global mental health agenda is negatively impacting the functioning of the country's traditional healing sites. I argue that crucial changes in the therapeutic culture of the Balaji temple, including the disappearance of a number of key healing rituals, are consequences of global mental health-inspired policy in India which is reducing the plural mental health landscape.

  4. Forming a joint dialogue among faith healers, traditional healers and formal health workers in mental health in a Kenyan setting: towards common grounds.

    Science.gov (United States)

    Musyimi, Christine W; Mutiso, Victoria N; Nandoya, Erick S; Ndetei, David M

    2016-01-07

    Qualitative evidence on dialogue formation and collaboration is very scanty in Kenya. This study thus aimed at the formation of dialogue and establishment of collaboration among the informal (faith and traditional healers) and formal health workers (clinicians) in enhancing community-based mental health in rural Kenya. Qualitative approach was used to identify barriers and solutions for dialogue formation by conducting nine Focus Group Discussions each consisting of 8-10 participants. Information on age, gender and role in health care setting as well as practitioners' (henceforth used to mean informal (faith and traditional healers) and formal health workers) perceptions on dialogue was collected to evaluate dialogue formation. Qualitative and quantitative data analysis was performed using thematic content analysis and Statistical Package Social Sciences (SPSS) software respectively. We identified four dominant themes such as; (i) basic understanding about mental illnesses, (ii) interaction and treatment skills of the respondents to mentally ill persons, (iii) referral gaps and mistrust among the practitioners and (iv) dialogue formation among the practitioners. Although participants were conversant with the definition of mental illness and had interacted with a mentally ill person in their routine practice, they had basic information on the causes and types of mental illness. Traditional and faith healers felt demeaned by the clinicians who disregarded their mode of treatment stereotyping them as "dirty". After various discussions, majority of practitioners showed interest in collaborating with each other and stated that they had joined the dialogue in order interact with people committed to improving the lives of patients. Dialogue formation between the formal and the informal health workers is crucial in establishing trust and respect between both practitioners and in improving mental health care in Kenya. This approach could be scaled up among all the

  5. Final Report: Evaluation of Tools and Metrics to Support Employer Selection of Health Plans.

    Science.gov (United States)

    Mattke, Soeren; Van Busum, Kristin R; Martsolf, Grant R

    2014-01-01

    The Patient Protection and Affordable Care Act (ACA) places strong emphasis on quality of care as a means to improve outcomes for Americans and promote the financial sustainability of our health care system. Included in the ACA are new disclosure requirements that require health plans to provide a summary of benefits and coverage that accurately describes the benefits under the plan or coverage. These requirements are intended to support employers' procurement of high-value health coverage for their employees. This study attempts to help employers understand the structural differences between health plans and the performance dimensions along which plans can differ, as well as to educate employers about available tools that can be used to evaluate plan options. The study also discusses the extent to which these and other tools or resources are used by employers to inform choices between health plans.

  6. Strategic Planning for Health Care Cost Controls in a Constantly Changing Environment.

    Science.gov (United States)

    Hembree, William E

    2015-01-01

    Health care cost increases are showing a resurgence. Despite recent years' comparatively modest increases, the projections for 2015 cost increases range from 6.6% to 7%--three to four times larger than 2015's expected underlying inflation. This resurgence is just one of many rapidly changing external and internal challenges health plan sponsors must overcome (and this resurgence advances the date when the majority of employers will trigger the "Cadillac tax"). What's needed is a planning approach that is effective in overcoming all known and yet-to-be-discovered challenges, not just affordability. This article provides detailed guidance in adopting six proven strategic planning steps. Following these steps will proactively and effectively create a flexible strategic plan for the present and future of employers' health plans that will withstand all internal and external challenges.

  7. The evolving role of traditional birth attendants in maternal health in post-conflict Africa: A qualitative study of Burundi and northern Uganda.

    Science.gov (United States)

    Chi, Primus Che; Urdal, Henrik

    2018-01-01

    Many conflict-affected countries are faced with an acute shortage of health care providers, including skilled birth attendants. As such, during conflicts traditional birth attendants have become the first point of call for many pregnant women, assisting them during pregnancy, labour and birth, and in the postpartum period. This study seeks to explore how the role of traditional birth attendants in maternal health, especially childbirth, has evolved in two post-conflict settings in sub-Saharan Africa (Burundi and northern Uganda) spanning the period of active warfare to the post-conflict era. A total of 63 individual semi-structured in-depth interviews and 8 focus group discussions were held with women of reproductive age, local health care providers and staff of non-governmental organisations working in the domain of maternal health who experienced the conflict, across urban, semi-urban and rural settings in Burundi and northern Uganda. Discussions focused on the role played by traditional birth attendants in maternal health, especially childbirth during the conflict and how the role has evolved in the post-conflict era. Transcripts from the interviews and focus group discussions were analysed by thematic analysis (framework approach). Traditional birth attendants played a major role in childbirth-related activities in both Burundi and northern Uganda during the conflict, with some receiving training and delivery kits from the local health systems and non-governmental organisations to undertake deliveries. Following the end of the conflict, traditional birth attendants have been prohibited by the government from undertaking deliveries in both Burundi and northern Uganda. In Burundi, the traditional birth attendants have been integrated within the primary health care system, especially in rural areas, and re-assigned the role of 'birth companions'. In this capacity they undertake maternal health promotion activities within their communities. In northern Uganda, on

  8. Environment, Safety, Health and Waste Management Plan

    International Nuclear Information System (INIS)

    1988-01-01

    The mission of the Feed Materials Production Center (FMPC) is the production of high qaulity uranium metal for use by the US Department of Energy (DOE) in Defense Programs. In order to accomplish this mission and to maintain the FMPC as a viable facility in the DOE production complex, the facility must be brought into full compliance with all federal and state regulations and industry standards for environmental protection and worker safety. Where past practices have resulted in environmental insult, a comprehensive program of remediation must be implemented. The purpose of this combined Environment, Safety, Health and Waste Management Plan is to provide a road map for achieving needed improvements. The plan is structured to provide a comprehensive projection from the current fiscal year (FY) through FY 1994 of the programs, projects and funding required to achieve compliance. To do this, the plan is subdivided into chapters which discuss the applicable regulations;project schedules and funding requirements;details of the various programs for environment, safety, health and waste management;details of the ongoing National Environmental Policy Act (NEPA);the quality assurance program and the environmental monitoring program. 14 refs., 30 figs., 29 tabs

  9. Cyber and Traditional Bullying Victimization as a Risk Factor for Mental Health Problems and Suicidal Ideation in Adolescents

    OpenAIRE

    Bannink, Rienke; Broeren, Suzanne; van de Looij – Jansen, Petra M.; de Waart, Frouwkje G.; Raat, Hein

    2014-01-01

    textabstractPurpose: To examine whether traditional and cyber bullying victimization were associated with adolescent's mental health problems and suicidal ideation at two-year follow-up. Gender differences were explored to determine whether bullying affects boys and girls differently. Methods: A two-year longitudinal study was conducted among first-year secondary school students (N = 3181). Traditional and cyber bullying victimization were assessed at baseline, whereas mental health status an...

  10. Health Canada unveils plan to distribute marijuana for medical use.

    Science.gov (United States)

    Thaczuk, Derek

    2003-08-01

    Under pressure from the courts, Health Canada reluctantly comes up with a distribution plan to provide dried cannabis and seeds to patients using medical marijuana. The plan has been greeted with considerable criticism

  11. Traditional and ayurvedic foods of Indian origin

    OpenAIRE

    Preetam Sarkar; Lohith Kumar DH; Chanda Dhumal; Shubham Subrot Panigrahi; Ruplal Choudhary

    2015-01-01

    The Ayurveda contains a wealth of knowledge on health sciences. Accordingly traditional foods and their dietary guidelines are prescribed in Ayurveda. There is so much similarity in ayurvedic dietetics and traditional foods that many of the traditional health foods in India can be called ayurvedic foods. This review article introduces the concepts of ayurvedic health foods in India and describes several traditional heath foods across various regions of India. Recommended dietary guidelines ac...

  12. Strategic Teleconference Planning in Rural Health Education.

    Science.gov (United States)

    Nagel, Liza; Boswell, Judy

    1997-01-01

    An introduction to planning interactive health education teleconferences via satellite discusses participant recruitment, satellite transmission coordination, scheduling considerations, format design, and use of site facilitators. Teleconference training of community service providers and community leaders should combine passive delivery of…

  13. Sanitation health risk and safety planning in urban residential ...

    African Journals Online (AJOL)

    The aim of this review paper was to determine the best sanitation health risk and safety planning approach for sustainable management of urban environment. This was achieved by reviewing the concept of sanitation safety planning as a tool. The review adopted exploratory research approach and used secondary data ...

  14. The e-Learning Effectiveness Versus Traditional Learning on a Health Informatics Laboratory Course.

    Science.gov (United States)

    Zogas, Spyros; Kolokathi, Aikaterini; Birbas, Konstantinos; Chondrocoukis, Gregory; Mantas, John

    2016-01-01

    This paper presents a comparison between e-Learning and traditional learning methods of a University course on Health Informatics domain. A pilot research took place among University students who divided on two learning groups, the e-learners and the traditional learners. A comparison of the examinations' marks for the two groups of students was conducted in order to find differences on students' performance. The study results reveal that the students scored almost the same marks independently of the learning procedure. Based on that, it can be assumed that the e-learning courses have the same effectiveness as the in-classroom learning sessions.

  15. Physical and mental health conditions of young college students with different Traditional Chinese Medicine constitutions in Zhejiang Province of China.

    Science.gov (United States)

    Lv, Heli; Zhu, Li; Chen, Zhiqiang; Jin, Huijuan; Jin, Lei

    2015-12-01

    To investigate Traditional Chinese Medicine (TCM) constitutions of youths in colleges, and their physical and mental health conditions of different TCM constitutions, so as to provide a theoretical basis for the TCM way to improve young people's physical and mental health. The Standard TCM Constitutions' Classification and Determination Questionnaire was used to measure the body health condition, and the Symptom Checklist 90 Questionnaire and the Questionnaire of the National Student Physical Health Standards were used to determine mental and physical health conditions respectively in 1421 young participants validly answering the questionnaires in Zhejiang Province. The participants had a mean age of 19.96 years (SD = 0.95 years) with the majority of females (55.10%). One fourth of the 1421 participants were the Ping-he constitution and others were the tendency constitutions. Participants with Pinghe module (which has characteristics of moderate posture, rosy, energetic and is a healthy condition in TCM) were healthier than those with tendency constitutions in physical and mental health, with 65.81 ± 7.83 (men) and 77.99 ± 7.24 (women) scores in the physical test and around 1.25 scores in the mental health test. College students with combined biased constitutions were more likely suffer force, sensitive, depression and anxiety. Most of college students have a tendency or biased constitution which could be more likely to suffer suboptimal health status and diseases. Youths in college themselves and health providers should pay more attention to their potential health issues and make proper healthcare plan according to their own TCM constitution.

  16. Studying health in Greenland

    DEFF Research Database (Denmark)

    Bjerregaard, Peter; Mulvad, Gert; Olsen, Jørn

    2003-01-01

    Health research in Greenland has contributed with several findings of interest for the global scientific community and has documented health problems and risk factors of importance for planning the local health care system. The study of how health develops in small, scattered communities during...... rapid epidemiological transition carries prospects of global significance. The Inuit are a genetically distinct people living under extreme physical conditions. Their traditional living conditions and diet are currently undergoing a transformation, which may approach their disease pattern...... to that of the industrialized world, while still including local outbreaks of tuberculosis. Health research in Greenland is logistically difficult and costly, but offers opportunities not found elsewhere in the world. A long tradition of registration enhances the possibilities for research. A number of research institutions...

  17. K basins interim remedial action health and safety plan

    Energy Technology Data Exchange (ETDEWEB)

    DAY, P.T.

    1999-09-14

    The K Basins Interim Remedial Action Health and Safety Plan addresses the requirements of the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA), as they apply to the CERCLA work that will take place at the K East and K West Basins. The provisions of this plan become effective on the date the US Environmental Protection Agency issues the Record of Decision for the K Basins Interim Remedial Action, currently planned in late August 1999.

  18. A national action plan for workforce development in behavioral health.

    Science.gov (United States)

    Hoge, Michael A; Morris, John A; Stuart, Gail W; Huey, Leighton Y; Bergeson, Sue; Flaherty, Michael T; Morgan, Oscar; Peterson, Janice; Daniels, Allen S; Paris, Manuel; Madenwald, Kappy

    2009-07-01

    Across all sectors of the behavioral health field there has been growing concern about a workforce crisis. Difficulties encompass the recruitment and retention of staff and the delivery of accessible and effective training in both initial, preservice training and continuing education settings. Concern about the crisis led to a multiphased, cross-sector collaboration known as the Annapolis Coalition on the Behavioral Health Workforce. With support from the Substance Abuse and Mental Health Services Administration, this public-private partnership crafted An Action Plan for Behavioral Health Workforce Development. Created with input from a dozen expert panels, the action plan outlines seven core strategic goals that are relevant to all sectors of the behavioral health field: expand the role of consumers and their families in the workforce, expand the role of communities in promoting behavioral health and wellness, use systematic recruitment and retention strategies, improve training and education, foster leadership development, enhance infrastructure to support workforce development, and implement a national research and evaluation agenda. Detailed implementation tables identify the action steps for diverse groups and organizations to take in order to achieve these goals. The action plan serves as a call to action and is being used to guide workforce initiatives across the nation.

  19. The Traditional Health Practitioners Act No 22 (2007 of South Africa: Its history, resolutions and implementations in perspective (Part 3: Implementations

    Directory of Open Access Journals (Sweden)

    Gabriel Louw

    2016-11-01

    Full Text Available Background The registration of an alleged 200,000 or more unregulated traditional healers in terms of the Traditional Health Practitioners Act (Act No 22, 2007 seems a challenging task. Section 1 of the Act prescribes clear legal guidelines for the registration of traditional healers on completion of a prescribed learning and training programme at an approved institution. The section also offers stipulations to acknowledge prior learning. Aims This study aimed to determine the various options open to traditional healers to obtain formal registration as traditional health practitioners. Methods This is an exploratory and descriptive study that follows the modern historical approach of investigation by means of a literature review. The emphasis is on using current documentation, like articles, books and news papers, as primary resources to reflect on the options available for the registration of traditional healers. It also puts the options for future registration of traditional healers in perspective. The findings are offered in narrative form. Results An inquiry into the Traditional Health Practitioners Act No 22 seems to reveal that its prescribed legal guidelines are too strict and too comprehensive to allow all ±200,000 traditional healers who are practising at present into the system. However, Act No 22 does make provision for other less rigid options, like acknowledging prior learning. This can allow the aspiring traditional health practitioner to obtain full or provincial registration. Conclusion There are implementation options available to accommodate a large number of unregistered healers into the system. The grandfather clause for instance recognizes prior learning and training. Another possibility is special entrance examinations.

  20. How Home Health Nurses Plan Their Work Schedules: A Qualitative Descriptive Study.

    Science.gov (United States)

    Irani, Elliane; Hirschman, Karen B; Cacchione, Pamela Z; Bowles, Kathryn H

    2018-06-12

    To describe how home health nurses plan their daily work schedules and what challenges they face during the planning process. Home health nurses are viewed as independent providers and value the nature of their work because of the flexibility and autonomy they hold in developing their work schedules. However, there is limited empirical evidence about how home health nurses plan their work schedules, including the factors they consider during the process and the challenges they face within the dynamic home health setting. Qualitative descriptive design. Semi-structured interviews were conducted with 20 registered nurses who had greater than 2 years of experience in home health and were employed by one of the three participating home health agencies in the mid-Atlantic region of the United States. Data were analyzed using conventional content analysis. Four themes emerged about planning work schedules and daily itineraries: identifying patient needs to prioritize visits accordingly, partnering with patients to accommodate their preferences, coordinating visit timing with other providers to avoid overwhelming patients, and working within agency standards to meet productivity requirements. Scheduling challenges included readjusting the schedule based on patient needs and staffing availability, anticipating longer visits, and maintaining continuity of care with patients. Home health nurses make autonomous decisions regarding their work schedules while considering specific patient and agency factors, and overcome challenges related to the unpredictable nature of providing care in a home health setting. Future research is needed to further explore nurse productivity in home health and improve home health work environments. Home health nurses plan their work schedules to provide high quality care that is patient-centered and timely. The findings also highlight organizational priorities to facilitate continuity of care and support nurses while alleviating the burnout

  1. Traditional alcohol production and use in three provinces in Vietnam: an ethnographic exploration of health benefits and risks

    Science.gov (United States)

    2014-01-01

    Background Gaps exist in knowledge about the production and use of traditional alcohols, particularly in Asia. This study adds new information about the nature, production and sale of traditional distilled spirit alcohol in Vietnam. Method This was an ethnographic study of traditional distilled spirit alcohol production in rural areas of three provinces in Vietnam. Researchers interviewed more than 300 individuals and recorded responses to general open-ended questions about local alcohol production. Interviews were recorded, transcribed, and studied to discern what information about traditional alcohol was important to the speakers. Results Methods of production followed long-held traditions. Participants listed both personal and community benefits (economic, health, and social) from traditional alcohol making. Older people favoured traditional alcohol, while younger people favoured brand-name beer. Typically people consumed 2-4 drinks daily, mainly at meal times. People consumed more alcohol at special events and festivals. Distribution patterns ranged from low-risk distribution to family and neighbours to high-risk distribution by an agent who might combine alcohol from several producers, which increases the opportunity for dilution and adulteration. The most commonly listed health risks associated with locally-made alcohol were local air pollution and water pollution; participants also mentioned traffic crashes and bad public behaviour. Depending on the location, community leaders reported that production may be relatively stable or it may be declining. Conclusions Traditional alcohol manufacture, sale, and use in Vietnam is a long-standing practice and low- to moderate-risk to health. There do not appear to be instances of accidental or intentional contamination. Urbanization seems to be affecting the market share of traditional alcohol as urbanized youth turn to branded products, mainly beer, making traditional alcohol making and consumption an activity mainly

  2. [Primary and secondary data on dementia care as an example of regional health planning].

    Science.gov (United States)

    Ulrich, Lisa-R; Schatz, Tanja R; Lappe, Veronika; Ihle, Peter; Barthen, Linda; Gerlach, Ferdinand M; Erler, Antje

    2017-12-01

    Health service planning that takes into account as far as possible the regional needs and regional discrepancies is a controversial health issue in Germany. In a pilot scheme, we tested a planning process for regional healthcare services, based on the example of dementia care. The aim of this article is to present the strengths and limitations of this planning process. We developed an indicator set for dementia care based on routine regional data obtained from two German statutory health insurance companies. Additionally, primary data based on a questionnaire sent to all GPs in the area were evaluated. These data were expanded through the addition of official socio-demographic population data. Procedures and evaluation strategies, discussion of the results and the derivation of planning measures followed, in close agreement with a group of local experts. Few epidemiological data on regional variations in health care planning are publicly available. Secondary data from statutory health insurance companies can be assessed to support the estimation of regional health care needs, but interpretation is difficult. The use of surveys to collect primary data, and the assessment of results by the local health board may facilitate interpretation and may contribute towards more valid statements regarding regional health planning. Despite the limited availability of data and the considerable efforts involved in data analysis, the project demonstrates how needs-based health service planning can be carried out in a small region, taking into account the increasing demands of the local health care providers and the special local features.

  3. The role of traditional health practitioners in Rural KwaZulu-Natal, South Africa: generic or mode specific?

    Science.gov (United States)

    Zuma, Thembelihle; Wight, Daniel; Rochat, Tamsen; Moshabela, Mosa

    2016-08-22

    Traditional health practitioners (THPs) play a vital role in the health care of the majority of the South African population and elsewhere on the African continent. However, many studies have challenged the role of THPs in health care. Concerns raised in the literature include the rationale, safety and effectiveness of traditional health practices and methods, as well as what informs them. This paper explores the processes followed in becoming a traditional healer and how these processes are related to THP roles. A qualitative research design was adopted, using four repeat group discussions with nine THPs, as part of a larger qualitative study conducted within the HIV Treatment as Prevention trial in rural South Africa. THPs were sampled through the local THP association and snowballing techniques. Data collection approaches included photo-voice and community walks. The role identity theory and content analysis were used to explore the data following transcription and translation. In the context of rural Northern KwaZulu-Natal, three types of THPs were identified: 1) Isangoma (diviner); 2) Inyanga (one who focuses on traditional medical remedies) and 3) Umthandazi (faith healer). Findings revealed that THPs are called by ancestors to become healers and/or go through an intensive process of learning about traditional medicines including plant, animal or mineral substances to provide health care. Some THPs identified themselves primarily as one type of healer, while most occupied multiple healing categories, that is, they practiced across different healing types. Our study also demonstrates that THPs fulfil roles that are not specific to the type of healer they are, these include services that go beyond the uses of herbs for physical illnesses or divination. THPs serve roles which include, but are not limited to, being custodians of traditional African religion and customs, educators about culture, counsellors, mediators and spiritual protectors. THPs' mode specific

  4. Traditional Birth Attendance (TBA) in a health system: what are the roles, benefits and challenges: A case study of incorporated TBA in Timor-Leste.

    Science.gov (United States)

    Ribeiro Sarmento, Decio

    2014-01-01

    One current strategy to overcome the issue of shortage of qualified health workers has focused on the use of community health workers in the developing countries to deliver health care services specifically to the most vulnerable communities in the rural areas. Timor-Leste is the one of the world's newest developing countries that has incorporated the traditional birth attendance in its health system through a family health promoter initiative in response to reproductive and child health, hence to improve primary health care delivery and increase number of healthcare workforce. The study utilized a non-systematic review of the literature using key words such as community health workers, traditional birth attendants, reproductive health, child health and health outcomes. A case study from Timor-Leste was also used. Traditional birth attendants have performed wide variety of tasks including outreach and case finding, health and patient education, referrals, home visits and care management. Evidence indicated that there were, to varying degrees, positive associations between traditional birth attendance training and maternity care. Traditional birth attendance training was found to be associated with significant increases in attributes such as knowledge, attitude, behavior, advice for antenatal care, and pregnancy outcomes. However, some challenges faced by traditional birth attendants' role in encouraging women to go to health center for preventive services would be the compliance and refusal of the referral. The implementation case study from Timor-Leste shows that integrating traditional birth attendance into a national healthcare system through Family Health Promoter program has been programmatic effective. It is recommended that the implementation should consider regular communication between health staff and community leaders in recruiting members of family health promoters, and the use of supportive supervision tools to identify weaknesses in the management of

  5. [A decade of reflection on health plans in Spain. SESPAS report 2010].

    Science.gov (United States)

    Fiuza Pérez, María Dolores; Aguiar Rodríguez, Juan Francisco; Monzón Batista, Nayra

    2010-12-01

    This article reports the experience of the Working Group of the SESPAS-SCSP (Spanish Society of Public Health and Healthcare Administration-Canary Islands Society of Public Health) in health policy and planning during the first decade of the 21st century and its possible impact on the design of health planning. We review the conclusions reached from 2000 to 2008 in the first five Biannual Planning and Health Policy meetings that took place during that period. The workshops were designed with two speakers who presented different views of the subject under discussion, a moderator, who led the debate on the findings, and a narrator who served as a notary and also took responsibility for the text summary of each table. Two general narrators were responsible for the final wording of the conclusions of each workshop or biannual meeting. From 2000 to 2008, there were 25 round tables with 121 conclusions and 160 participants. We believe that the SESPAS working groups provide multidisciplinary professional values within a context of debate in a professional environment, and create spaces for reflection, thus helping to improve the health planning system in Spain. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  6. The Bambuí Health and Aging Study (BHAS: private health plan and medical care utilization by older adults

    Directory of Open Access Journals (Sweden)

    Lima-Costa Maria Fernanda F.

    2002-01-01

    Full Text Available The aim of this cross sectional study was to investigate whether holding a private health plan affects the consumption of medical services (hospitalization and visits to a doctor and use of medications by older adults. All residents in Bambuí town (Minas Gerais, Brazil aged > or = 60 years (n = 1,742 were selected. From these, 92.2% were interviewed and 85.9% were examined (blood tests and physical measurements. After adjustments for counfounders, those under exclusive public coverage (n = 1,296, compared with those holding a private health plan (n = 310, presented some evidence of having worse health status, reported less visits to a doctor, and used a small number of prescribed medications. The main explanation for the aged holding a private health plan was economic, not health. Even though those who had only public health coverage complained more in relation to medical care (70.9%, an important proportion of the aged with a private health care plan presented some kind of complaint (45.2%. Another worrying factor was the difficulty to acquire medication because of financial problems (47.2 and 25.2% reported, respectively. Further investigations are needed to verify whether our results can be generalized to other communities of the country.

  7. eHealth recruitment challenges.

    Science.gov (United States)

    Thompson, Debbe; Canada, Ashanti; Bhatt, Riddhi; Davis, Jennifer; Plesko, Lisa; Baranowski, Tom; Cullen, Karen; Zakeri, Issa

    2006-11-01

    Little is known about effective eHealth recruitment methods. This paper presents recruitment challenges associated with enrolling African-American girls aged 8-10 years in an eHealth obesity prevention program, their effect on the recruitment plan, and potential implications for eHealth research. Although the initial recruitment strategy was literature-informed, it failed to enroll the desired number of girls within a reasonable time period. Therefore, the recruitment strategy was reformulated to incorporate principles of social marketing and traditional marketing techniques. The resulting plan included both targeted, highly specific strategies (e.g., selected churches), and more broad-based approaches (e.g., media exposure, mass mailings, radio advertisements). The revised plan enabled recruitment goals to be attained. Media appeared to be particularly effective at reaching the intended audience. Future research should identify the most effective recruitment strategies for reaching potential eHealth audiences.

  8. The role of global traditional and complementary systems of medicine in the treatment of mental health disorders.

    Science.gov (United States)

    Gureje, Oye; Nortje, Gareth; Makanjuola, Victor; Oladeji, Bibilola D; Seedat, Soraya; Jenkins, Rachel

    2015-02-01

    Traditional and complementary systems of medicine include a broad range of practices, which are commonly embedded in cultural milieus and reflect community beliefs, experiences, religion, and spirituality. Two major components of this system are discernible: complementary alternative medicine and traditional medicine, with different clientele and correlates of patronage. Evidence from around the world suggests that a traditional or complementary system of medicine is commonly used by a large number of people with mental illness. Practitioners of traditional medicine in low-income and middle-income countries fill a major gap in mental health service delivery. Although some overlap exists in the diagnostic approaches of traditional and complementary systems of medicine and conventional biomedicine, some major differences exist, largely in the understanding of the nature and cause of mental disorders. Treatments used by providers of traditional and complementary systems of medicine, especially traditional and faith healers in low-income and middle-income countries, might sometimes fail to meet widespread understandings of human rights and humane care. Nevertheless, collaborative engagement between traditional and complementary systems of medicine and conventional biomedicine might be possible in the care of people with mental illness. The best model to bring about that collaboration will need to be established by the needs of the extant mental health system in a country. Research is needed to provide an empirical basis for the feasibility of such collaboration, to clearly delineate its boundaries, and to test its effectiveness in bringing about improved patient outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Assessing the health equity impacts of regional land-use plan making: An equity focussed health impact assessment of alternative patterns of development of the Whitsunday Hinterland and Mackay Regional Plan, Australia (Short report)

    International Nuclear Information System (INIS)

    Gunning, Colleen; Harris, Patrick; Mallett, John

    2011-01-01

    Health service and partners completed an equity focussed health impact assessment to influence the consideration of health and equity within regional land-use planning in Queensland, Australia. This project demonstrated how an equity oriented assessment matrix can assist in testing regional planning scenarios. It is hoped that this HIA will contribute to the emerging interest in ensuring that potential differential health impacts continue to be considered as part of land-use planning processes.

  10. Does the Association with Psychosomatic Health Problems Differ between Cyberbullying and Traditional Bullying?

    Science.gov (United States)

    Beckman, Linda; Hagquist, Curt; Hellstrom, Lisa

    2012-01-01

    The association between mental health problems and traditional bullying is well known, whereas the strength of the association in cyberbullying is less known. This study aimed to compare the association between mutually exclusive groups of bullying involvement and psychosomatic problems as measured by the PsychoSomatic Problems scale. The sample…

  11. Responding to the World Health Organization Global Disability Action Plan in Egypt: A Technical Consultancy to develop a National Disability, Health and Rehabilitation Plan.

    Science.gov (United States)

    Gutenbrunner, Christoph; Nugraha, Boya

    2018-04-18

    A technical consultation to develop a National Disability, Health and Rehabilitation Plan (NDHRP) for Egypt was carried out in 2015. Its overall goal was to improve health, functioning, well-being, quality of life, and participation of persons with disability in Egypt by supporting the Ministry of Health and Population and other stakeholders to improve access to health services and strengthen health-related rehabilitation services for all persons in need. The methodological steps of the technical consultation were as follows: collecting and reviewing accessible documents and data; site visits to state institutions, health and rehabilitation services; discussions with relevant stakeholders in rehabilitation, including persons with disability; drafting recommendations based on the principles of the World Report on Disability and the World Health Organization Global Disability Action Plan and the information collected; discussion with stakeholders in a workshop; and preparation of a final report. The development of a NDHRP was successful and led to recommendations with a good level of consensus among stakeholders in Egypt. The authors hope that the NDHRP will lead to improved rehabilitation service provision, and health and quality of life of persons with disability and chronic health conditions living in Egypt.

  12. Closing the gap: the potential of Christian Health Associations in expanding access to family planning

    Directory of Open Access Journals (Sweden)

    Lauren VanEnk

    2017-01-01

    Full Text Available Recognizing the health impact of timing and spacing pregnancies, the Sustainable Development Goals call for increased access to family planning globally. While faith-based organizations in Africa provide a significant proportion of health services, family planning service delivery has been limited. This evaluation seeks to assess the effectiveness of implementing a systems approach in strengthening the capacity of Christian Health Associations to provide family planning and increase uptake in their communities.From January 2014 to September 2015, the capacity of three Christian Health Associations in East Africa—Caritas Rwanda, Uganda Catholic Medical Bureau, and Uganda Protestant Medical Bureau—was strengthened with the aims of improving access to women with unmet need and harmonizing faith-based service delivery contributions with their national family planning programs. The key components of this systems approach to family planning included training, supervision, commodity availability, family planning promotion, data collection, and creating a supportive environment. Community-based provision of family planning, including fertility awareness methods, was introduced across intervention sites for the first time. Five hundred forty-seven facility- and community-based providers were trained in family planning, and 393,964 people were reached with family planning information. Uptake of family planning grew substantially in Year 1 (12,691 and Year 2 (19,485 across all Christian Health Associations as compared to the baseline year (3,551. Cumulatively, 32,176 clients took up a method during the intervention, and 43 percent of clients received this service at the community level. According to a provider competency checklist, facility- and community-based providers were able to adequately counsel clients on new fertility awareness methods. Integration of Christian Health Associations into the national family planning strategy improved through

  13. Ten years of health workforce planning in the Netherlands: a tentative evaluation of GP planning as an example

    Directory of Open Access Journals (Sweden)

    Van Greuningen Malou

    2012-08-01

    Full Text Available Abstract Introduction In many countries, health-care labour markets are constantly being challenged by an alternation of shortage and oversupply. Avoiding these cyclic variations is a major challenge. In the Netherlands, a workforce planning model has been used in health care for ten years. Case description Since 1970, the Dutch government has explored different approaches to determine the inflow in medical schools. In 2000, a simulation model for health workforce planning was developed to estimate the required and available capacity of health professionals in the Netherlands. In this paper, this model is explained, using the Dutch general practitioners as an example. After the different steps in the model are clarified, it is shown how elements can be added to arrive at different versions of the model, or ‘scenarios’. A comparison is made of the results of different scenarios for different years. In addition, the subsequent stakeholder decision-making process is considered. Discussion and evaluation Discussion of this paper shows that workforce planning in the Netherlands is a complex modelling task, which is sensitive to different developments influencing the balance between supply and demand. It seems plausible that workforce planning has resulted in a balance between supply and demand of general practitioners. Still, it remains important that the modelling process is accepted by the different stakeholders. Besides calculating the balance between supply and demand, there needs to be an agreement between the stakeholders to implement the advised training inflow. The Dutch simulation model was evaluated using six criteria to be met by models suitable for policy objectives. This model meets these criteria, as it is a comprehensive and parsimonious model that can include all relevant factors. Conclusion Over the last decade, health workforce planning in the Netherlands has become an accepted instrument for calculating the required supply of

  14. Enhancing the Career Planning Self-Determination of Young Adults with Mental Health Challenges.

    Science.gov (United States)

    Sowers, Jo-Ann; Swank, Paul

    2017-01-01

    The impact of an intervention on the self-determination and career planning engagement of young adults with mental health challenges was studied. Sixty-seven young adults, 20 to 30 years of age, with mental health diagnoses (e.g., depression, bipolar disorder) were randomly assigned to intervention and control groups. Statistically significant greater increases were made by the intervention group versus the control group for self-determination and career planning engagement, and self-determination at least partially mediated increases in career planning engagement. With career planning self-determination interventions, young adults with mental health challenges might be able to achieve better career and life outcomes than is typical for this population.

  15. The Joint Action on Health Workforce Planning and Forecasting: Results of a European programme to improve health workforce policies.

    Science.gov (United States)

    Kroezen, Marieke; Van Hoegaerden, Michel; Batenburg, Ronald

    2018-02-01

    Health workforce (HWF) planning and forecasting is faced with a number of challenges, most notably a lack of consistent terminology, a lack of data, limited model-, demand-based- and future-based planning, and limited inter-country collaboration. The Joint Action on Health Workforce Planning and Forecasting (JAHWF, 2013-2016) aimed to move forward on the HWF planning process and support countries in tackling the key challenges facing the HWF and HWF planning. This paper synthesizes and discusses the results of the JAHWF. It is shown that the JAHWF has provided important steps towards improved HWF planning and forecasting across Europe, among others through the creation of a minimum data set for HWF planning and the 'Handbook on Health Workforce Planning Methodologies across EU countries'. At the same time, the context-sensitivity of HWF planning was repeatedly noticeable in the application of the tools through pilot- and feasibility studies. Further investments should be made by all actors involved to support and stimulate countries in their HWF efforts, among others by implementing the tools developed by the JAHWF in diverse national and regional contexts. Simultaneously, investments should be made in evaluation to build a more robust evidence base for HWF planning methods. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Applying social science and public health methods to community-based pandemic planning.

    Science.gov (United States)

    Danforth, Elizabeth J; Doying, Annette; Merceron, Georges; Kennedy, Laura

    2010-11-01

    Pandemic influenza is a unique threat to communities, affecting schools, businesses, health facilities and individuals in ways not seen in other emergency events. This paper aims to outline a local government project which utilised public health and social science research methods to facilitate the creation of an emergency response plan for pandemic influenza coincidental to the early stages of the 2009 H1N1 ('swine flu') outbreak. A multi-disciplinary team coordinated the creation of a pandemic influenza emergency response plan which utilised emergency planning structure and concepts and encompassed a diverse array of county entities including schools, businesses, community organisations, government agencies and healthcare facilities. Lessons learned from this project focus on the need for (1) maintaining relationships forged during the planning process, (2) targeted public health messaging, (3) continual evolution of emergency plans, (4) mutual understanding of emergency management concepts by business and community leaders, and (5) regional coordination with entities outside county boundaries.

  17. Traditional birth attendants in rural Nepal: knowledge, attitudes and practices about maternal and newborn health.

    Science.gov (United States)

    Thatte, N; Mullany, L C; Khatry, S K; Katz, J; Tielsch, J M; Darmstadt, G L

    2009-01-01

    Efforts to formalise the role of traditional birth attendants (TBAs) in maternal and neonatal health programmes have had limited success. TBAs' continued attendance at home deliveries suggests the potential to influence maternal and neonatal outcomes. The objective of this qualitative study was to identify and understand the knowledge, attitudes and practices of TBAs in rural Nepal. Twenty-one trained and untrained TBAs participated in focus groups and in-depth interviews about antenatal care, delivery practices, maternal complications and newborn care. Antenatal care included advice about nutrition and tetanus toxoid (TT) immunisation, but did not include planning ahead for transport in cases of complications. Clean delivery practices were observed by most TBAs, though hand-washing practices differed by training status. There was no standard practice to identify maternal complications, such as excessive bleeding, prolonged labour, or retained placenta, and most referred outside in the event of such complications. Newborn care practices included breastfeeding with supplemental feeds, thermal care after bathing, and mustard seed oil massage. TBAs reported high job satisfaction and desire to improve their skills. Despite uncertainty regarding the role of TBAs to manage maternal complications, TBAs may be strategically placed to make potential contributions to newborn survival.

  18. Employee choice of a high-deductible health plan across multiple employers.

    Science.gov (United States)

    Lave, Judith R; Men, Aiju; Day, Brian T; Wang, Wei; Zhang, Yuting

    2011-02-01

    To determine factors associated with selecting a high-deductible health plan (HDHP) rather than a preferred provider plan (PPO) and to examine switching and market segmentation after initial selection. Claims and benefit information for 2005-2007 from nine employers in western Pennsylvania first offering HDHP in 2006. We examined plan growth over time, used logistic regression to determine factors associated with choosing an HDHP, and examined the distribution of healthy and sick members across plan types. We linked employees with their dependents to determine family-level variables. We extracted risk scores, covered charges, employee age, and employee gender from claims data. We determined census-level race, education, and income information. Health status, gender, race, and education influenced the type of individual and family policies chosen. In the second year the HDHP was offered, few employees changed plans. Risk segmentation between HDHPs and PPOs existed, but it did not increase. When given a choice, those who are healthier are more likely to select an HDHP leading to risk segmentation. Risk segmentation did not increase in the second year that HDHPs were offered. © Health Research and Educational Trust.

  19. The Malaysian health care system: Ecology, plans, and reforms

    Directory of Open Access Journals (Sweden)

    Andrea Sebastian

    2016-08-01

    Full Text Available Malaysia is on its way to achieving developed nation status in the next 4 years. Currently, Malaysia is on track for three Millennium Development Goals (MDG1, MDG4, and MDG7. The maternal mortality rate, infant mortality rate, and mortality rate of children younger than 5 years improved from 25.6% (2012 to 6.6% (2013, and 7.7% (2012 per 100,000 live births, respectively whereas immunization coverage for infants increased to an average of 90%. As of 2013 the ratio of physicians to patients improved to 1:633 while the ratio of health facilities to the population was 1:10,272. The current government administration has proposed a reform in the form of the 10th Malaysian Plan coining the term “One Care for One Malaysia” as the newly improved and reorganized health care plan, where efficiency, effectiveness, and equity are the main focus. This review illustrates Malaysia’s transition from pre-independence to the current state, and its health and socioeconomic achievement as a country. It aims to contribute knowledge through identifying the plans and reforms by the Malaysian government while highlighting the challenges faced as a nation.

  20. School Health Index: A Self-Assessment and Planning Guide. Middle School/High School.

    Science.gov (United States)

    Barrios, Lisa C.; Burgeson, Charlene R.; Crossett, Linda; Harrykissoon, Samantha D.; Pritzl, Jane; Wechsler, Howell; Kuester, Sarah A.; Pederson, Linda; Graffunder, Corinne; Rainford, Neil; Sleet, David

    2004-01-01

    The "School Health Index" is a self-assessment and planning guide that will enable schools to: (1) identify the strengths and weaknesses of school policies and programs for promoting health and safety; (2) develop an action plan for improving student health and safety, and (3) involve teachers, parents, students, and the community in improving…

  1. Federal Employees Health Benefits Program: Enrollment Options Following the Termination of a Plan or Plan Option. Final rule.

    Science.gov (United States)

    2015-10-28

    The U.S. Office of Personnel Management (OPM) is issuing a final rule to amend the Federal Employees Health Benefits (FEHB) Program regulations regarding enrollment options following the termination of a plan or plan option.

  2. Paying for individual health insurance through tax-sheltered cafeteria plans.

    Science.gov (United States)

    Hall, Mark A; Monahan, Amy B

    2010-01-01

    When employees without group health insurance buy individual coverage, they do so using after-tax income--costing them from 20% to 50% more than others pay for equivalent coverage. Prior to the passage of the Patient Protection and Affordable Care Act (PPACA), several states promoted a potential solution that would allow employees to buy individual insurance through tax-sheltered payroll deduction. This technical but creative approach would allow insurers to combine what is known as "list-billing" with a Section 125 "cafeteria plan." However, these state-level reform attempts have failed to gain significant traction because state small-group reform laws and federal restrictions on medical underwriting cloud the legality of tax-sheltered list-billing. Several authorities have taken the position that insurance paid for through a cafeteria plan must meet the nondiscrimination requirements of the Health Insurance Portability and Accountability Act with respect to eligibility, premiums, and benefits. The recently enacted Patient Protection and Affordable Care Act addresses some of the legal uncertainty in this area, but much remains. For health reform to have its greatest effect, federal regulators must clarify whether individual health insurance can be purchased on a pre-tax basis through a cafeteria plan.

  3. Employee choice of flexible spending account participation and health plan.

    Science.gov (United States)

    Hamilton, Barton H; Marton, James

    2008-07-01

    Despite the fact that flexible spending accounts (FSAs) are becoming an increasingly popular employer-provided health benefit, there has been very little empirical study of FSA use among employees at the individual level. This study contributes to the literature on FSAs using a unique data set that provides three years of employee-level-matched benefits data. Motivated by the theoretical model of FSA choice presented in Cardon and Showalter (J. Health Econ. 2001; 20(6):935-954), we examine the determinants of FSA participation and contribution levels using cross-sectional and random-effect two-part models. FSA participation and health plan choice are also modeled jointly in each year using conditional logit models. We find that, even after controlling for a number of other demographic characteristics, non-whites are less likely to participate in the FSA program, have lower contributions conditional on participation, and have a lower probability of switching to new lower cost share, higher premium plans when they were introduced. We also find evidence that choosing health plans with more expected out-of-pocket expenses is correlated with participation in the FSA program. Copyright (c) 2007 John Wiley & Sons, Ltd.

  4. The search conference as a method in planning community health promotion actions

    Directory of Open Access Journals (Sweden)

    Eva Magnus

    2016-08-01

    Full Text Available Aims: The aim of this article is to describe and discuss how the search conference can be used as a method for planning health promotion actions in local communities. Design and methods: The article draws on experiences with using the method for an innovative project in health promotion in three Norwegian municipalities. The method is described both in general and how it was specifically adopted for the project. Results and conclusions: The search conference as a method was used to develop evidence-based health promotion action plans. With its use of both bottom-up and top-down approaches, this method is a relevant strategy for involving a community in the planning stages of health promotion actions in line with political expectations of participation, ownership, and evidence-based initiatives.

  5. The Obama health care plan: what it means for mental health care of older adults.

    Science.gov (United States)

    Sorrell, Jeanne M

    2009-01-01

    Health care was an important issue for both the Obama and McCain election campaigns. Now that Barack Obama is poised to serve as the 44th President of the United States, many health care providers are focused on what Obama's administration will mean for new health care initiatives. This article focuses specifically on aspects of the Obama and Biden health care plan that affects mental health care for older adults.

  6. Salubridad Chicana: Su Preservacion Y Mantenimiento -- The Chicano Plan for Mental Health.

    Science.gov (United States)

    Duran, Ruben, Ed.; And Others

    In devising the mental health plan for Chicanos, the social, economic, and political forces that adversely affect their emotional well-being must be considered. While defining mental health needs and proposing ways to meet those needs, the cultural background of the Chicano people must seriously be considered. The plan should stress the importance…

  7. Perspectives of planning from the point of view of professional Family Health Strategy.

    Directory of Open Access Journals (Sweden)

    Polyana da Costa RIBEIRO

    2015-02-01

    Full Text Available The article looks at similarities and differences of the community diagnosis within the local planning of family health teams in Teresina. Was based on case study and focus group with teams belonging to the same territorial basis, involving hospital, health center of urban and rural area. Discusses three analytical dimensions: planning process, diagnosis in the planning of health teams and facilities/limits. It was evidenced that the planning is in its incipient, short-term, individualized and unsatisfactory demand needs. The interventions of the social actors have not involved sustainable actions, reflecting the verticality of the programmes and of distortions in the deployment process of the teams. Urge vigilance to managers with the organizational foundation of primary care, which is the diagnosis, in addition to implementing strategies for men’s health, adolescent, bedridden and caregivers and collective education, neglected.

  8. Family Planning in the Democratic Republic of the Congo: Encouraging Momentum, Formidable Challenges

    Science.gov (United States)

    Kwete, Dieudonné; Binanga, Arsene; Mukaba, Thibaut; Nemuandjare, Théophile; Mbadu, Muanda Fidele; Kyungu, Marie-Thérèse; Sutton, Perri; Bertrand, Jane T

    2018-01-01

    Momentum for family planning in the Democratic Republic of the Congo (DRC) is evident in multiple ways: strong political will, increasing donor support, a growing number of implementing organizations, innovative family planning programming, and a cohesive family planning stakeholder group. Between 2013 and 2017, the modern contraceptive prevalence rate (mCPR) in the capital city of Kinshasa increased from 18.5% to 26.7% among married women, but as of 2013–14, it was only 7.8% at the national level. The National Multisectoral Strategic Plan for Family Planning: 2014–2020 calls for achieving an mCPR of 19.0% by 2020, an ambitious goal in light of formidable challenges to family planning in the DRC. Of the 16,465 health facilities reporting to the national health information system in 2017, only 40% offer family planning services. Key challenges include uncertainty over the political situation, difficulties of ensuring access to family planning services in a vast country with a weak transportation infrastructure, funding shortfalls for procuring adequate quantities of contraceptives, weak contraceptive logistics and supply chain management, strong cultural norms that favor large families, and low capacity of the population to pay for contraceptive services. This article describes promising initiatives designed to address these barriers, consistent with the World Health Organization's framework for health systems strengthening. For example, the national family planning coordinating mechanism is being replicated at the provincial level to oversee the expansion of family planning service delivery. Promising initiatives are being implemented to improve the supply and quality of services and generate demand for family planning, including social marketing of subsidized contraceptives at both traditional and non-traditional channels and strengthening of services in military health facilities. To expand contraceptive access, family planning is being institutionalized in

  9. Family Planning in the Democratic Republic of the Congo: Encouraging Momentum, Formidable Challenges.

    Science.gov (United States)

    Kwete, Dieudonné; Binanga, Arsene; Mukaba, Thibaut; Nemuandjare, Théophile; Mbadu, Muanda Fidele; Kyungu, Marie-Thérèse; Sutton, Perri; Bertrand, Jane T

    2018-03-21

    Momentum for family planning in the Democratic Republic of the Congo (DRC) is evident in multiple ways: strong political will, increasing donor support, a growing number of implementing organizations, innovative family planning programming, and a cohesive family planning stakeholder group. Between 2013 and 2017, the modern contraceptive prevalence rate (mCPR) in the capital city of Kinshasa increased from 18.5% to 26.7% among married women, but as of 2013-14, it was only 7.8% at the national level. The National Multisectoral Strategic Plan for Family Planning: 2014-2020 calls for achieving an mCPR of 19.0% by 2020, an ambitious goal in light of formidable challenges to family planning in the DRC. Of the 16,465 health facilities reporting to the national health information system in 2017, only 40% offer family planning services. Key challenges include uncertainty over the political situation, difficulties of ensuring access to family planning services in a vast country with a weak transportation infrastructure, funding shortfalls for procuring adequate quantities of contraceptives, weak contraceptive logistics and supply chain management, strong cultural norms that favor large families, and low capacity of the population to pay for contraceptive services. This article describes promising initiatives designed to address these barriers, consistent with the World Health Organization's framework for health systems strengthening. For example, the national family planning coordinating mechanism is being replicated at the provincial level to oversee the expansion of family planning service delivery. Promising initiatives are being implemented to improve the supply and quality of services and generate demand for family planning, including social marketing of subsidized contraceptives at both traditional and non-traditional channels and strengthening of services in military health facilities. To expand contraceptive access, family planning is being institutionalized in

  10. PLAN Bicol, Philippines: health manpower development program in action.

    Science.gov (United States)

    Lind, K

    1994-06-01

    PLAN Bicol in the Philippines is a community based Health Manpower Development Program (HMDP) geared toward training and mobilization of indigenous health practitioners, providing infrastructural and logistical support to individual families, and educating the community about health, nutrition, and the environment. The field officer recommends at the initiation of a project that program staff have roles that are well defined. New programs should be introduced to the community first and should involve the community in the planning stages. The HMDP program is directed to 38 villages located around national parks that have suffered from deforestation. Community health issues are malnutrition, low immunization, and lack of access to health services. HMDP established a training program for auxiliary health workers (AHWs), who make a commitment to return to their villages after training. Midwives are being trained at local schools. Village houses are being built and repaired; water systems and sanitary toilet facilities are being installed. Village health stations have been constructed and equipped with basic medicines, supplies, and equipment, and are open 5 days a week. Health education classes inform the community about nutrition and health. The problems at inception were the unwillingness of field staff to participate in the program and a high drop out rate among AHWs. Problems were worked out as the program progressed. Facilitative factors are the close coordination with the provincial health office, community acceptance, and the availability of qualified people.

  11. Health insurance: how does your plan compare? Plus, a look to new reforms.

    Science.gov (United States)

    2012-11-01

    A good insurance plan can steer you to the care that helps and away from wasting your time and money on unnecessary tests and treatments. For the third year running, we are presenting health plan rankings from the National Committee for Quality Assurance (NCQA), a nonprofit health care accreditation and quality measurement group, of a record 984 plans on their quality of care, customer satisfaction, and commitment to improvement and disclosure of information. This year, the NCQA ranked 474 private plans (which consumers obtain through a job or purchase on their own), 395 Medicare Advantage plans, and 115 Medicaid HMOs.

  12. Are Integrated Plan Providers Associated With Lower Premiums on the Health Insurance Marketplaces?

    Science.gov (United States)

    La Forgia, Ambar; Maeda, Jared Lane K; Banthin, Jessica S

    2018-04-01

    As the health insurance industry becomes more consolidated, hospitals and health systems have started to enter the insurance business. Insurers are also rapidly acquiring providers. Although these "vertically" integrated plan providers are small players in the insurance market, they are becoming more numerous. The health insurance marketplaces (HIMs) offer a unique setting to study integrated plan providers relative to other insurer types because the HIMs were designed to promote competition. In this descriptive study, the authors compared the premiums of the lowest priced silver plans of integrated plan providers with other insurer types on the 2015 and 2016 HIMs. Integrated plan providers were associated with modestly lower premiums relative to most other insurer types. This study provides early insights into premium competition on the HIMs. Examining integrated plan providers as a separate insurer type has important policy implications because they are a growing segment of the marketplaces and their pricing behavior may influence future premium trends.

  13. Responding to the World Health Organization Global Disability Action Plan in Egypt: A Technical Consultancy to develop a National Disability, Health and Rehabilitation Plan

    Directory of Open Access Journals (Sweden)

    Christoph Gutenbrunner

    2018-01-01

    Full Text Available Objective: A technical consultation to develop a National Disability, Health and Rehabilitation Plan (NDHRP for Egypt was carried out in 2015. Its overall goal was to improve health, functioning, well-being, quality of life, and participation of persons with disability in Egypt by supporting the Ministry of Health and Population and other stakeholders to improve access to health services and strengthen health-related rehabilitation services for all persons in need. Methods: The methodological steps of the technical consultation were as follows: collecting and reviewing accessible documents and data; site visits to state institutions, health and rehabilitation services; discussions with relevant stakeholders in rehabilitation, including persons with disability; drafting recommendations based on the principles of the World Report on Disability and the World Health Organization Global Disability Action Plan and the information collected; discussion with stakeholders in a workshop; and preparation of a final report. Results and discussion: The development of a NDHRP was successful and led to recommendations with a good level of consensus among stakeholders in Egypt. The authors hope that the NDHRP will lead to improved rehabilitation service provision, and health and quality of life of persons with disability and chronic health conditions living in Egypt.

  14. Progresses and challenges of utilizing traditional birth attendants in maternal and child health in Nigeria.

    Science.gov (United States)

    Amutah-Onukagha, Ndidiamaka; Rodriguez, Monica; Opara, Ijeoma; Gardner, Michelle; Assan, Maame Araba; Hammond, Rodney; Plata, Jesus; Pierre, Kimberly; Farag, Ehsan

    2017-01-01

    Despite advances in modern healthcare, Traditional Birth Attendants (TBA) have continued to be heavily utilized in rural communities in Nigeria. Major disparities in maternal health care in Nigeria remain present despite the goal of the United Nations Millennium Development Goal to reduce maternal mortality by 2015. The objective of this study is to review the contribution of TBAs in the birthing process in Nigeria, and to examine barriers and opportunities for utilizing TBAs in improving maternal and child health outcomes in Nigeria. A literature review of two major electronic databases was conducted using the PRISMA framework to identify English language studies conducted between 2006 and 2016. Inclusion criteria included articles that examined the role of traditional birth attendants as a factor influencing maternal health in Nigeria. The value of TBAs has not been fully examined as few studies have aimed to examine its potential role in reducing maternal mortality with proper training. Eight manuscripts that were examined highlighted the role of TBAs in maternal health including outcomes of utilizing trained versus non-trained TBAs. Specific areas of training for TBAs that were identified and recommended in review including: recognizing delivery complications, community support for TBA practices through policy, evaluation of TBA training programs and increasing collaboration between healthcare facilities and TBAs. Policies focused on improving access to health services and importantly, formal health education training to TBAs, are required to improve maternal health outcomes and underserved communities.

  15. Will the Traditional Health Practitioners Act (Act No 22, 2007 challenge the holy grails of South African medical doctors?

    Directory of Open Access Journals (Sweden)

    Gabriel Louw

    2017-02-01

    Full Text Available Background The South African healthcare establishment is primarily managed and overseen by medical doctors. This powerbase was established over many years, especially after the early 1930s. World War II gave doctors the final approval to take this supervisory and sole decision-making role regarding healthcare training, practice models and other health workers in South Africa. This phenomenon led initially to doctors having a certain jurisdiction to set the pace and to make the rules. This jurisdiction became more comprehensive and extent with time in South Africa to include a collection of unique medical traditions, customs, privileges, habits, healthcare rights and empowerment as well as exclusive medical training and practice models to become known as the holy grails of the South African medical doctors. The power of these holy grails has become untouchable to anyone outside the medical domain. Since the 1980s, some powers vested in these holy grails have been lost to the allied health professions and to other insiders of the HPCSA brotherhood itself. The recognition of traditional healers by means of the Traditional Health Practitioners Act (Act No 22, 2007 seems to challenge these holy grails of medical doctors. This may also create internal conflict in the South African medical brotherhood that can cost medical doctors more ground. Aims The study aimed to determine if the Traditional Health Practitioners Act No 22 (2007 challenges the holy grails of South African medical doctors, subsequently affecting the long-established management and guardian system of the medical field within South Africa or the practice rights of medical doctors. Methods This is an exploratory and descriptive study that makes use of an historical approach by means of investigation and a literature review. The emphasis is on using current documentation like articles, books and newspapers as primary sources to reflect on the possible effect of the Traditional Health

  16. Community and health systems barriers and enablers to family planning and contraceptive services provision and use in Kabwe District, Zambia.

    Science.gov (United States)

    Silumbwe, Adam; Nkole, Theresa; Munakampe, Margarate Nzala; Milford, Cecilia; Cordero, Joanna Paula; Kriel, Yolandie; Zulu, Joseph Mumba; Steyn, Petrus S

    2018-05-31

    Unmet need for contraception results in several health challenges such as unintended pregnancies, unwanted births and unsafe abortions. Most interventions have been unable to successfully address this unmet need due to various community and health system level factors. Identifying these inhibiting and enabling factors prior to implementation of interventions forms the basis for planning efforts to increase met needs. This qualitative study was part of the formative phase of a larger research project that aimed to develop an intervention to increase met needs for contraception through community and health system participation. The specific study component reported here explores barriers and enablers to family planning and contraceptive services provision and utilisation at community and health systems levels. Twelve focus group discussions were conducted with community members (n = 114) and two with healthcare providers (n = 19). Ten in-depth interviews were held with key stakeholders. The study was conducted in Kabwe district, Zambia. Interviews/discussions were translated and transcribed verbatim. Data were coded and organised using NVivo 10 (QSR international), and were analysed using thematic analysis. Health systems barriers include long distances to healthcare facilities, stock-outs of preferred methods, lack of policies facilitating contraceptive provision in schools, and undesirable provider attitudes. Community level barriers comprise women's experience with contraceptive side effects, myths, rumours and misconceptions, societal stigma, and negative traditional and religious beliefs. On the other hand, health systems enablers consist of political will from government to expand contraceptive services access, integration of contraceptive services, provision of couples counselling, and availability of personnel to offer basic methods mix. Functional community health system structures, community desire to delay pregnancy, and knowledge of contraceptive

  17. Can a community health worker and a trained traditional birth attendant work as a team to deliver child health interventions in rural Zambia?

    Science.gov (United States)

    Yeboah-Antwi, Kojo; Hamer, Davidson H; Semrau, Katherine; Waltensperger, Karen Z; Snetro-Plewman, Gail; Kambikambi, Chilobe; Sakala, Amon; Filumba, Stephen; Sichamba, Bias; Marsh, David R

    2014-10-27

    Teaming is an accepted approach in health care settings but rarely practiced at the community level in developing countries. Save the Children trained and deployed teams of volunteer community health workers (CHWs) and trained traditional birth attendants (TBAs) to provide essential newborn and curative care for children aged 0-59 months in rural Zambia. This paper assessed whether CHWs and trained TBAs can work as teams to deliver interventions and ensure a continuum of care for all children under-five, including newborns. We trained CHW-TBA teams in teaming concepts and assessed their level of teaming prospectively every six months for two years. The overall score was a function of both teamwork and taskwork. We also assessed personal, community and service factors likely to influence the level of teaming. We created forty-seven teams of predominantly younger, male CHWs and older, female trained TBAs. After two years of deployment, twenty-one teams scored "high", twelve scored "low," and fourteen were inactive. Teamwork was high for mutual trust, team cohesion, comprehension of team goals and objectives, and communication, but not for decision making/planning. Taskwork was high for joint behavior change communication and outreach services with local health workers, but not for intra-team referral. Teams with members residing within one hour's walking distance were more likely to score high. It is feasible for a CHW and a trained TBA to work as a team. This may be an approach to provide a continuum of care for children under-five including newborns.

  18. Effects of Early Dual-Eligible Special Needs Plans on Health Expenditure.

    Science.gov (United States)

    Zhang, Yongkang; Diana, Mark L

    2017-10-18

    To examine the effects of the penetration of dual-eligible special needs plans (D-SNPs) on health care spending. Secondary state-level panel data from Medicare-Medicaid Linked Enrollee Analytic Data Source (MMLEADS) public use file and Special Needs Plan Comprehensive Reports, Area Health Resource Files, and Medicaid Managed Care Enrollment Report between 2007 and 2011. A difference-in-difference strategy that adjusts for dual-eligibles' demographic and socioeconomic characteristics, state health resources, beneficiaries' health risk factors, Medicare/Medicaid enrollment, and state- and year-fixed effects. Data from MMLEADS were summarized from Centers for Medicare and Medicaid Services (CMS)'s Chronic Conditions Data Warehouse, which contains 100 percent of Medicare enrollment data, claims for beneficiaries who are enrolled in the fee-for-service (FFS) program, and Medicaid Analytic Extract files. The MMLEADS public use file also includes payment information for managed care. Data in Special Needs Plan Comprehensive Reports were from CMS's Health Plan Management System. Results indicate that D-SNPs penetration was associated with reduced Medicare spending per dual-eligible beneficiary. Specifically, a 1 percent increase in D-SNPs penetration was associated with 0.2 percent reduction in Medicare spending per beneficiary. We found no association between D-SNPs penetration and Medicaid or total spending. Involving Medicaid services in D-SNPs may be crucial to improve coordination between Medicare and Medicaid programs and control Medicaid spending among dual-eligible beneficiaries. Starting from 2013, D-SNPs were mandated to have contracts with state Medicaid agencies. This change may introduce new effects of D-SNPs on health care spending. More research is needed to examine the impact of D-SNPs on dual-eligible spending. © Health Research and Educational Trust.

  19. The Effect of Florida Medicaid's State-Mandated Formulary Provision on Prescription Drug Use and Health Plan Costs in a Medicaid Managed Care Plan.

    Science.gov (United States)

    Munshi, Kiraat D; Mager, Douglas; Ward, Krista M; Mischel, Brian; Henderson, Rochelle R

    2018-02-01

    Formulary or preferred drug list (PDL) management is an effective strategy to ensure clinically efficient prescription drug management by managed care organizations (MCOs). Medicaid MCOs participating in Florida's Medicaid program were required to use a state-mandated PDL between May and August 2014. To examine differences in prescription drug use and plan costs between a single Florida Medicaid managed care (MMC) health plan that implemented a state-mandated PDL policy on July 1, 2014, and a comparable MMC health plan in another state without a state-mandated PDL, controlling for sociodemographic confounders. A retrospective analysis with a pre-post design was conducted using deidentified administrative claims data from a large pharmacy benefit manager. The prepolicy evaluation period was January 1 through June 30, 2014, and the postpolicy period was January 1 through June 30, 2015. Continuously eligible Florida MMC plan members were matched on sociodemographic and health characteristics to their counterparts enrolled in a comparable MMC health plan in another state without a state-mandated formulary. Outcomes were drug use, measured as the number of 30-day adjusted nonspecialty drug prescriptions per member per period, and total drug plan costs per member per period for all drugs, with separate measures for generic and brand drugs. Bivariate comparisons were conducted using t-tests. Employing a difference-in-differences (DID) analytic approach, multivariate negative binomial regression and generalized estimating equation models were used to analyze prescription drug use and costs. The final analytical sample consisted of 18,372 enrollees, evenly divided between the 2 groups. In the postpolicy evaluation period, overall and generic use declined, while brand use increased for members in the Florida health plan. Drug costs, especially for brands, significantly increased for Florida health plan members. No significant changes were observed over the same time period

  20. The U.S. National Action Plan to Improve Health Literacy: A Model for Positive Organizational Change.

    Science.gov (United States)

    Baur, Cynthia; Harris, Linda; Squire, Elizabeth

    2017-01-01

    This chapter presents the U.S. National Action Plan to Improve Health Literacy and its unique contribution to public health and health care in the U.S. The chapter details what the National Action Plan is, how it evolved, and how it has influenced priorities for health literacy improvement work. Examples of how the National Action Plan fills policy and research gaps in health care and public health are included. The first part of the chapter lays the foundation for the development of the National Action Plan, and the second part discusses how it can stimulate positive organizational change to help create health literate organizations and move the nation towards a health literate society.

  1. Health and safety plan for the Environmental Restoration Program at Oak Ridge National Laboratory

    International Nuclear Information System (INIS)

    Clark, C. Jr.; Burman, S.N.; Cipriano, D.J. Jr.; Uziel, M.S.; Kleinhans, K.R.; Tiner, P.F.

    1994-08-01

    This Programmatic Health and Safety plan (PHASP) is prepared for the U.S. Department of Energy (DOE) Oak Ridge National Laboratory (ORNL) Environmental Restoration (ER) Program. This plan follows the format recommended by the U.S. Environmental Protection Agency (EPA) for remedial investigations and feasibility studies and that recommended by the EM40 Health and Safety Plan (HASP) Guidelines (DOE February 1994). This plan complies with the Occupational Safety and Health Administration (OSHA) requirements found in 29 CFR 1910.120 and EM-40 guidelines for any activities dealing with hazardous waste operations and emergency response efforts and with OSHA requirements found in 29 CFR 1926.65. The policies and procedures in this plan apply to all Environmental Restoration sites and activities including employees of Energy Systems, subcontractors, and prime contractors performing work for the DOE ORNL ER Program. The provisions of this plan are to be carried out whenever activities are initiated that could be a threat to human health or the environment. This plan implements a policy and establishes criteria for the development of procedures for day-to-day operations to prevent or minimize any adverse impact to the environment and personnel safety and health and to meet standards that define acceptable management of hazardous and radioactive materials and wastes. The plan is written to utilize past experience and best management practices to minimize hazards to human health and safety and to the environment from event such as fires, explosions, falls, mechanical hazards, or any unplanned release of hazardous or radioactive materials to air, soil, or surface water

  2. Health and safety plan for the Environmental Restoration Program at Oak Ridge National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Clark, C. Jr.; Burman, S.N.; Cipriano, D.J. Jr.; Uziel, M.S.; Kleinhans, K.R.; Tiner, P.F.

    1994-08-01

    This Programmatic Health and Safety plan (PHASP) is prepared for the U.S. Department of Energy (DOE) Oak Ridge National Laboratory (ORNL) Environmental Restoration (ER) Program. This plan follows the format recommended by the U.S. Environmental Protection Agency (EPA) for remedial investigations and feasibility studies and that recommended by the EM40 Health and Safety Plan (HASP) Guidelines (DOE February 1994). This plan complies with the Occupational Safety and Health Administration (OSHA) requirements found in 29 CFR 1910.120 and EM-40 guidelines for any activities dealing with hazardous waste operations and emergency response efforts and with OSHA requirements found in 29 CFR 1926.65. The policies and procedures in this plan apply to all Environmental Restoration sites and activities including employees of Energy Systems, subcontractors, and prime contractors performing work for the DOE ORNL ER Program. The provisions of this plan are to be carried out whenever activities are initiated that could be a threat to human health or the environment. This plan implements a policy and establishes criteria for the development of procedures for day-to-day operations to prevent or minimize any adverse impact to the environment and personnel safety and health and to meet standards that define acceptable management of hazardous and radioactive materials and wastes. The plan is written to utilize past experience and best management practices to minimize hazards to human health and safety and to the environment from event such as fires, explosions, falls, mechanical hazards, or any unplanned release of hazardous or radioactive materials to air, soil, or surface water.

  3. Computer-Assisted Orthognathic Surgery for Patients with Cleft Lip/Palate: From Traditional Planning to Three-Dimensional Surgical Simulation.

    Directory of Open Access Journals (Sweden)

    Daniel Lonic

    Full Text Available Although conventional two-dimensional (2D methods for orthognathic surgery planning are still popular, the use of three-dimensional (3D simulation is steadily increasing. In facial asymmetry cases such as in cleft lip/palate patients, the additional information can dramatically improve planning accuracy and outcome. The purpose of this study is to investigate which parameters are changed most frequently in transferring a traditional 2D plan to 3D simulation, and what planning parameters can be better adjusted by this method.This prospective study enrolled 30 consecutive patients with cleft lip and/or cleft palate (mean age 18.6±2.9 years, range 15 to 32 years. All patients received two-jaw single-splint orthognathic surgery. 2D orthodontic surgery plans were transferred into a 3D setting. Severe bony collisions in the ramus area after 2D plan transfer were noted. The position of the maxillo-mandibular complex was evaluated and eventually adjusted. Position changes of roll, midline, pitch, yaw, genioplasty and their frequency within the patient group were recorded as an alternation of the initial 2D plan. Patients were divided in groups of no change from the original 2D plan and changes in one, two, three and four of the aforementioned parameters as well as subgroups of unilateral, bilateral cleft lip/palate and isolated cleft palate cases. Postoperative OQLQ scores were obtained for 20 patients who finished orthodontic treatment.83.3% of 2D plans were modified, mostly concerning yaw (63.3% and midline (36.7% adjustments. Yaw adjustments had the highest mean values in total and in all subgroups. Severe bony collisions as a result of 2D planning were seen in 46.7% of patients. Possible asymmetry was regularly foreseen and corrected in the 3D simulation.Based on our findings, 3D simulation renders important information for accurate planning in complex cleft lip/palate cases involving facial asymmetry that is regularly missed in conventional 2D

  4. Computer-Assisted Orthognathic Surgery for Patients with Cleft Lip/Palate: From Traditional Planning to Three-Dimensional Surgical Simulation

    Science.gov (United States)

    Lonic, Daniel; Pai, Betty Chien-Jung; Yamaguchi, Kazuaki; Chortrakarnkij, Peerasak; Lin, Hsiu-Hsia; Lo, Lun-Jou

    2016-01-01

    Background Although conventional two-dimensional (2D) methods for orthognathic surgery planning are still popular, the use of three-dimensional (3D) simulation is steadily increasing. In facial asymmetry cases such as in cleft lip/palate patients, the additional information can dramatically improve planning accuracy and outcome. The purpose of this study is to investigate which parameters are changed most frequently in transferring a traditional 2D plan to 3D simulation, and what planning parameters can be better adjusted by this method. Patients and Methods This prospective study enrolled 30 consecutive patients with cleft lip and/or cleft palate (mean age 18.6±2.9 years, range 15 to 32 years). All patients received two-jaw single-splint orthognathic surgery. 2D orthodontic surgery plans were transferred into a 3D setting. Severe bony collisions in the ramus area after 2D plan transfer were noted. The position of the maxillo-mandibular complex was evaluated and eventually adjusted. Position changes of roll, midline, pitch, yaw, genioplasty and their frequency within the patient group were recorded as an alternation of the initial 2D plan. Patients were divided in groups of no change from the original 2D plan and changes in one, two, three and four of the aforementioned parameters as well as subgroups of unilateral, bilateral cleft lip/palate and isolated cleft palate cases. Postoperative OQLQ scores were obtained for 20 patients who finished orthodontic treatment. Results 83.3% of 2D plans were modified, mostly concerning yaw (63.3%) and midline (36.7%) adjustments. Yaw adjustments had the highest mean values in total and in all subgroups. Severe bony collisions as a result of 2D planning were seen in 46.7% of patients. Possible asymmetry was regularly foreseen and corrected in the 3D simulation. Conclusion Based on our findings, 3D simulation renders important information for accurate planning in complex cleft lip/palate cases involving facial asymmetry that is

  5. Three years in - changing plan features in the U.S. health insurance marketplace.

    Science.gov (United States)

    McKillop, Caitlin N; Waters, Teresa M; Kaplan, Cameron M; Kaplan, Erin K; Thompson, Michael P; Graetz, Ilana

    2018-06-15

    A central objective of recent U.S. healthcare policy reform, most notably the Affordable Care Act's (ACA) Health Insurance Marketplace, has been to increase access to stable, affordable health insurance. However, changing market dynamics (rising premiums, changes in issuer participation and plan availability) raise significant concerns about the marketplaces' ability to provide a stable source of healthcare for Americans that rely on them. By looking at the effect of instability on changes in the consumer choice set, we can analyze potential incentives to switch plans among price-sensitive enrollees, which can then be used to inform policy going forward. Data on health plan features for non-tobacco users in 2512 counties in 34 states participating in federally-facilitated exchanges from 2014 to 2016 was obtained from the Centers for Medicaid & Medicare Services. We examined how changes in individual plan features, including premiums, deductibles, issuers, and plan types, impact consumers who had purchased the lowest-cost silver or bronze plan in their county the previous year. We calculated the cost of staying in the same plan versus switching to another plan the following year, and analyzed how costs vary across geographic regions. In most counties in 2015 and 2016 (53.7 and 68.2%, respectively), the lowest-cost silver plan from the previous year was still available, but was no longer the cheapest plan. In these counties, consumers who switched to the new lowest-cost plan would pay less in monthly premiums on average, by $51.48 and $55.01, respectively, compared to staying in the same plan. Despite potential premium savings from switching, however, the majority would still pay higher average premiums compared to the previous year, and most would face higher deductibles and an increased probability of having to change provider networks. While the ACA has shown promise in expanding healthcare access, continued changes in the availability and affordability of health

  6. eHealth and IMIA's Strategic Planning Process - IMIA conference introductory address.

    Science.gov (United States)

    Murray, Peter; Haux, Reinhold; Lorenzi, Nancy

    2008-01-01

    The International Medical Informatics Association (IMIA) is the only organization in health and biomedical informatics which is fully international in scope, bridging the academic, health practice, education, and health industry worlds through conferences, working groups, special interest groups and publications. Authored by the IMIA Interim Vice President for Strategic Planning Implementation and co-authored by the current IMIA President and the IMIA Past-President, the intention of this paper is to introduce IMIA's current strategic planning process and to set this process in relation to 'eHealth: Combining Health Telematics, Telemedicine, Biomedical Engineering and Bioinformatics to the Edge', the theme of this conference. From the viewpoint of an international organization such as IMIA, an eHealth strategy needs to be considered in a comprehensive way, including broadly stimulating high-quality health and biomedical informatics research and education, as well as providing support to bridging outcomes towards a new practice of health care in a changing world.

  7. The effectiveness of health appraisal processes currently in addressing health and wellbeing during spatial plan appraisal: a systematic review.

    Science.gov (United States)

    Gray, Selena; Carmichael, Laurence; Barton, Hugh; Mytton, Julie; Lease, Helen; Joynt, Jennifer

    2011-11-24

    Spatial planning affects the built environment, which in turn has the potential to have a significant impact on health, for good or ill. One way of ensuring that spatial plans take due account of health is through the inclusion of health considerations in the statutory and non statutory appraisal processes linked to plan-making processes. A systematic review to identify evaluation studies of appraisals or assessments of plans where health issues were considered from 1987 to 2010. A total of 6161 citations were identified: 6069 from electronic databases, 57 fromwebsite searches, with a further 35 citations from grey literature, of which 20 met the inclusion criteria. These 20 citations reported on a total of 135 different case studies: 11 UK HIA; 11 non UK high income countries HIA, 5 UK SEA or other integrated appraisal; 108 non UK high income SEA or other integrated appraisal. All studies were in English. No relevant studies were identified reporting on low or middle income countries.The studies were limited by potential bias (no independent evaluation, with those undertaking the appraisal also responsible for reporting outcomes), lack of detail and a lack of triangulation of results. Health impact assessments generally covered the four specified health domains (physical activity, mental health and wellbeing, environmental health issues such as pollution and noise, injury) more comprehensively than SEA or other integrated appraisals, although mental health and wellbeing was an underdeveloped area. There was no evidence available on the incorporation of health in Sustainability Appraisal, limited evidence that the recommendations from any type of appraisal were implemented, and almost no evidence that the recommendations had led to the anticipated outcomes or improvements in health postulated. Research is needed to assess (i) the degree to which statutory plan appraisal processes (SA in the UK) incorporate health; (ii) whether recommendations arising from health

  8. The effectiveness of health appraisal processes currently in addressing health and wellbeing during spatial plan appraisal: a systematic review

    Directory of Open Access Journals (Sweden)

    Gray Selena

    2011-11-01

    Full Text Available Abstract Background Spatial planning affects the built environment, which in turn has the potential to have a significant impact on health, for good or ill. One way of ensuring that spatial plans take due account of health is through the inclusion of health considerations in the statutory and non statutory appraisal processes linked to plan-making processes. Methods A systematic review to identify evaluation studies of appraisals or assessments of plans where health issues were considered from 1987 to 2010. Results A total of 6161 citations were identified: 6069 from electronic databases, 57 fromwebsite searches, with a further 35 citations from grey literature, of which 20 met the inclusion criteria. These 20 citations reported on a total of 135 different case studies: 11 UK HIA; 11 non UK high income countries HIA, 5 UK SEA or other integrated appraisal; 108 non UK high income SEA or other integrated appraisal. All studies were in English. No relevant studies were identified reporting on low or middle income countries. The studies were limited by potential bias (no independent evaluation, with those undertaking the appraisal also responsible for reporting outcomes, lack of detail and a lack of triangulation of results. Health impact assessments generally covered the four specified health domains (physical activity, mental health and wellbeing, environmental health issues such as pollution and noise, injury more comprehensively than SEA or other integrated appraisals, although mental health and wellbeing was an underdeveloped area. There was no evidence available on the incorporation of health in Sustainability Appraisal, limited evidence that the recommendations from any type of appraisal were implemented, and almost no evidence that the recommendations had led to the anticipated outcomes or improvements in health postulated. Conclusion Research is needed to assess (i the degree to which statutory plan appraisal processes (SA in the UK

  9. The persuasive power of oral health promotion messages: a theory of planned behavior approach to dental checkups among young adults.

    Science.gov (United States)

    Anderson, Christina N; Noar, Seth M; Rogers, Brandi D

    2013-01-01

    Although routine dental checkups are important for both oral and overall health, several factors influence young adults' use or nonuse of dental services. The two studies included in this report tested the theory of reasoned action (TRA), the theory of planned behavior (TPB), and an expanded TPB model in predicting young adults' routine dental checkups. Additionally, the study tested the perceived message effectiveness of TPB-based messages. Results support the use of an expanded TPB model (particularly adding satisfaction with the dentist and environmental constraints to the traditional model) for an understanding of routine dental checkup intention and behavior, and, most notably, provide support for the use of subjective norm-based messages to prompt dental checkups. This study lays the groundwork for a health communication campaign encouraging routine dental checkups among young adults. The use of targeting and tailoring to design effective oral health media campaign messages is discussed.

  10. EDITORIAL Traditional medicine: Reawakening a “pending agendum”.

    African Journals Online (AJOL)

    admin

    that show the workforce represented by practitioners of traditional medicine ... sector to health, wellness and people-centered health care; and ... J. Health Dev. and supervised use of traditional medicine practitioners in strengthening and expanding primary health care services. Furthermore, both the Health Policy (13) and ...

  11. Electronic health records: a valuable tool for dental school strategic planning.

    Science.gov (United States)

    Filker, Phyllis J; Cook, Nicole; Kodish-Stav, Jodi

    2013-05-01

    The objective of this study was to investigate if electronic patient records have utility in dental school strategic planning. Electronic health records (EHRs) have been used by all predoctoral students and faculty members at Nova Southeastern University's College of Dental Medicine (NSU-CDM) since 2006. The study analyzed patient demographic and caries risk assessment data from October 2006 to May 2011 extracted from the axiUm EHR database. The purpose was to determine if there was a relationship between high oral health care needs and patient demographics, including gender, age, and median income of the zip code where they reside in order to support dental school strategic planning including the locations of future satellite clinics. The results showed that about 51 percent of patients serviced by the Broward County-based NSU-CDM oral health care facilities have high oral health care needs and that about 60 percent of this population resides in zip codes where the average income is below the median income for the county ($41,691). The results suggest that EHR data can be used adjunctively by dental schools when proposing potential sites for satellite clinics and planning for future oral health care programming.

  12. 77 FR 22691 - Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes...

    Science.gov (United States)

    2012-04-17

    ... 1545-BK59 Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes... certain health insurance policies and plan sponsors of certain self-insured health plans to fund the... health insurance policies) or R. Lisa Mojiri-Azad at (202) 622-6080 (regarding self- insured health...

  13. Impact of Training of Traditional Birth Attendants on Maternal Health Care: A Community-based Study.

    Science.gov (United States)

    Satishchandra, D M; Naik, V A; Wantamutte, A S; Mallapur, M D; Sangolli, H N

    2013-12-01

    To study the impact of Training of Traditional Birth Attendants (TBAs) on maternal health care in a rural area. An interventional study in the Primary Health Center area was conducted over 1-year period between March 2006 and February 2007, which included all the 50 Traditional Birth Attendants (30 previously trained and 20 untrained), as study participants. Pretest evaluation regarding knowledge, attitude, and practices about maternal care was done. Post-test evaluation was done at the first month (early) and at the fifth month (late) after the training. Analysis was done by using Mc. Nemer's test, Chi-square test with Yates's correction and Fischer's exact test. Early and late post-test evaluation showed that there was a progressive improvement in the maternal health care provided by both the groups. Significant reduction in the maternal and perinatal deaths among the deliveries conducted by TBAs after the training was noted. Training programme for TBAs with regular follow-ups in the resource-poor setting will not only improve the quality of maternal care but also reduce perinatal deaths.

  14. Special event planning for the emergency manager.

    Science.gov (United States)

    Gaynor, Peter T

    2009-11-01

    In the domain of emergency management and homeland security there is a lack of a formal planning process at the local level when it comes to special event planning. The unique nature of special event planning demands an understanding of the planning process for both traditional and non-traditional planning partners. This understanding will make certain that local governments apply due diligence when planning for the safety of the public. This paper offers a practical roadmap for planning at the local level. It will address those 'special events' that are beyond routine local events but not of a sufficient scale to be granted National Special Security Event status. Due to the infrequency of 'special events' in most communities, it is imperative that deliberate planning takes place. Upon conclusion, the reader will be able to construct a planning process tailored to the needs of their community, guide both traditional and non-traditional planning partners through the planning process, determine priorities, explore alternatives, plan for contingencies, conduct a confirmation brief, facilitate operations and assemble an after-action report and improvement plan.

  15. Perception and utilization of traditional birth attendants by pregnant women attending primary health care clinics in a rural Local Government Area in Ogun State, Nigeria

    Directory of Open Access Journals (Sweden)

    Ebuehi OM

    2012-02-01

    Full Text Available Olufunke M Ebuehi, IA AkintujoyeReproductive and International Health Unit, Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, NigeriaBackground: In developing countries, most childbirth occurs at home and is not assisted by skilled attendants. This situation increases the risk of death for both mother and child and has severe maternal and neonatal health complications. The purpose of this study was to explore pregnant women’s perceptions and utilization of traditional birth attendant (TBA services in a rural Local Government Area (LGA in Ogun State, southwest Nigeria.Methods: A quantitative design was used to obtain information using a structured questionnaire from 250 pregnant women attending four randomly selected primary health care clinics in the LGA. Data were analyzed using Epi Info (v 3.5.1 statistical software.Results: Almost half (48.8% of the respondents were in the age group 26–35 years, with a mean age of 29.4 ± 7.33 years. About two-thirds (65.6% of the respondents had been pregnant 2–4 times before. TBA functions, as identified by respondents, were: “taking normal delivery” (56.7%, “providing antenatal services” (16.5%, “performing caesarean section” (13.0%, “providing family planning services” (8.2%, and “performing gynaecological surgeries” (5.6%. About 6/10 (61.0% respondents believed that TBAs have adequate knowledge and skills to care for them, however, approximately 7/10 (69.7% respondents acknowledged that complications could arise from TBA care. Services obtained from TBAs were: routine antenatal care (81.1%, normal delivery (36.1%, “special maternal bath to ward off evil spirits” (1.9%, “concoctions for mothers to drink to make baby strong” (15.1%, and family planning services (1.9%. Reasons for using TBA services were: “TBA services are cheaper” (50.9%, “TBA services are more culturally acceptable in my environment” (34.0%,

  16. What health plans do people prefer? The trade-off between premium and provider choice.

    Science.gov (United States)

    Determann, Domino; Lambooij, Mattijs S; de Bekker-Grob, Esther W; Hayen, Arthur P; Varkevisser, Marco; Schut, Frederik T; Wit, G Ardine de

    2016-09-01

    Within a healthcare system with managed competition, health insurers are expected to act as prudent buyers of care on behalf of their customers. To fulfil this role adequately, understanding consumer preferences for health plan characteristics is of vital importance. Little is known, however, about these preferences and how they vary across consumers. Using a discrete choice experiment (DCE) we quantified trade-offs between basic health plan characteristics and analysed whether there are differences in preferences according to age, health status and income. We selected four health plan characteristics to be included in the DCE: (i) the level of provider choice and associated level of reimbursement, (ii) the primary focus of provider contracting (price, quality, social responsibility), (iii) the level of service benefits, and (iv) the monthly premium. This selection was based on a literature study, expert interviews and focus group discussions. The DCE consisted of 17 choice sets, each comprising two hypothetical health plan alternatives. A representative sample (n = 533) of the Dutch adult population, based on age, gender and educational level, completed the online questionnaire during the annual open enrolment period for 2015. The final model with four latent classes showed that being able to choose a care provider freely was by far the most decisive characteristic for respondents aged over 45, those with chronic conditions, and those with a gross income over €3000/month. Monthly premium was the most important choice determinant for young, healthy, and lower income respondents. We conclude that it would be very unlikely for half of the sample to opt for health plans with restricted provider choice. However, a premium discount up to €15/month by restricted health plans might motivate especially younger, healthier, and less wealthy consumers to choose these plans. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Strategic Medicines Planning in Primary Health Care | Adindu ...

    African Journals Online (AJOL)

    Strategic medicines planning requires broad understanding of health and medicines realities within a context. Pharmacists viewing the community from a holistic perspective promote effectiveness in pharmacy, and facilitate synergy among the various groups to solve intractable medicines problems. Strategic medicines ...

  18. Shopping on the Public and Private Health Insurance Marketplaces: Consumer Decision Aids and Plan Presentation.

    Science.gov (United States)

    Wong, Charlene A; Kulhari, Sajal; McGeoch, Ellen J; Jones, Arthur T; Weiner, Janet; Polsky, Daniel; Baker, Tom

    2018-05-29

    The design of the Affordable Care Act's (ACA) health insurance marketplaces influences complex health plan choices. To compare the choice environments of the public health insurance exchanges in the fourth (OEP4) versus third (OEP3) open enrollment period and to examine online marketplace run by private companies, including a total cost estimate comparison. In November-December 2016, we examined the public and private online health insurance exchanges. We navigated each site for "real-shopping" (personal information required) and "window-shopping" (no required personal information). Public (n = 13; 12 state-based marketplaces and HealthCare.gov ) and private (n = 23) online health insurance exchanges. Features included consumer decision aids (e.g., total cost estimators, provider lookups) and plan display (e.g., order of plans). We examined private health insurance exchanges for notable features (i.e., those not found on public exchanges) and compared the total cost estimates on public versus private exchanges for a standardized consumer. Nearly all studied consumer decision aids saw increased deployment in the public marketplaces in OEP4 compared to OEP3. Over half of the public exchanges (n = 7 of 13) had total cost estimators (versus 5 of 14 in OEP3) in window-shopping and integrated provider lookups (window-shopping: 7; real-shopping: 8). The most common default plan orders were by premium or total cost estimate. Notable features on private health insurance exchanges were unique data presentation (e.g., infographics) and further personalized shopping (e.g., recommended plan flags). Health plan total cost estimates varied substantially between the public and private exchanges (average difference $1526). The ACA's public health insurance exchanges offered more tools in OEP4 to help consumers select a plan. While private health insurance exchanges presented notable features, the total cost estimates for a standardized consumer varied widely on public

  19. Exploring traditional and cyberbullying among Irish adolescents.

    Science.gov (United States)

    Callaghan, Mary; Kelly, Colette; Molcho, Michal

    2015-02-01

    This study aimed to explore the associations of traditional and cyberbullying victimisation with self-reported health and life satisfaction, and to examine whether involvement in risk behaviours contributes to these health outcomes. We asked questions on involvement in traditional and cyberbullying, risk behaviours, self-reported health and life satisfaction to school children. In total, 318 students aged from 15 to 18 years old in 8 post-primary schools in Ireland completed the survey. Children who were victims of bullying were more likely to report poor health, low life satisfaction and engaging in risky behaviours. Although not statistically significant, we found that cyber victimisation was positively associated with increased reporting of poor health and low life satisfaction. Traditional bullying is the most common type of bullying among school children in Ireland, and overall, seems to have a stronger association with poor health. However, a sizable proportion of children are victims of cyberbullying or of both cyberbullying and traditional bullying. It is, therefore, important to acknowledge, identify and address all types of bullying to improve the health outcomes of children.

  20. Controlling for race/ethnicity: a comparison of California commercial health plans CAHPS scores to NCBD benchmarks

    Directory of Open Access Journals (Sweden)

    Lopez Rebeca A

    2010-01-01

    Full Text Available Abstract Background Because California has higher managed care penetration and the race/ethnicity of Californians differs from the rest of the United States, we tested the hypothesis that California's lower health plan Consumer Assessment of Healthcare Providers and Systems (CAHPS® survey results are attributable to the state's racial/ethnic composition. Methods California CAHPS survey responses for commercial health plans were compared to national responses for five selected measures: three global ratings of doctor, health plan and health care, and two composite scores regarding doctor communication and staff courtesy, respect, and helpfulness. We used the 2005 National CAHPS 3.0 Benchmarking Database to assess patient experiences of care. Multiple stepwise logistic regression was used to see if patient experience ratings based on CAHPS responses in California commercial health plans differed from all other states combined. Results CAHPS patient experience responses in California were not significantly different than the rest of the nation after adjusting for age, general health rating, individual health plan, education, time in health plan, race/ethnicity, and gender. Both California and national patient experience scores varied by race/ethnicity. In both California and the rest of the nation Blacks tended to be more satisfied, while Asians were less satisfied. Conclusions California commercial health plan enrollees rate their experiences of care similarly to enrollees in the rest of the nation when seven different variables including race/ethnicity are considered. These findings support accounting for more than just age, gender and general health rating before comparing health plans from one state to another. Reporting on race/ethnicity disparities in member experiences of care could raise awareness and increase accountability for reducing these racial and ethnic disparities.

  1. Oak Ridge National Laboratory Environmenal, Safety, and Health Management Plan

    International Nuclear Information System (INIS)

    1991-12-01

    The 1990 Tiger Team Appraisal of Oak Ridge National Laboratory (ORNL) revealed that neither Martin Marietta Energy Systems, Inc. (Energy Systems) nor ORNL had a strategic plan for Environmental, Safety, and Health (ES ampersand H) activities. There were no detailed plans describing ORNL's mission, objectives, and strategies for ES ampersand H activities. A number of plans do exist that cover various aspects of ES ampersand H. Their scope ranges from multiyear program plans to annual audit schedules to compliance plans to action plans from specific audits. However, there is not a single document that identifies the plans and the objectives they are to address. This document describes the strategic plan for ORNL and provides the linkage among existing plans. It gives a brief description of the organization and management of ES ampersand H activities at ORNL. The plan identifies the general strategies to be taken by ORNL, using the overall guidance from Energy Systems in its corporate ES ampersand H Strategic Plan. It also identifies more detailed plans for implementation of these strategies, where appropriate

  2. Ebola Preparedness Planning and Collaboration by Two Health Systems in Wisconsin, September to December 2014.

    Science.gov (United States)

    Leonhardt, Kathryn Kraft; Keuler, Megan; Safdar, Nasia; Hunter, Paul

    2016-08-01

    We describe the collaborative approach used by 2 health systems in Wisconsin to plan and prepare for the threat of Ebola virus disease. This was a descriptive study of the preparedness planning, infection prevention, and collaboration with public health agencies undertaken by 2 health systems in Wisconsin between September and December 2014. The preparedness approach used by the 2 health systems relied successfully on their robust infrastructure for planning and infection prevention. In the setting of rapidly evolving guidance and unprecedented fear regarding Ebola, the 2 health systems enhanced their response through collaboration and coordination with each other and government public health agencies. Key lessons learned included the importance of a rigorous planning process, robust infection prevention practices, and coalitions between public and private health sectors. The potential threat of Ebola virus disease stimulated emergency preparedness in which acute care facilities played a leading role in the public health response. Leveraging the existing expertise of health systems is essential when faced with emerging infectious diseases. (Disaster Med Public Health Preparedness. 2016;10:691-697).

  3. Work plan, health and safety plan, and site characterization for the Rust Spoil Area (D-106)

    International Nuclear Information System (INIS)

    Bohrman, D.E.; Uziel, M.S.; Landguth, D.C.; Hawthorne, S.W.

    1990-06-01

    As part of the Resource Conservation and Recovery Act (RCRA) Facility Investigation (RFI) of the Department of Energy's Y-12 Plant located in Oak Ridge, Tennessee, this work plan has been developed for the Rust Spoil Area (a solid waste disposal area). The work plan was developed by the Measurement Applications and Development Group (MAD) of the Health and Safety Research Division (HASRD) at Oak Ridge National Laboratory (ORNL) and will be implemented jointly by ORNL/MAD and the Y-12 Environmental Surveillance Section. This plan consists of four major sections: (1) a project description giving the scope and objectives of the investigation at the Rust Spoil Area; (2) field and sampling procedures describing sample documentation, soil sampling techniques, sample packaging and preservation, equipment decontamination, and disposal of investigation generated wastes; (3) sample analysis procedures detailing necessary analytical laboratory procedures to ensure the quality of chemical results from sample receipt through analysis and data reporting; and (4) a health and safety plan which describes general site hazards and particular hazards associated with specific tasks, assigns responsibilities, establishes personnel protection standards and mandatory safety procedures, and provides emergency information for contingencies that may arise during the course of field operations

  4. 48 CFR 970.5223-1 - Integration of environment, safety, and health into work planning and execution.

    Science.gov (United States)

    2010-10-01

    ..., safety, and health into work planning and execution. 970.5223-1 Section 970.5223-1 Federal Acquisition... Integration of environment, safety, and health into work planning and execution. As prescribed in 970.2303-3(b), insert the following clause: Integration of Environment, Safety, and Health Into Work Planning and...

  5. 77 FR 58488 - Hawaii State Plan for Occupational Safety and Health

    Science.gov (United States)

    2012-09-21

    ... DEPARTMENT OF LABOR Occupational Safety and Health Administration 29 CFR Part 1952 [Docket ID. OSHA 2012-0029] RIN 1218-AC78 Hawaii State Plan for Occupational Safety and Health AGENCY: Occupational... announces the Occupational Safety and Health Administration's (OSHA) decision to modify the Hawaii State...

  6. 41 CFR 60-741.25 - Health insurance, life insurance and other benefit plans.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life insurance and other benefit plans. 60-741.25 Section 60-741.25 Public Contracts and Property Management... Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service...

  7. Beyond medical pluralism: characterising health-care delivery of biomedicine and traditional medicine in rural Guatemala.

    Science.gov (United States)

    Hoyler, Elizabeth; Martinez, Roxana; Mehta, Kurren; Nisonoff, Hunter; Boyd, David

    2018-04-01

    Although approximately one half of Guatemalans are indigenous, the Guatemalan Maya account for 72% of the extremely poor within the country. While some biomedical services are available in these communities, many Maya utilise traditional medicine as a significant, if not primary, source of health care. While existing medical anthropological research characterises these modes of medicine as medically dichotomous or pluralistic, our research in a Maya community of the Western Highlands, Concepción Huista, builds on previous studies and finds instead a syncretistic, imbricated local health system. We find significant overlap and interpenetration of the biomedical and traditional medical models that are described best as a framework where practitioners in both settings employ elements of the other in order to best meet community needs. By focusing on the practitioner's perspective, we demonstrate that in addition to patients' willingness to seek care across health systems, practitioners converse across seemingly distinct systems via incorporation of certain elements of the 'other'. Interventions to date have not accounted for this imbrication. Guatemalan governmental policies to support local healers have led to little practical change in the health-care landscape of the country. Therefore, understanding this complex imbrication is crucial for interventions and policy changes.

  8. [Traditional and Complementary Medicine in Brazil: inclusion in the Brazilian Unified National Health System and integration with primary care].

    Science.gov (United States)

    Sousa, Islandia Maria Carvalho de; Tesser, Charles Dalcanale

    2017-01-23

    This study aimed to analyze the inclusion of Traditional and Complementary Medicine in Brazilian Unified National Health System (SUS) and its integration with primary healthcare (PHC). A qualitative study drew on institutional data, indexed articles, and case studies in selected Brazilian cities: Campinas (São Paulo State), Florianópolis (Santa Catarina State), Recife (Pernambuco State), Rio de Janeiro, and São Paulo. The analysis adopted the perspective of inclusion of Traditional and Complementary Medicine in the healthcare network and its integration with primary healthcare, based on the following dimensions: presence of Traditional and Complementary Medicine on the municipal agenda; position in the services; mode of access to Traditional and Complementary Medicine; Traditional and Complementary Medicine practitioners; types of practices; demand profile; and potential for expansion in the SUS. The authors identified and characterized four types of inclusion and integration of Traditional and Complementary Medicine, whether in association or not: Type 1 - in primary healthcare via professionals from the family health teams - Integrated; Type 2 - in primary healthcare via professionals with full-time employment - Juxtaposed; Type 3 - in primary healthcare via matrix-organized teams - Matrix Organization; Type 4 - in specialized services - Without Integration. The combination of types 1 and 3 was considered a potential guideline for the expansion of Traditional and Complementary Medicine in the SUS and can orient the growth and integration of Traditional and Complementary Medicine with primary healthcare. The growing presence of Traditional and Complementary Medicine in the SUS requires conceiving its strategic expansion, while existing experiences should not be wasted.

  9. Introducing the World Health Organization Postpartum Family Planning Compendium.

    Science.gov (United States)

    Sonalkar, Sarita; Gaffield, Mary E

    2017-01-01

    The postpartum period offers multiple opportunities for healthcare providers to assist with family planning decision making. However, there are also many changing factors during the first year after delivery that can affect family planning choices. Given that several different documents have addressed WHO guidance on postpartum family planning, the electronic WHO Postpartum Family Planning Compendium (http://srhr.org/postpartumfp) has been introduced. This resource integrates essential guidance on postpartum family planning for clinicians, program managers, and policy makers. The development of the Compendium included consultations with family planning experts, key international stakeholders, and web developers. Once the website had been created, user testing by family planning experts allowed for improvements to be made before the official launch. Future directions are adaptation of the website into a mobile application that can be more easily integrated to low-resource settings, and translation of the content into French and Spanish. © 2016 World Health Organization. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

  10. Planning ahead in public health? A qualitative study of the time horizons used in public health decision-making.

    Science.gov (United States)

    Taylor-Robinson, David C; Milton, Beth; Lloyd-Williams, Ffion; O'Flaherty, Martin; Capewell, Simon

    2008-12-18

    In order to better understand factors that influence decisions for public health, we undertook a qualitative study to explore issues relating to the time horizons used in decision-making. Qualitative study using semi-structured interviews. 33 individuals involved in the decision making process around coronary heart disease were purposively sampled from the UK National Health Service (national, regional and local levels), academia and voluntary organizations. Analysis was based on the framework method using N-VIVO software. Interviews were transcribed, coded and emergent themes identified. Many participants suggested that the timescales for public health decision-making are too short. Commissioners and some practitioners working at the national level particularly felt constrained in terms of planning for the long-term. Furthermore respondents felt that longer term planning was needed to address the wider determinants of health and to achieve societal level changes. Three prominent 'systems' issues were identified as important drivers of short term thinking: the need to demonstrate impact within the 4 year political cycle; the requirement to 'balance the books' within the annual commissioning cycle and the disruption caused by frequent re-organisations within the health service. In addition respondents suggested that the tools and evidence base for longer term planning were not well established. Many public health decision and policy makers feel that the timescales for decision-making are too short. Substantial systemic barriers to longer-term planning exist. Policy makers need to look beyond short-term targets and budget cycles to secure investment for long-term improvement in public health.

  11. 75 FR 70114 - Amendment to the Interim Final Rules for Group Health Plans and Health Insurance Coverage...

    Science.gov (United States)

    2010-11-17

    ... HEALTH AND HUMAN SERVICES Office of Consumer Information and Insurance Oversight 45 CFR Part 147 RIN 0950-AA17 [OCIIO-9991-IFC2] Amendment to the Interim Final Rules for Group Health Plans and Health Insurance... Administration, Department of Labor; Office of Consumer Information and Insurance Oversight, Department of Health...

  12. 20 CFR 1002.163 - What types of health plans are covered by USERRA?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What types of health plans are covered by USERRA? 1002.163 Section 1002.163 Employees' Benefits OFFICE OF THE ASSISTANT SECRETARY FOR VETERANS... by USERRA? (a) USERRA defines a health plan to include an insurance policy or contract, medical or...

  13. Public Health Planning for Vulnerable Populations and Pandemic Influenza

    National Research Council Canada - National Science Library

    Cameron, Wendy K

    2008-01-01

    This thesis addresses planning for vulnerable populations, those segments of each community that are normally independent but that may require special assistance during a health emergency such as an influenza pandemic...

  14. 1997 Operating plan for the Office of International Health Programs

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-11-01

    One year ago, the Office of International Health Programs provided you with our 1996 Operating Plan, which defined our ideas and ideals for conducting business in 1996. We have again this year undertaken an intensive planning effort, first reviewing our accomplishments and shortcomings during 1996, and then developing plans and priorities for the upcoming year, taking into account input from customers and outside review panels, and ensuring that the demands on the office have been balanced with anticipated human, financial, and material resources.

  15. Assessing the integration of health center and community emergency preparedness and response planning.

    Science.gov (United States)

    Wineman, Nicole V; Braun, Barbara I; Barbera, Joseph A; Loeb, Jerod M

    2007-11-01

    To assess the state of health center integration into community preparedness, we undertook a national study of linkages between health centers and the emergency preparedness and response planning initiatives in their communities. The key objectives of this project were to gain a better understanding of existing linkages in a nationally representative sample of health centers, and identify health center demographic and experience factors that were associated with strong linkages. The objectives of the study were to gain a baseline understanding of existing health center linkages to community emergency preparedness and response systems and to identify factors that were associated with strong linkages. A 60-item questionnaire was mailed to the population of health centers supported by the Health Resources and Services Administration's Bureau of Primary Health Care in February 2005. Results were aggregated and a chi square analysis identified factors associated with stronger linkages. Overall performance on study-defined indicators of strong linkages was low: 34% had completed a hazard vulnerability analysis in collaboration with the community emergency management agency, 30% had their role documented in the community plan, and 24% participated in community-wide exercises. Stronger linkages were associated with experience responding to a disaster and a perception of high risk for experiencing a disaster. The potential for health centers to participate in an integrated response is not fully realized, and their absence from community-based planning leaves an already vulnerable population at greater risk. Community planners should be encouraged to include health centers in planning and response and centers should receive more targeted resources for community integration.

  16. Paying Medicare Advantage plans by competitive bidding: how much competition is there?

    Science.gov (United States)

    Biles, Brian; Pozen, Jonah; Guterman, Stuart

    2009-08-01

    Private health plans that enroll Medicare beneficiaries--known as Medicare Advantage (MA) plans--are being paid $11 billion more in 2009 than it would cost to cover these beneficiaries in regular fee-for-service Medicare. To generate Medicare savings for offsetting the costs of health reform, the Obama Administration has proposed eliminating these extra payments to private insurers and instituting a competitive bidding system that pays MA plans based on the bids they submit. This study examines the concentration of enrollment among MA plans and the degree to which firms offering MA plans actually face competition. The results show that in the large majority of U.S. counties, MA plan enrollment is highly concentrated in a small number of firms. Given the relative lack of competition in many markets as well as the potential impact on traditional Medicare, the authors call for careful consideration of a new system for setting MA plan payments.

  17. Service user involvement in care planning: the mental health nurse's perspective.

    Science.gov (United States)

    Anthony, P; Crawford, P

    2000-10-01

    A dissonance between espoused values of consumerism within mental health care and the 'reality' of clinical practice has been firmly established in the literature, not least in terms of service user involvement in care planning. In order to begin to minimize such dissonance, it is vital that mental health nurse perceptions of service user involvement in the core activity of care planning are better understood. The main findings of this qualitative study, which uses semistructured interviews, suggest that mental health nurses value the concept of user involvement but consider it to be problematic in certain circumstances. The study reveals that nurses hold similar views about the 'meaning' of patient involvement in care planning but limited resources, individual patients characteristics and limitations in nursing care are the main inhibiting factors. Factors perceived as promoting and increasing user involvement included: provision of accurate information, 'user-friendly' documentation, mechanisms for gaining service user feedback, and high staff morale.

  18. Navy Health Care Strategic Planning Process: A Draft Functional Description

    Science.gov (United States)

    1993-09-01

    are: 1. Conduct Health Care Planning 2. Manage Human Resoutrce 3. Manage Finances 4. Manag Education and Training 5. Provide Health Care Support to...and general officer medical records. This module is underdevelopment. 3. Manage Finances . This module is designed to be used by comptrollers. It assists

  19. Faith in the 'cultural fix': limits to a planned cultural change program in a rural health service.

    Science.gov (United States)

    Mahony, K

    2000-01-01

    This paper, by way of a narrative on the author's participation, explains the limits to a planned cultural change program in a large rural health service. Cultural change was identified by the CEO as crucial to the success of a major restructuring of the service, and the attitudes and beliefs of the 'old guard' were considered to be constraining progress. Advocates of cultural integration contend that shared core values across an organisation can overcome such obstacles. This is a matter of faith. An application of Habermasian theory suggests that organisational leaders are drawing on traditional/religious beliefs and practices to bolster their visions and missions at a time of motivational crisis. Though a need for cultural change in some sectors of the health services is acknowledged, the particular challenges in attempting to manipulate the traditionally embedded culture and sub-cultures of the health services is highlighted. An analysis of some of the ideas and beliefs surrounding authority, deference and discipline is undertaken. It is argued that the ritualistic reinforcement of these beliefs and the reproduction of sub-cultures along material and ideal interests militate against the implementation of objectives delineated by the CEO. While cultural analysis has revealed the irrational face of organisations and can bring to conscious awareness the taken-for-granted beliefs which inform behaviour, the cultural integrationists have a further agenda. They aim to manipulate organisational culture to subtly control employees' beliefs and hence behaviour. Cultural control is a covert form of top down authority that can be just as directive and centralizing as bureaucratic control. The author also maintains that cultural change programs alone cannot fix a problem that arose in the macro-economic sphere: a chronic lack of resources ever since the state responded to the economic crisis by cutting funds to health and welfare services.

  20. Successful business process design. Business plan development for the occupational health services unit.

    Science.gov (United States)

    Kalina, C M; Fitko, J

    1997-02-01

    1. The occupational health nurse is often mandated by management to validate health services offered and programs developed for employees as valuable to the business and company mission. 2. The business plan of the occupational health service is a working document, changing as needs of the client/customer and internal and external business and socio-economic environment evolve. 3. Alignment with and support of the company mission, goals, and objectives is another method of proving good occupational health is good business. 4. Business planning is a basic business tool the wise and prudent occupational health nurse can use in proving good occupational health is vital to the success of a company.

  1. [Implementation of a safety and health planning system in a teaching hospital].

    Science.gov (United States)

    Mariani, F; Bravi, C; Dolcetti, L; Moretto, A; Palermo, A; Ronchin, M; Tonelli, F; Carrer, P

    2007-01-01

    University Hospital "L. Sacco" had started in 2006 a two-year project in order to set up a "Health and Safety Management System (HSMS)" referring to the technical guideline OHSAS 18001:1999 and the UNI and INAIL "Guidelines for a health and safety management system at workplace". So far, the following operations had been implemented: Setting up of a specific Commission within the Risk Management Committee; Identification and appointment of Departmental Representatives of HSMS; Carrying out of a training course addressed to Workers Representatives for Safety and Departmental Representatives of HSMS; Development of an Integrated Informative System for Prevention and Safety; Auditors qualification; Inspection of the Occupational Health Unit and the Prevention and Safety Service: reporting of critical situations and monitoring solutions adopted. Short term objectives are: Self-evaluation through check-lists of each department; Sharing of the Improvement Plan among the departments of the hospital; Planning of Health and Safety training activities in the framework of the Hospital Training Plan; Safety audit.

  2. Emergency planning and management in health care: priority research topics.

    Science.gov (United States)

    Boyd, Alan; Chambers, Naomi; French, Simon; Shaw, Duncan; King, Russell; Whitehead, Alison

    2014-06-01

    Many major incidents have significant impacts on people's health, placing additional demands on health-care organisations. The main aim of this paper is to suggest a prioritised agenda for organisational and management research on emergency planning and management relevant to U.K. health care, based on a scoping study. A secondary aim is to enhance knowledge and understanding of health-care emergency planning among the wider research community, by highlighting key issues and perspectives on the subject and presenting a conceptual model. The study findings have much in common with those of previous U.S.-focused scoping reviews, and with a recent U.K.-based review, confirming the relative paucity of U.K.-based research. No individual research topic scored highly on all of the key measures identified, with communities and organisations appearing to differ about which topics are the most important. Four broad research priorities are suggested: the affected public; inter- and intra-organisational collaboration; preparing responders and their organisations; and prioritisation and decision making.

  3. Why Breast Cancer Patients Seek Traditional Healers

    Directory of Open Access Journals (Sweden)

    Mazanah Muhamad

    2012-01-01

    Full Text Available Traditional healing is a common practice in low and middle income countries such as Malaysia. Eighty percent of Malaysians consult traditional healers or “bomoh” at some time in their life for health-related issues. The purpose of our study was to explore why breast cancer patients visit traditional healers. This is a qualitative study utilizing in-depth interviews with 11 cancer survivors who sought both traditional and Western medicine. The findings revealed the following reasons for which patients seek traditional healers: (1 recommendation from family and friends, (2 sanction from family, (3 perceived benefit and compatibility, (4 healer credibility, and (5 reservation with Western medicine and system delay. These factors work together and are strongly influenced by the Malaysian cultural context. The issue with the Western health system is common in a developing country with limited health facilities.

  4. Why Breast Cancer Patients Seek Traditional Healers

    International Nuclear Information System (INIS)

    Muhamad, M.; Merriam, Sh.; Merriam, Sh.; Suhami, N.

    2012-01-01

    Traditional healing is a common practice in low and middle income countries such as Malaysia. Eighty percent of Malaysians consult traditional healers or bomoh at some time in their life for health-related issues. The purpose of our study was to explore why breast cancer patients visit traditional healers. This is a qualitative study utilizing in-depth interviews with 11 cancer survivors who sought both traditional and Western medicine. The findings revealed the following reasons for which patients seek traditional healers: (1) recommendation from family and friends, (2) sanction from family, (3) perceived benefit and compatibility, (4) healer credibility, and (5) reservation with Western medicine and system delay. These factors work together and are strongly influenced by the Malaysian cultural context. The issue with the Western health system is common in a developing country with limited health facilities

  5. Early Experience with Employee Choice of Consumer-Directed Health Plans and Satisfaction with Enrollment

    Science.gov (United States)

    Fowles, Jinnet Briggs; Kind, Elizabeth A; Braun, Barbara L; Bertko, John

    2004-01-01

    Objective To assess the initial impact of offering consumer-defined health plan (CDHP) options on employees. Data Sources/Study Setting A mail survey of 4,680 employees in the corporate offices of Humana Inc. in June 2001. Study Design The study was a cross-sectional mail survey of employees aged 18 and older who were eligible for health care benefits. The survey was conducted following open enrollment. The primary outcome is the choice of consumer-directed health plan or not; the secondary outcome is satisfaction with the enrollment process. Important covariates include sociodemographic characteristics (age, gender, race, educational level, exempt or nonexempt status, type of coverage), health status, health care utilization, and plan design preferences. Data Collection Methods A six-page questionnaire was mailed to the home of each employee, followed by a reminder postcard and two subsequent mailings to nonrespondents. Principal Findings The response rate was 66.2 percent. Seven percent selected one of the two new plan options. Because there were no meaningful differences between employees choosing either of the two new options, these groups were combined in multivariate analysis. A logistic regression modeled the likelihood of choosing the novel plan options. Those selecting the new plans were less likely to be black (odds ratio [OR] 0.46), less likely to have only Humana coverage (OR 0.30), and more likely to have single coverage (OR 1.77). They were less likely to have a chronic health problem (OR 0.56) and more likely to have had no recent medical visits (OR 3.21). They were more likely to believe that lowest premiums were the most important plan attribute (OR 2.89) and to think there were big differences in the premiums of available plans (OR 5.19). Employees in fair or poor health were more likely to have a difficult time during the online enrollment process. They were more likely to find the communications very helpful (OR 0.42) and the benefits

  6. The changing roles of community nurses: the case of health plan nurses in Israel.

    Science.gov (United States)

    Nissanholtz-Gannot, Rachel; Rosen, Bruce; Hirschfeld, Miriam

    2017-12-23

    In Israel, approximately one-third of the country's nurses work in community settings - primarily as salaried employees in Israel's four non-profit health plans. Many health system leaders believe that the roles of health plan nurses have changed significantly in recent years due to a mix of universal developments (such as population aging and academization of the profession) and Israel-specific changes (such as the introduction of extensive quality monitoring in primary care). The main objectives of the study were to identify recent changes in the roles of health plan nurses and their current areas of activity. It also explored the experience of front-line nurses with regard to autonomy, work satisfaction, and barriers to further role development. The study integrated interviews and surveys of nurses and other professionals conducted across 4 years. Data generated from earlier study components were used to guide questions and focus for later components. In 2013, in-depth interviews were held with 55 senior nursing and medical professionals supplemented by interviews in mid-2017 with the head nurses in the four health plans. In addition, a national survey was conducted in 2014-5 among a representative sample of 1019 community nurses who work for the health plans and who are engaged in direct patient care. Six hundred ninety-two nurses responded to the survey, yielding a response rate of 69%. The survey sample consisted of an equal number of nurses from each health plan, and the observations were weighted accordingly. Senior professionals identified general themes associated with a shift in nursing roles, including a transition from reactive to initiated work, increased specialization, and a shifting of tasks from hospitals to community settings. They identified the current main areas of activity in the health plans as being: routine care, chronic care, health promotion, quality monitoring and improvement, specialized care (such as wound care), and home care. In

  7. NIF special equipment construction health and safety plan

    Energy Technology Data Exchange (ETDEWEB)

    Sawicki, R.H.

    1997-07-28

    The purpose of this plan is to identify how the construction and deployment activities of the National Ignition Facility (NIF) Special Equipment (SE) will be safely executed. This plan includes an identification of (1) the safety-related responsibilities of the SE people and their interaction with other organizations involved; (2) safety related requirements, policies, and documentation; (3) a list of the potential hazards unique to SE systems and the mechanisms that will be implemented to control them to acceptable levels; (4) a summary of Environmental Safety and Health (ES&H) training requirements; and (5) requirements of contractor safety plans that will be developed and used by all SE contractors participating in site activities. This plan is a subsidiary document to the NIF Construction Safety Program (CSP) and is intended to compliment the requirements stated therein with additional details specific to the safety needs of the SE construction-related activities. If a conflict arises between these two documents, the CSP will supersede. It is important to note that this plan does not list all of the potential hazards and their controls because the design and safety analysis process is still ongoing. Additional safety issues win be addressed in the Final Safety Analysis Report, Operational Safety Procedures (OSPs), and other plans and procedures as described in Section 3.0 of this plan.

  8. NIF special equipment construction health and safety plan

    International Nuclear Information System (INIS)

    Sawicki, R.H.

    1997-01-01

    The purpose of this plan is to identify how the construction and deployment activities of the National Ignition Facility (NIF) Special Equipment (SE) will be safely executed. This plan includes an identification of (1) the safety-related responsibilities of the SE people and their interaction with other organizations involved; (2) safety related requirements, policies, and documentation; (3) a list of the potential hazards unique to SE systems and the mechanisms that will be implemented to control them to acceptable levels; (4) a summary of Environmental Safety and Health (ES ampersand H) training requirements; and (5) requirements of contractor safety plans that will be developed and used by all SE contractors participating in site activities. This plan is a subsidiary document to the NIF Construction Safety Program (CSP) and is intended to compliment the requirements stated therein with additional details specific to the safety needs of the SE construction-related activities. If a conflict arises between these two documents, the CSP will supersede. It is important to note that this plan does not list all of the potential hazards and their controls because the design and safety analysis process is still ongoing. Additional safety issues win be addressed in the Final Safety Analysis Report, Operational Safety Procedures (OSPs), and other plans and procedures as described in Section 3.0 of this plan

  9. Health Care Waste Segregation Behavior among Health Workers in Uganda: An Application of the Theory of Planned Behavior

    OpenAIRE

    Akulume, Martha; Kiwanuka, Suzanne N.

    2016-01-01

    Objective. The goal of this study was to assess the appropriateness of the theory of planned behavior in predicting health care waste segregation behaviors and to examine the factors that influence waste segregation behaviors. Methodology. One hundred and sixty-three health workers completed a self-administered questionnaire in a cross-sectional survey that examined the theory of planned behavior constructs (attitudes, subjective norms, perceived behavioral control, and intention) and externa...

  10. Revisiting public health preparedness: Incorporating social justice principles into pandemic preparedness planning for influenza.

    Science.gov (United States)

    Kayman, Harvey; Ablorh-Odjidja, Angela

    2006-01-01

    Public health professionals are responsible for ensuring the health of the nation, which requires that planners for public health emergencies recognize that not including protection for underserved or marginalized communities poses a risk to the entire population. To assure the protection of these populations in the event of a pandemic outbreak, preparedness planning will benefit from the application of several principles of social justice in assuring the protection of all individuals. This article will review the history between public health and social justice, provide a brief review of pandemic preparedness planning efforts, discuss the importance of and make recommendations for the incorporation of principles of social justice in the development of pandemic preparedness plans, and highlight some of the challenges faced by public health in effectively and equitably meeting its charge to protect the nation's health.

  11. A Comparison of Mental Health and Alcohol Use Between Traditional and Nontraditional Students.

    Science.gov (United States)

    Trenz, Rebecca C; Ecklund-Flores, Lisa; Rapoza, Kimberly

    2015-01-01

    To describe differences in life stress, anxiety, depression, and alcohol use between traditional and nontraditional college students. A targeted, stratified sample of college students (N = 1,187; Mage = 23.96, SD = 7.30; female, 67.2%) completed study surveys in Spring 2011. Participants completed demographic information, life stress (Crisis in Family Systems), anxiety (Beck Anxiety Inventory), depression (Center for Epidemiologic Studies Depression Scale), and alcohol use (Alcohol Use Disorders Identification Test-Consumption) surveys during regularly scheduled class times. Fifty-three percent (n = 630) of study participants were nontraditional students. Nontraditional students scored significantly higher than traditional students on life stress (t[1182] = -3.05, p students did not differ on alcohol use. Interventions for nontraditional college students should address the mental health issues specific to this growing college subpopulation.

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

    Directory of Open Access Journals (Sweden)

    Rasul Fani khiavi

    2016-09-01

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

  13. Mental health court outcomes: a comparison of re-arrest and re-arrest severity between mental health court and traditional court participants.

    Science.gov (United States)

    Moore, Marlee E; Hiday, Virginia Aldigé

    2006-12-01

    Mental health courts have been proliferating across the country since their establishment in the late 1990's. Although numerous advocates have proclaimed their merit, only few empirical studies have evaluated their outcomes. This paper evaluates the effect of one mental health court on criminal justice outcomes by examining arrests and offense severity from one year before to one year after entry into the court, and by comparing mental health court participants to comparable traditional criminal court defendants on these measures. Multivariate models support the prediction that mental health courts reduce the number of new arrests and the severity of such re-arrests among mentally ill offenders. Similar analysis of mental health court completers and non-completers supports the prediction that a "full dose" of mental health treatment and court monitoring produce even fewer re-arrests.

  14. Plan for radiological security at a university health center

    International Nuclear Information System (INIS)

    Huiaman Mendoza, G.M.; Sanchez Riojas, M.M.; Felix JImenez, D.

    1998-01-01

    This work shows a radiological security plan applied to a Basic Radiological Service at a university health center. Factors taken into account were installation designs, equipment operation parameters, work procedures, image system and responsibilities

  15. On the importance of planned health education: Prevention of ski injury as an example

    NARCIS (Netherlands)

    Kok, G.; Bouter, L. M.

    1990-01-01

    The planning of health education aimed at preventing sports injuries is often incomplete and not stated explicitly. In most instances, the evaluation is incomplete or nonexistent. We present a theoretical framework for planning and evaluating health education, illustrating the main points by using

  16. Determinants of responsibility for health, spiritual health and interpersonal relationship based on theory of planned behavior in high school girl students.

    Science.gov (United States)

    Rezazadeh, Afsaneh; Solhi, Mahnaz; Azam, Kamal

    2015-01-01

    Adolescence is a sensitive period of acquiring normal and abnormal habits for all oflife. The study investigates determinants of responsibility for health, spiritual health and interpersonal relations and predictive factors based on the theory of planned behavior in high school girl students in Tabriz. In this Cross-sectional study, 340 students were selected thorough multi-stage sampling. An author-made questionnaire based on standard questionnaires of Health Promotion and Lifestyle II (HPLPII), spiritual health standards (Palutzian & Ellison) and components of the theory of planned behavior (attitudes, subjective norms, perceived behavioral control, and behavioral intention) was used for data collection. The questionnaire was validated in a pilot study. Data were analyzed using SPSS v.15 and descriptive and analytical tests (Chi-square test, Pearson correlation co-efficient and liner regression test in backward method). Students' responsibility for health, spiritual health, interpersonal relationships, and concepts of theory of planned behavior was moderate. We found a significant positive correlation (ptheory of planned behavior. Attitude and perceived behavioral control predicted 35% of intention of behavioral change (pbehavioral control predicted 74% of behavioral change in accountability for health (pbehavioral change in spiritual health (pbehavioral change in interpersonal relationship (pbehavioral intention and its determinants such as perceived behavioral control should be noted in promoting intervention programs.

  17. A dosimetric comparison between traditionally planned and inverse planned radiation therapy of non-small cell lung cancer

    International Nuclear Information System (INIS)

    Wu, V.W.C.; Sham, J.S.T.; Kwong, D.L.W.

    2003-01-01

    This study applied inverse planning in 3-dimensional conformal radiation therapy (3DCRT) of non-small cell lung cancer (NSCLC) patients and evaluated its dosimetric results by comparison with the forward planning of 3DCRT and inverse planning of intensity modulated radiotherapy (IMRT). For each of the 15 NSCLC patients recruited, the forward 3DCRT, inverse 3DCRT and inverse EVIRT plans were produced using the FOCUS treatment planning system. The dosimetric results and the planner's time of all treatment plans were recorded and compared. The inverse 3DCRT plans demonstrated the best target dose homogeneity among the three planning methods. The tumour control probability of the inverse 3DCRT plans was similar to the forward plans (p 0.217) but inferior to the IMRT plans (p < 0.001). A similar pattern was observed in uncomplicated tumour control. The average planning time for the inverse 3DCRT plans was the shortest and its difference was significant compared with the forward 3DCRT plans (p < 0.001) but not with the IMRT plans (p = 0.276). In conclusion, inverse planning for 3DCRT is a reasonable alternative to the forward planning for NSCLC patients with a reduction of the planner's time. However, further dose escalation and improvement of tumour control have to rely on IMRT. Copyright (2003) Australian Institute of Radiography

  18. Availability of more healthful food alternatives in traditional, convenience, and nontraditional types of food stores in two rural Texas counties.

    Science.gov (United States)

    Bustillos, Brenda; Sharkey, Joseph R; Anding, Jenna; McIntosh, Alex

    2009-05-01

    Limited research has focused on the availability of more healthful food alternatives in traditional food stores (supermarkets and grocery stores) in rural areas. Current market trends suggest that food items may be available for purchase in stores other than traditional food stores. An observational survey was developed and used on-site to document the availability and variety of fruit and vegetables (fresh, canned, and frozen), meats (meat, poultry, fish, and eggs), dairy (milk, yogurt, and cheese), and grains (whole grains and refined grains) in all traditional food stores, convenience stores, and nontraditional food stores (dollar stores and mass merchandisers) in two rural Texas counties. Descriptive statistics and t tests identified that although the widest selection of more healthful food items was available in supermarkets, not all supermarkets carried all items. Grocery stores carried less variety of fresh fruits (8+/-0.7 vs 4.7+/-0.3; Pconvenience or nontraditional food stores. Among convenience and nontraditional food stores, "dollar" stores offered the best variety of more healthful canned fruits and vegetables, whole-wheat bread, and whole-grain cereal. Mass merchandisers and dollar stores offered a greater variety of more healthful types of canned tuna and poultry, reduced-fat and skim milk, and low-fat tortillas. In these rural counties, traditional food stores offered greater availability of more healthful food choices across food groups. More healthful food choices in canned fruits and vegetables, canned meat and fish, milk, and grains were also available in dollar stores, mass merchandisers, and convenience stores. Results suggest that a complete understanding of the food environment, especially in rural areas, requires knowledge of the availability and variety of healthful food in all types of stores that are accessible to families.

  19. Making Dreams, Not Babies: The Power of Hope in a Teen Family Planning Clinic.

    Science.gov (United States)

    Raines, Kimberly

    2018-04-01

    Teenage pregnancy is a signifi cant social issue in the United States, resulting in increased levels of poverty. Most public health family planning efforts have traditionally focused on teaching teens the how-to of contraception, with little focus on teaching the why-to. During my time as a nurse practitioner in a public health department family planning clinic, I developed a method to open discussions with patients about the possibilities of a future that includes delayed childbearing. My experience with this strategy taught me that hope may indeed be the most powerful contraceptive of all.

  20. Making dreams, not babies: the power of hope in a teen family planning clinic.

    Science.gov (United States)

    Raines, Kimberly

    2009-01-01

    Teenage pregnancy is a significant social issue in the United States, resulting in increased levels of poverty. Most public health family planning efforts have traditionally focused on teaching teens the how-to of contraception, with little focus on teaching the why-to. During my time as a nurse practitioner in a public health department family planning clinic, I developed a method to open discussions with patients about the possibilities of a future that includes delayed childbearing. My experience with this strategy taught me that hope may indeed be the most powerful contraceptive of all.

  1. Engagement of Traditional Healers and Birth Attendants as a Controversial Proposal to Extend the HIV Health Workforce.

    Science.gov (United States)

    Audet, Carolyn M; Hamilton, Erin; Hughart, Leighann; Salato, Jose

    2015-06-01

    "Medical pluralism" is the use of multiple health systems and is common among people living with HIV/AIDS in sub-Saharan Africa. Healers and traditional birth attendants (TBAs) often are a patient's first and/or preferred line of treatment; this often results in delayed, interrupted, or abandoned diagnosis and therapy. Literature from the study of medical pluralism suggests that HIV care and treatment programs are infrequently and inconsistently engaging healers around the world. Mistrust and misunderstanding among patients, clinical providers, and traditional practitioners make the development of effective partnerships difficult, particularly regarding early HIV diagnosis and antiretroviral therapy. We provide recommendations for the development of successful collaboration health workforce efforts based on both published articles and case studies from our work in rural Mozambique.

  2. Role of GIS in social sector planning: can developing countries benefit from the examples of primary health care (PHC) planning in Britain?

    Science.gov (United States)

    Ishfaq, Mohammad; Lodhi, Bilal Khan

    2012-04-01

    Social sector planning requires rational approaches where community needs are identified by referring to relative deprivation among localities and resources are allocated to address inequalities. Geographical information system (GIS) has been widely argued and used as a base for rational planning for equal resource allocation in social sectors around the globe. Devolution of primary health care is global strategy that needs pains taking efforts to implement it. GIS is one of the most important tools used around the world in decentralization process of primary health care. This paper examines the scope of GIS in social sector planning by concentration on primary health care delivery system in Pakistan. The work is based on example of the UK's decentralization process and further evidence from US. This paper argues that to achieve benefits of well informed decision making to meet the communities' needs GIS is an essential tool to support social sector planning and can be used without any difficulty in any environment. There is increasing trend in the use of Health Management Information System (HMIS) in Pakistan with ample internet connectivity which provides well established infrastructure in Pakistan to implement GIS for health care, however there is need for change in attitude towards empowering localities especially with reference to decentralization of decision making. This paper provides GIS as a tool for primary health care planning in Pakistan as a starting point in defining localities and preparing locality profiles for need identification that could help developing countries in implementing the change.

  3. Health Information Management Education: A Comparison of Faculty Mentoring in Traditional vs. Distance Education Programs

    Science.gov (United States)

    Davidian, Marilyn R.

    2010-01-01

    Fifty years of research has demonstrated the value of faculty mentoring for students. The purpose of this research was to explore the faculty mentoring experiences among graduates of traditional and distance education programs in health information management professional education. The sample (n = 1039) was drawn from baccalaureate and masters…

  4. Ten years of health workforce planning in the Netherlands: a tentative evaluation of GP planning as an example.

    NARCIS (Netherlands)

    Greuningen, M. van; Batenburg, R.S.; Velden, L.F.J. van der

    2012-01-01

    INTRODUCTION: In many countries, health-care labour markets are constantly being challenged by an alternation of shortage and oversupply. Avoiding these cyclic variations is a major challenge. In the Netherlands, a workforce planning model has been used in health care for ten years. Case description

  5. Review and action plan for oral health improvement in Sheffield special schools.

    Science.gov (United States)

    Worsley, D J; Jones, K; Harris, J C; Charlesworth, J; Marshman, Z

    2018-03-01

    A description of the process of a review of oral health improvement in special schools in Sheffield and the implementation of an action plan for these activities. Public health competencies encompassed: assessing the evidence on oral health and dental interventions, programmes and services; strategic leadership and collaborative working for health; oral health improvement. Copyright© 2018 Dennis Barber Ltd.

  6. [Local planning: the speech of basic health care center manager].

    Science.gov (United States)

    Cubas, Márcia Regina

    2005-01-01

    As planning is understood as a management tool, this article offers an argument through the speech framework of Basic Health Care Center Managers in the city of Curitiba-PR, by means of the Collective Subject Speech Methodology on local planning aspects. Its purpose is to bring local managers to a reflection concerning their styles, practices and experiences, as well as to collaborate with central level leading teams towards building their planning processes in an upward, participatory, communicative and strategic way. Considerations of the speeches built from central ideas are presented: planning methodology; inter-sectoriality; territorial basis; team and community participation; training, autonomy and particular profile of local managers; the manager's agenda; and institutional culture.

  7. HMO market penetration and costs of employer-sponsored health plans.

    Science.gov (United States)

    Baker, L C; Cantor, J C; Long, S H; Marquis, M S

    2000-01-01

    Using two employer surveys, we evaluate the role of increased health maintenance organization (HMO) market share in containing costs of employer-sponsored coverage. Total costs for employer health plans are about 10 percent lower in markets in which HMOs' market share is above 45 percent than they are in markets with HMO enrollments of below 25 percent. This is the result of lower premiums for HMOs than for non-HMO plans, as well as the competitive effect of HMOs that leads to lower non-HMO premiums for employers that continue to offer these benefits. Slower growth in premiums in areas with high HMO enrollments suggests that expanded HMO market share may also lower the long-run growth in costs.

  8. Past, present and perspectives of Manipur traditional medicine: A major health care system available for rural population in the North-East India.

    Science.gov (United States)

    Deb, Lokesh; Laishram, Surbala; Khumukcham, Nongalleima; Ningthoukhongjam, Dhaneshwor; Nameirakpam, Surjit Singh; Dey, Amitabha; Moirangthem, Dinesh Singh; Talukdar, Narayan Chandra; Ningthoukhongjam, Tombi Raj

    2015-07-01

    Traditional health care practices are still being followed extensively in Manipur, North-East India. This is the major or the only medical facility available in some rural areas of Manipur. Cross cultural ethno-pharmacological survey was conducted to document traditional health care practices by Maiba-Maibi (male-female traditional health care practitioners of Manipur). All together 59 traditional practitioners belonging to 12 ethnic communities in nine districts of the Manipur state were interviewed. A predesigned questionnaire was used for interviews, which included queries for type of ailments treating, symptoms, bioresources used, method of preparation, dosage forms, formulation, unit doses. The entire interviews were done in the residence of respective Maiba-Maibi, their patient handing and preparation of medicinal formulations were documented in written and audio-visual format. The survey recorded traditional knowledge on 949 formulations used for 66 human ailments. Five hundred forty six plant products, 42 animal products and 22 organic/inorganic materials were found to be used in these 949 formulations. Five plant species - Zingiber officinale (Zingiberaceae), Cocos nucifera (Arecaceae), Oroxylum indicum (Bignonaceae), Curcuma longa (Zingiberaceae) and Allium sativum (Liliaceae) used by maximum number of Maiba and Maibi in maximum number of formulations. This particular method of documentation keeps traditional knowledge alive. The WHO estimated perspective of traditional medicine across the world. These observations support therapeutic worth of Manipur Traditional medicines (MTM). Having generated a large database in course of this survey, next focus targeted for the scientific justification of MTM with an aim to develop commercially viable products. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Referral Practices Among U.S. Publicly Funded Health Centers That Offer Family Planning Services.

    Science.gov (United States)

    Carter, Marion W; Robbins, Cheryl L; Gavin, Loretta; Moskosky, Susan

    2018-01-29

    Referrals to other medical services are central to healthcare, including family planning service providers; however, little information exists on the nature of referral practices among health centers that offer family planning. We used a nationally representative survey of administrators from 1,615 publicly funded health centers that offered family planning in 2013-14 to describe the use of six referral practices. We focused on associations between various health center characteristics and frequent use of three active referral practices. In the prior 3 months, a majority of health centers (73%) frequently asked clients about referrals at clients' next visit. Under half (43%) reported frequently following up with referral sources to find out if their clients had been seen. A third (32%) of all health centers reported frequently using three active referral practices. In adjusted analysis, Planned Parenthood clinics (adjusted odds ratio 0.55) and hospital-based clinics (AOR 0.39) had lower odds of using the three active referral practices compared with health departments, and Title X funding status was not associated with the outcome. The outcome was positively associated with serving rural areas (AOR 1.39), having a larger client volume (AOR 3.16), being a part of an insurance network (AOR 1.42), and using electronic health records (AOR 1.62). Publicly funded family planning providers were heavily engaged in referrals. Specific referral practices varied widely and by type of care. More assessment of these and other aspects of referral systems and practices is needed to better characterize the quality of care.

  10. In place of fear: aligning health care planning with system objectives to achieve financial sustainability.

    Science.gov (United States)

    Birch, Stephen; Murphy, Gail Tomblin; MacKenzie, Adrian; Cumming, Jackie

    2015-04-01

    The financial sustainability of publicly funded health care systems is a challenge to policymakers in many countries as health care absorbs an ever increasing share of both national wealth and government spending. New technology, aging populations and increasing public expectations of the health care system are often cited as reasons why health care systems need ever increasing funding as well as reasons why universal and comprehensive public systems are unsustainable. However, increases in health care spending are not usually linked to corresponding increases in need for care within populations. Attempts to promote financial sustainability of systems such as limiting the range of services is covered or the groups of population covered may compromise their political sustainability as some groups are left to seek private cover for some or all services. In this paper, an alternative view of financial sustainability is presented which identifies the failure of planning and management of health care to reflect needs for care in populations and to integrate planning and management functions for health care expenditure, health care services and the health care workforce. We present a Health Care Sustainability Framework based on disaggregating the health care expenditure into separate planning components. Unlike other approaches to planning health care expenditure, this framework explicitly incorporates population health needs as a determinant of health care requirements, and provides a diagnostic tool for understanding the sources of expenditure increase. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  11. Health Care Consumerism: Lessons My 401(k) Plan Taught Me.

    Science.gov (United States)

    Steinberg, Allen T

    2015-01-01

    Changes to the U.S. health care system are here. As we think about how individuals will pay for health care--while actively employed and while retired--our experiences with 401(k) plans provide some valuable lessons. In order to support employees in this new health care world--a challenge arguably more daunting than the 401(k) challenge we faced 20 years ago--some very different types of support are needed. Employers should consider providing their employees with the resources to manage health care changes.

  12. Developing a promotion plan for health care marketing.

    Science.gov (United States)

    Hallums, A

    1994-07-01

    Promotion of a health care provider's services is essential for communication with its customers and consumers. It is relevant to an organization's marketing strategy and is an element of what is described as the marketing mix. This paper considers the relationship of promotion to the marketing of services and proposes a plan for the promotion of the organization as a whole which can also be applied to an individual service or specialty. Whilst specific reference is made to an National Health Service (NHS) Trust it is also relevant to a Directly Managed Unit.

  13. Impact of the Prevention Plan on Employee Health Risk Reduction

    OpenAIRE

    Loeppke, Ronald; Edington, Dee W.; Bég, Sami

    2010-01-01

    This study evaluated the impact of The Prevention Plan™ on employee health risks after 1 year of integrated primary prevention (wellness and health promotion) and secondary prevention (biometric and lab screening as well as early detection) interventions. The Prevention Plan is an innovative prevention benefit that provides members with the high-tech/high-touch support and encouragement they need to adopt healthy behaviors. Support services include 24/7 nurse hotlines, one-on-one health coach...

  14. Mediators of the effects of rice intake on health in individuals consuming a traditional Japanese diet centered on rice.

    Science.gov (United States)

    Koga, Minori; Toyomaki, Atsuhito; Miyazaki, Akane; Nakai, Yukiei; Yamaguchi, Atsuko; Kubo, Chizuru; Suzuki, Junko; Ohkubo, Iwao; Shimizu, Mari; Musashi, Manabu; Kiso, Yoshinobu; Kusumi, Ichiro

    2017-01-01

    Although the Japanese diet is believed to be balanced and healthy, its benefits have been poorly investigated, especially in terms of effects on mental health. We investigated dietary patterns and physical and mental health in the Japanese population using an epidemiological survey to determine the health benefits of the traditional Japanese diet. Questionnaires to assess dietary habits, quality of life, sleep quality, impulsivity, and depression severity were distributed to 550 randomly selected middle-aged and elderly individuals. Participants with any physical or mental disease were excluded. Two-hundred and seventy-eight participants were selected for the final statistical analysis. We determined rice to be one of the most traditional foods in Japanese cuisine. Scores for each questionnaire were computed, and the correlations between rice intake and health indices were assessed. When analyzing the direct correlations between rice intake and health indices, we found only two correlations, namely those with quality of life (vitality) and sleep quality. Path analysis using structural equation modeling was performed to investigate the association between rice intake and health, with indirect effects included in the model. Additional associations between rice intake and health were explained using this model when compared to those using direct correlation analysis. Path analysis was used to identify mediators of the rice-health association. These mediators were miso (soybean paste) soup, green tea, and natto (fermented soybean) intake. Interestingly, these mediators have been major components of the Japanese diet since 1975, which has been considered one of the healthiest diets since the 1960s. Our results indicate that the combination of rice with other healthy foods, which is representative of the traditional Japanese diet, may contribute to improvements in physical and mental health.

  15. Mediators of the effects of rice intake on health in individuals consuming a traditional Japanese diet centered on rice.

    Directory of Open Access Journals (Sweden)

    Minori Koga

    Full Text Available Although the Japanese diet is believed to be balanced and healthy, its benefits have been poorly investigated, especially in terms of effects on mental health. We investigated dietary patterns and physical and mental health in the Japanese population using an epidemiological survey to determine the health benefits of the traditional Japanese diet. Questionnaires to assess dietary habits, quality of life, sleep quality, impulsivity, and depression severity were distributed to 550 randomly selected middle-aged and elderly individuals. Participants with any physical or mental disease were excluded. Two-hundred and seventy-eight participants were selected for the final statistical analysis. We determined rice to be one of the most traditional foods in Japanese cuisine. Scores for each questionnaire were computed, and the correlations between rice intake and health indices were assessed. When analyzing the direct correlations between rice intake and health indices, we found only two correlations, namely those with quality of life (vitality and sleep quality. Path analysis using structural equation modeling was performed to investigate the association between rice intake and health, with indirect effects included in the model. Additional associations between rice intake and health were explained using this model when compared to those using direct correlation analysis. Path analysis was used to identify mediators of the rice-health association. These mediators were miso (soybean paste soup, green tea, and natto (fermented soybean intake. Interestingly, these mediators have been major components of the Japanese diet since 1975, which has been considered one of the healthiest diets since the 1960s. Our results indicate that the combination of rice with other healthy foods, which is representative of the traditional Japanese diet, may contribute to improvements in physical and mental health.

  16. Traditional botanical medicine: an introduction.

    Science.gov (United States)

    Rosenbloom, Richard A; Chaudhary, Jayesh; Castro-Eschenbach, Diane

    2011-01-01

    The role of traditional medicine in the well-being of mankind has certainly journeyed a long way. From an ancient era, in which knowledge was limited to a few traditional healers and dominated by the use of whole plants or crude drugs, the science has gradually evolved into a complete healthcare system with global recognition. Technologic advancements have facilitated traditional science to deliver numerous breakthrough botanicals with potency equivalent to those of conventional drugs. The renewed interest in traditional medicine is mainly attributed to its ability to prevent disease, promote health, and improve quality of life. Despite the support received from public bodies and research organizations, development of botanical medicines continues to be a challenging process. The present article gives a summarized description of the various difficulties encountered in the development and evaluation of botanical drugs, including isolation of active compounds and standardization of plant ingredients. It indicates a future direction of traditional medicine toward evidence-based evaluation of health claims through well-controlled safety and efficacy studies.

  17. [Sustainability focus in the health plans of the autonomous communities: sustainable development as an opportunity].

    Science.gov (United States)

    Moyano-Santiago, Miguel A; Rivera-Lirio, Juana M

    2016-01-01

    To determine the degree to which the health plans of the autonomous communities focus on the usual three dimensions of sustainability: economic, social and environmental, both in the general level of discourse and in the different areas of intervention. A qualitative study was conducted through content analysis of a large sample of documents. The specific methodology was analysis of symbolic and operational sensitivity in a sample of eleven health plans of the Spanish state. Social aspects, such as social determinants or vulnerable groups, are receiving increasing attention from the health planner, although there is room to strengthen attention to environmental issues and to provide specific interventions in economic terms. The analysis demonstrates the incipient state of health plans as strategic planning documents that integrate economic, social and environmental aspects and contribute to the sustainability of the different health systems of the country. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

  18. Use of traditional medicine among type 2 diabetic Libyans.

    Science.gov (United States)

    Ashur, Sana Taher; Shah, Shamsul Azhar; Bosseri, Soad; Shamsuddin, Khadijah

    2017-07-16

    The use of traditional medicines is common among patients with chronic illnesses and this practice might pose health risks. The use among Libyan patients with diabetes is unknown. Therefore, this study aimed to estimate the prevalence of traditional medicine use in the previous year among Libyans with type 2 diabetes and to examine the association between its use and sociodemographic and clinical characteristics of the patients. A cross-sectional study was conducted at a large diabetes centre in Tripoli. A self-reported questionnaire was used for data collection. Of the 523 respondents, 28.9% used traditional remedies. Sex was the only variable significantly associated with traditional medicine use; more women used traditional medicines (P = 0.01). A total of 77 traditional medicine items were reported to be used, of which herbs were the most common. The use of traditional medicine for diabetes is prevalent and some of the reported items could pose health risks. Health education programmes are suggested to raise the awareness of the health risks of this practice.

  19. Strategic media planning: furthering the impact of health care advertising.

    Science.gov (United States)

    Patrick, G

    1985-11-01

    The changing marketplace and the competitive atmosphere makes advertising increasingly necessary for health care providers. Alternative delivery systems are already using the media to promote their products and hospitals will also need to market the services they provide. This article traces the history of health care advertising and outlines how to prepare an effective media plan.

  20. Natural and accelerated bioremediation research program plan

    International Nuclear Information System (INIS)

    1995-09-01

    This draft plan describes a ten-year program to develop the scientific understanding needed to harness and develop natural and enhanced biogeochemical processes to bioremediate contaminated soils, sediments and groundwater at DOE facilities. The Office of Health and Environmental Research (OHER) developed this program plan, with advice and assistance from DOE's Office of Environmental Management (EM). The program builds on OHER's tradition of sponsoring fundamental research in the life and environmental sciences and was motivated by OHER's and Office of Energy Research's (OER's) commitment to supporting DOE's environmental management mission and the belief that bioremediation is an important part of the solution to DOE's environmental problems

  1. The commercialization of traditional medicine in modern Cambodia.

    Science.gov (United States)

    Ros, Bandeth; Lê, Gillian; McPake, Barbara; Fustukian, Suzanne

    2018-01-01

    Globally, traditional medicine has long been used to address relatively common illness, mental ill health and during childbirth and post-natal care. However, traditional medicine is primarily provided by the private sector and it is unclear how far expenditures on traditional medicine contribute to household impoverishment. A life history method was used to understand the health seeking experience of 24 households over the last 60 years in Cambodia, a country with high out-of-pocket expenditures for health. The life histories suggest that traditional medicine in Cambodia has been undergoing a process of commercialization, with significant impacts on poor households. In the earlier lives of respondents, payments for traditional medicine were reported to have been flexible, voluntary or appropriate to patients' financial means. In contrast, contemporary practitioners appear to seek immediate cash payments that have frequently led to considerable debt and asset sales by traditional medicine users. Given traditional medicine's popularity as a source of treatment in Cambodia and its potential to contribute to household impoverishment, we suggest that it needs to be included in a national conversation about achieving Universal Health Coverage in the country. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  2. Traditional birth attendants issue: a menace in developing countries.

    Science.gov (United States)

    Buowari, O Y

    2012-01-01

    A significant proportion of births in Nigeria still occur at homes of traditional birth attendant. Traditional birth attendants are popular in developing and low resource countries. They lack no formal education or medical training and their clients end up with obstetric complications which lead to severe morbidity and mortality. Two cases of pregnant women that engaged the services of traditional birth attendants (TBA) before presenting at a health facility are presented. They ended up with severe morbidity and mortalities. A 29 year old gravida 3 + para 2+0 woman with two previous caesarean section(C/S) was counselled for elective c/s but declined. She presented at the home of a TBA, had spontaneous vagina deliver, collapsed one hour after delivery and was dead by the time she was brought to the hospital. A 30 year old gravida 10 para 7 + 3 presented in hospital after being in labour at the home of a TBA for three days. On presentation in hospital there was absent foetal heart sound. At surgery there was ruptured uterus and subtotal hysterectomy was done. To improve the situation better access to optimal antenatal care and intrapartum care together with early referral of high-risk patients must be facilitated. Increased community awareness, promotion of appropriate technology for effective health care planning strategy from the grassroots level to tertiary centres is important in the reduction of obstructed labour. One of the most effective means of reducing maternal mortality is the provision of caesarean section for all women who need it.

  3. Change in challenging times: a plan for extending and improving health coverage.

    Science.gov (United States)

    Lambrew, Jeanne M; Podesta, John D; Shaw, Teresa L

    2005-01-01

    Some speculate that Americans are neither politically capable of nor morally committed to solving the health system problems. We disagree. We propose a plan that insures all and improves the value and cost-effectiveness of health care by knitting together employer-sponsored insurance and Medicaid; promoting prevention, research, and information technology; and financing its investments through a dedicated value-added tax. By prioritizing practicality, fairness, and responsibility, the plan aims to avoid ideological battles and prevent fear of major change. By emphasizing the moral imperative for change, especially relative to other options on the policy agenda, it aims to create momentum for expanding and improving health coverage for all.

  4. Health workforce planning in Europe: creating learning country clusters.

    NARCIS (Netherlands)

    Batenburg, R.

    2015-01-01

    In this article, the different dimensions and determinants of health workforce planning (HWF) are investigated to improve context-sensitivity and mutual learning among groups of countries with similar HWF characteristics. A novel approach to scoring countries according to their HFW characteristics

  5. 42 CFR 422.106 - Coordination of benefits with employer or union group health plans and Medicaid.

    Science.gov (United States)

    2010-10-01

    ... group health plans and Medicaid. 422.106 Section 422.106 Public Health CENTERS FOR MEDICARE & MEDICAID... plans and Medicaid. (a) General rule. If an MA organization contracts with an employer, labor... enrollees in an MA plan, or contracts with a State Medicaid agency to provide Medicaid benefits to...

  6. Traditional practices, beliefs and uses of medicinal plants in relation to maternal-baby health of Criollo woman in central Argentina.

    Science.gov (United States)

    Martínez, Gustavo J

    2008-12-01

    to present information on traditional practices and medicinal uses of plants for treating health diseases related to the reproductive cycle of Criollo women living in the hills of the province of Córdoba; and to interpret these uses in the context of this population's folk medicine. data were collected during several field trips to the study area based on the guidelines of a research project that included ethnographic and ethnobotanical aspects of the study area. a rural community of central Argentina. a total of 62 peasants were interviewed on the basis of a semi-structured system. Repeated open and extensive interviews were also undertaken with seven women who had previously worked as midwives in areas of difficult access. this study found that 12 different female diseases and complaints are treated using a total of 48 plant species belonging to 27 botanical families, with 71 different medicinal uses. The traditional beliefs and practices associated with maternal-baby health care in rural areas highlights the existing combination of principles reformulated from humoral medicine, the use of analogical reasoning, and ontological and functional interpretations of morbid processes. The principle of Hypocratical opposition and hot-cold categorisation are significant criteria that rule over the practices of mother and child health care during birth and puerperium. consequences of traditional knowledge on the health care of peasant women are discussed, based on the analysis of traditional practices from a peasant's point of view.

  7. Precision medicine and traditional chinese medicine of dialogue

    Directory of Open Access Journals (Sweden)

    Lou Xin

    2017-01-01

    Full Text Available The precision medicine is more precise individualized medicine, based on the patient’s genes or physiological to formulate the specific treatment plan, for the realization of individualized treatment of various diseases to provide valuable information.But with the progress of modern science and technology, modern medicine dependence on medical instruments are too serious, traditional ways are gradually forgotten.If the machine depends on the instrument test results too serious which don’t combined with the actual diagnosis, the cause of misdiagnosis, so we should pay attention to the overall analysis of diseases and systematic diagnosis and examination, use of the overall treatment concept traced back to find the cause of Traditional Chinese Medicine, finally decide to select a best treatment plan.We should use the dialectical attitude to look at the precise medical. Not blindly requirements according to the road of precision medicine of Traditional Chinese Medicine to go, to shine in himself field, form of self characteristic of Traditional Chinese Medicine.Can learn some of the advantages of accurate concept, the good and rejecting the bad, hope the Traditional Chinese Medicine in the modern environment more walk more far.

  8. Business Plan: Elpis Restaurant

    OpenAIRE

    Tran, Luu Quoc Phong

    2016-01-01

    The purpose of this Bachelor’s thesis is to create a business plan for starting up a restaurant in European – Asian style in Helsinki. While the restaurants are in European or Asian style separately, this restaurant will be unique with dishes which are based on local traditional dishes, traditional Asian dishes and mixture between them as well as creation of new dishes. This business plan is created to minimize the risk when starting up a restaurant. The plan will not only help the restaur...

  9. Challenging tradition in Nigeria.

    Science.gov (United States)

    Supriya, K E

    1991-01-01

    In Nigeria since 1987, the National Association of Nigeria Nurses and Midwives (NSNNM) has used traditional medial and traditional health care workers to curtail the practice of female circumcision. Other harmful traditions are being changed also, such as early marriage, taboos of pregnancy and childbirth, and scarification. 30,000 member of NANNM are involved in this effort to halt the harmful practices themselves and to change community opinion. The program involved national and state level workshops on harmful health consequences of traditional practices and instruction on how to conduct focus group discussions to assess women's beliefs and practices. The focus groups were found to be a particularly successful method of opening up discussion of taboo topics and expressing deep emotions. The response to the knowledge that circumcision was not necessary was rage and anger, which was channeled into advocacy roles or change in the practice. The result was the channeled into advocacy roles for change in the practice. The result was the development of books, leaflets and videos. One community group designed a dress with a decorative motif of tatoos and bodily cuts to symbolize circumcision and scarring. Plays and songs were written and performed. Artists provided models of female genitalia both before and after circumcision. The campaign has been successful in bringing this issue to the public attention in prominent ways, such a national television, health talk shows, and women;s magazines. One of the most important results of the effort has been the demonstration that culture and tradition can be changed from within, rather than from outside imposition of values and beliefs.

  10. Evolution and early evidence of the impact of consumer-driven health plans: from e-commerce venture to health savings accounts.

    Science.gov (United States)

    Parente, Stephen T; Feldman, Roger

    2008-08-01

    Using results from peer-reviewed empirical analyses we describe the development and impact of the consumer-driven health plan market over the last 5 years. The results of these analyses show that consumers are responding to the financial incentives of these new health insurance benefits. Although the results may not always be what the consumer-driven health plan developers intended, there is clear evidence of 'consumerism', where individuals act in a way that generally increases their access to healthcare or investments, if the opportunity is present. Just as Medicare Part D enrollment demonstrated consumers could identify differences in prescription drug plans and make rational choices, so too are prospective patients able to function as consumers in the medical marketplace when give the opportunity.

  11. An economic analysis of health plan conversions: are they in the public interest?

    Science.gov (United States)

    Beaulieu, Nancy Dean

    2004-01-01

    Over the last decade, managed-care companies have been consolidating on both a regional and national scale. More recently, nonprofit health plans have been converting to for-profit status, and this conversion has frequently occurred as a step to facilitate merger or acquisition with a for-profit company. Some industry observers attribute these managed-care marketplace trends to an industry shakeout resulting from increased competition in the sector. At the same time, these perceived competitive pressures have led to questions about the long-run viability of nonprofit health plans. Furthermore, some industry and government leaders believe that some nonprofits are already conducting themselves like for-profit health plans and question the state premium tax exemption ordinarily accorded to such plans. This paper examines related health policy issues through the lens of a case study of the proposed conversion of the CareFirst Blue Cross Blue Shield company to a for-profit public-stock company and its merger with the Wellpoint Corporation. Company executives and board members argued that CareFirst lacked access to sufficient capital and faced serious threats to its viability as a financially healthy nonprofit health care company. They also argued that CareFirst and its beneficiaries would benefit from merger through enhanced economies of scale and product-line extensions. Critics of the proposed conversion and merger raised concerns about the adverse impacts on access to care, coverage availability, quality of care, safety-net providers, and the cost of health insurance. Analyses demonstrate that CareFirst wields substantial market power in its local market, that it is unlikely to realize cost savings through expanded economies of scale, and that access to capital concerns are largely driven by the perceived need for further expansion through merger and acquisition. Although it is impossible to predict future changes in quality of care for CareFirst, analyses suggest

  12. 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

    2017-10-01

    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

  13. Health service planning contributes to policy dialogue around strengthening district health systems: an example from DR Congo 2008-2013.

    Science.gov (United States)

    Rajan, Dheepa; Kalambay, Hyppolite; Mossoko, Mathias; Kwete, Dieudonné; Bulakali, Joseph; Lokonga, Jean-Pierre; Porignon, Denis; Schmets, Gerard

    2014-10-31

    This case study from DR Congo demonstrates how rational operational planning based on a health systems strengthening strategy (HSSS) can contribute to policy dialogue over several years. It explores the operationalization of a national strategy at district level by elucidating a normative model district resource plan which details the resources and costs of providing an essential health services package at district level. This paper then points to concrete examples of how the results of this exercise were used for Ministry of Health (MoH) decision-making over a time period of 5 years. DR Congo's HSSS and its accompanying essential health services package were taken as a base to construct a normative model health district comprising of 10 Health Centres (HC) and 1 District Hospital (DH). The normative model health district represents a standard set by the Ministry of Health for providing essential primary health care services. The minimum operating budget necessary to run a normative model health district is $17.91 per inhabitant per year, of which $11.86 is for the district hospital and $6.05 for the health centre. The Ministry of Health has employed the results of this exercise in 4 principal ways: 1.Advocacy and negotiation instrument; 2. Instrument to align donors; 3. Field planning; 4. Costing database to extract data from when necessary. The above results have been key in the policy dialogue on affordability of the essential health services package in DR Congo. It has allowed the MoH to provide transparent information on financing needs around the HSSS; it continues to help the MoH negotiate with the Ministry of Finance and bring partner support behind the HSSS.

  14. 48 CFR 952.223-71 - Integration of environment, safety, and health into work planning and execution.

    Science.gov (United States)

    2010-10-01

    ..., safety, and health into work planning and execution. 952.223-71 Section 952.223-71 Federal Acquisition... Provisions and Clauses 952.223-71 Integration of environment, safety, and health into work planning and... safety and health standards applicable to the work conditions of contractor and subcontractor employees...

  15. Health insurance coverage and use of family planning services among current and former foster youth: implications of the health care reform law.

    Science.gov (United States)

    Dworsky, Amy; Ahrens, Kym; Courtney, Mark

    2013-04-01

    This research uses data from a longitudinal study to examine how two provisions in the Patient Protection and Affordable Care Act could affect health insurance coverage among young women who have aged out of foster care. It also explores how allowing young people to remain in foster care until age twenty-one affects their health insurance coverage, use of family planning services, and information about birth control. We find that young women are more likely to have health insurance if they remain in foster care until their twenty-first birthday and that having health insurance is associated with an increase in the likelihood of receiving family planning services. Our results also suggest that many young women who would otherwise lack health insurance after aging out of foster care will be eligible for Medicaid under the health care reform law. Because having health insurance is associated with use of family planning services, this increase in Medicaid eligibility may result in fewer unintended pregnancies among this high-risk population.

  16. Factors that hinder community participation in developing and implementing comprehensive council health plans in Manyoni District, Tanzania

    Directory of Open Access Journals (Sweden)

    Emmanuel G. Kilewo

    2015-06-01

    Full Text Available Background: Decentralization of public health planning is proposed to facilitate public participation in health issues. Health Sector Reform in Tanzania places emphasis on the participation of lower level health facilities and community in health planning process. Despite availability of policies, guidelines, and community representative organs, actual implementation of decentralization strategies is poorly achieved. This study intended to find out factors that hinder community participation in developing and implementing Comprehensive Council Health Plan (CCHP. Materials and methods: A qualitative approach was conducted in this study with key informants from Health Facility Governing Committees (HFGC, Council Health Service Board (CHSB, and Council Health Management Team (CHMT. Data were collected using in-depth interviews. Data generated were analyzed for themes and patterns. Results: Factors that hindered community participation included lack of awareness on the CCHP among HFGC members, poor communication and information sharing between CHMT and HFGC, unstipulated roles and responsibilities of HFGC, lack of management capacity among HFGC members, and lack of financial resources for implementing HFGC activities. Conclusions: The identified challenges call for policy makers to revisit the decentralization by devolution policy by ensuring that local governance structures have adequate resources as well as autonomy to participate in planning and managing CCHP in general and health facility plans in particular.

  17. Looking to the future of new media in health marketing: deriving propositions based on traditional theories.

    Science.gov (United States)

    Della, Lindsay J; Eroglu, Dogan; Bernhardt, Jay M; Edgerton, Erin; Nall, Janice

    2008-01-01

    Market trend data show that the media marketplace continues to rapidly evolve. Recent research shows that substantial portions of the U.S. media population are "new media" users. Today, more than ever before, media consumers are exposed to multiple media at the same point in time, encouraged to participate in media content generation, and challenged to learn, access, and use the new media that are continually entering the market. These media trends have strong implications for how consumers of health information access, process, and retain health-related knowledge. In this article we review traditional information processing models and theories of interpersonal and mass media access and consumption. We make several theory-based propositions for how traditional information processing and media consumption concepts will function as new media usage continues to increase. These propositions are supported by new media usage data from the Centers for Disease Control and Prevention's entry into the new media market (e.g., podcasting, virtual events, blogging, and webinars). Based on these propositions, we conclude by presenting both opportunities and challenges that public health communicators and marketers will face in the future.

  18. Do the majority of South Africans regularly consult traditional healers?

    Directory of Open Access Journals (Sweden)

    Gabriel Louw

    2016-12-01

    Full Text Available Background The statutory recognition of traditional healers as healthcare practitioners in South Africa in terms of the Traditional Health Practitioners Act 22 of 2007 is based on various assumptions, opinions and generalizations. One of the prominent views is that the majority of South Africans regularly consult traditional healers. It even has been alleged that this number can be as high as 80 per cent of the South African population. For medical doctors and other health practitioners registered with the Health Professions Council of South Africa (HPCSA, this new statutory status of traditional health practitioners, means the required presence of not only a healthcare competitor that can overstock the healthcare market with service lending, medical claims and healthcare costs, but also a competitor prone to malpractice. Aims The study aimed to determine if the majority of South Africans regularly consult traditional healers. Methods This is an exploratory and descriptive study following the modern historical approach of investigation and literature review. The emphasis is on using current documentation like articles, books and newspapers, as primary sources to determine if the majority of South Africans regularly consult traditional healers. The findings are offered in narrative form. Results It is clear that there is no trustworthy statistics on the percentages of South Africans using traditional healers. A scientific survey is needed to determine the extent to which traditional healers are consulted. This will only be possible after the Traditional Health Practitioners Act No 22 has been fully enacted and traditional health practitioners have become fully active in the healthcare sector. Conclusion In poorer, rural areas no more than 11.2 per cent of the South African population regularly consult traditional healers, while the figure for the total population seems to be no more than 1.4 per cent. The argument that the majority of South

  19. [Methodological quality evaluation of randomized controlled trials for traditional Chinese medicines for treatment of sub-health].

    Science.gov (United States)

    Zhao, Jun; Liao, Xing; Zhao, Hui; Li, Zhi-Geng; Wang, Nan-Yue; Wang, Li-Min

    2016-11-01

    To evaluate the methodological quality of the randomized controlled trials(RCTs) for traditional Chinese medicines for treatment of sub-health, in order to provide a scientific basis for the improvement of clinical trials and systematic review. Such databases as CNKI, CBM, VIP, Wanfang, EMbase, Medline, Clinical Trials, Web of Science and Cochrane Library were searched for RCTS for traditional Chinese medicines for treatment of sub-health between the time of establishment and February 29, 2016. Cochrane Handbook 5.1 was used to screen literatures and extract data, and CONSORT statement and CONSORT for traditional Chinese medicine statement were adopted as the basis for quality evaluation. Among the 72 RCTs included in this study, 67 (93.05%) trials described the inter-group baseline data comparability, 39(54.17%) trials described the unified diagnostic criteria, 28(38.89%) trials described the unified standards of efficacy, 4 (5.55%) trials mentioned the multi-center study, 19(26.38%) trials disclosed the random distribution method, 6(8.33%) trials used the random distribution concealment, 15(20.83%) trials adopted the method of blindness, 3(4.17%) study reported the sample size estimation in details, 5 (6.94%) trials showed a sample size of more than two hundred, 19(26.38%) trials reported the number of withdrawal, defluxion cases and those lost to follow-up, but only 2 trials adopted the ITT analysis,10(13.89%) trials reported the follow-up results, none of the trial reported the test registration and the test protocol, 48(66.7%) trials reported all of the indicators of expected outcomes, 26(36.11%) trials reported the adverse reactions and adverse events, and 4(5.56%) trials reported patient compliance. The overall quality of these randomized controlled trials for traditional Chinese medicines for treatment of sub-health is low, with methodological defects in different degrees. Therefore, it is still necessary to emphasize the correct application of principles

  20. Account planning: applying an advertising discipline to health communication and social marketing.

    Science.gov (United States)

    Mackert, Michael

    2012-01-01

    As health marketers seek new models to design campaigns, the advertising discipline of account planning offers an approach that can improve campaign development. The underlying principle of account planning is to bring the consumer perspective to all phases of campaign development, primarily through qualitative formative research. Account planners design the overall communication strategy and contribute to creative development of individual executions. The creative brief, a primary tool of account planning, is especially useful in conceptualizing campaigns. This report discusses the history and approach of account planning, followed by an example of account planning in the design of a social marketing campaign.

  1. Is enough attention given to climate change in health service planning? An Australian perspective

    Directory of Open Access Journals (Sweden)

    Anthony J. Burton

    2014-06-01

    Full Text Available Background: Within an Australian context, the medium to long-term health impacts of climate change are likely to be wide, varied and amplify many existing disorders and health inequities. How the health system responds to these challenges will be best considered in the context of existing health facilities and services. This paper provides a snapshot of the understanding that Australian health planners have of the potential health impacts of climate change. Methods: The first author interviewed (n=16 health service planners from five Australian states and territories using an interpretivist paradigm. All interviews were digitally recorded, key components transcribed and thematically analysed. Results: Results indicate that the majority of participants were aware of climate change but not of its potential health impacts. Despite this, most planners were of the opinion that they would need to plan for the health impacts of climate change on the community. Conclusion: With the best available evidence pointing towards there being significant health impacts as a result of climate change, now is the time to undertake proactive service planning that address market failures within the health system. If considered planning is not undertaken then Australian health system can only deal with climate change in an expensive ad hoc, crisis management manner. Without meeting the challenges of climate change to the health system head on, Australia will remain unprepared for the health impacts of climate change with negative consequences for the health of the Australian population.

  2. PLAN FOR PRIMARY HEALTH CARE IN MINAS GERAIS AND SCIENTIFIC PRODUCTION

    Directory of Open Access Journals (Sweden)

    Tatiana Oliveira Silva Bittencourt

    2014-05-01

    Full Text Available This study aimed to identify studies on the Master Plan for Primary Health Care from the year 2003. We conducted a bibliographic study on MEDLINE, LILACS, SCIELO , BDENF and Google Scholar . The results are detailed in tables and discussed from four themes. The Master Plan for Primary Health Care is an innovative and daring in the reorganization of primary care in the municipalities miners. Gave the participants an important opportunity for professional qualification. Difficulties in its implementation outperformed the potential and were present in most of the municipalities surveyed. Among the main challenges for its implementation highlights the lack of professional motivation and credibility by some involved in this process. The literature made little progress on this issue , and we hope that further research be undertaken in order to contribute to studies of evaluation of public policies and in particular the extension and consolidation of this plan.

  3. Traditional Chinese food technology and cuisine.

    Science.gov (United States)

    Li, Jian-rong; Hsieh, Yun-Hwa P

    2004-01-01

    From ancient wisdom to modern science and technology, Chinese cuisine has been established from a long history of the country and gained a global reputation of its sophistication. Traditional Chinese foods and cuisine that exhibit Chinese culture, art and reality play an essential role in Chinese people's everyday lives. Recently, traditional Chinese foods have drawn a great degree of attention from food scientists and technologists, the food industry, and health promotion institutions worldwide due to the extensive values they offer beyond being merely another ethnic food. These traditional foods comprise a wide variety of products, such as pickled vegetables, salted fish and jellyfish, tofu and tofu derived products, rice and rice snack foods, fermented sauces, fish balls and thousand-year-old eggs. An overview of selected popular traditional Chinese foods and their processing techniques are included in this paper. Further development of the traditional techniques for formulation and production of these foods is expected to produce economic, social and health benefits.

  4. Health and Safety Plan for Waste Area Grouping 6 at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    Van Hoesen, S.D.; Clark, C. Jr.; Burman, S.N.; Manis, L.W.; Barre, W.L.

    1993-12-01

    The Martin Marietta Energy Systems, Inc. (Energy Systems), policy is to provide a safe and healthful workplace for all employees and subcontractors. The accomplishment of this policy requires that operations at Waste Area Grouping (WAG) 6 at the Department of Energy (DOE) Oak Ridge National Laboratory are guided by an overall plan and consistent proactive approach to safety and health (S ampersand H) issues. The plan is written to utilize past experience and best management practices to minimize hazards to human health or the environment from events such as fires, explosions, falls, mechanical hazards, or any unplanned release of hazardous or radioactive materials to air, soil, or surface water This plan explains additional site-specific health and safety requirements such as Site Specific Hazards Evaluation Addendums (SSHEAs) to the Site Safety and Health Plan which should be used in concert with this plan and existing established procedures

  5. 29 CFR 825.212 - Employee failure to pay health plan premium payments.

    Science.gov (United States)

    2010-07-01

    ... Family and Medical Leave Act § 825.212 Employee failure to pay health plan premium payments. (a)(1) In... obligations to maintain health insurance coverage cease under FMLA if an employee's premium payment is more... an employee's insurance in accordance with this section and fails to restore the employee's health...

  6. The Olympic and Paralympic Games 2012: literature review of the logistical planning and operational challenges for public health.

    Science.gov (United States)

    Enock, K E; Jacobs, J

    2008-11-01

    To undertake a review of the literature relating to public health planning and interventions at previous summer Olympic and Paralympic Games and other relevant major summer sporting events or mass gatherings, with a focus on official publications and peer-reviewed articles. Literature review. A literature review was undertaken using all biomedical databases and a freetext search using Google to widen the search beyond peer-reviewed publications. Search terms used were: Olympics; Paralympics; mass gatherings; mass gathering medicine; sporting events; weather; planning; and organisation. Citations within articles were searched to identify additional references that would inform this review. This literature review concentrates on the public health aspects of population care at mass gatherings, particularly the Olympic and Paralympic Games which are set over several weeks, focusing on surveillance, prevention and health service quality. The literature identified 10 areas of public health planning: public health command centre and communication; surveillance, assessment and control; environmental health and safety; infectious disease outbreaks; implications of weather conditions; health promotion; travel information; economic assessments; public transport and reduction of asthma events; and preparing athletes for potential allergies. The following themes emerged as crucial factors for the success of any public health interventions at Olympic and Paralympic Games: detailed planning of deliverables; pre-identification of critical success factors; management of risk; detailed contingency planning; and full testing of all plans prior to the event. The 2012 Olympic Games will provide an exciting challenge for public health providers and systems. Preparation requires early detailed planning of policies, procedures and on-site health promotion events, in addition to helping to set up the surveillance and monitoring systems that will capture public health activity alongside

  7. Clean air plans and action plans: perspectives from the viewpoint of environmental and public health; Luftreinhalteplaene und Aktionsplaene - eine Bewertung aus umweltmedizinischer Sicht

    Energy Technology Data Exchange (ETDEWEB)

    Eikmann, T.; Herr, C. [Inst. fuer Hygiene und Umweltmedizin, Universitaetsklinikum Giessen und Marburg, Justus-Liebig-Univ. Giessen, Giessen (Germany); [Technische Univ. Dreden, Pirna (Germany). Inst. fuer Abfallwirtschaft und Altlasten; Koeckler, H. [Center for Environmental Systems Research (CESR), Univ. Kassel (Germany); [Mentec GmbH, Aue/Sa. (Germany); Nieden, A. zur [Inst. fuer Hygiene und Umweltmedizin, Universitaetsklinikum Giessen und Marburg, Justus-Liebig-Univ. Giessen, Giessen (Germany); FG Stadtklimatologie, Univ. Kassel (Germany); Katzschner, L. [FG Stadtklimatologie, Univ. Kassel (Germany); [INTECUS Dresden GmbH (Germany); Schimmelpfennig, M. [Gesundheitsamt der Stadt Kassel (Germany); Eikmann, S. [GUK - Gesellschaft fuer Umwelttoxikologie und Krankenhaushygiene mbH, Wetzlar (Germany)

    2005-07-01

    The present discussion on the health effects associated with airborne fine particulate matter has lead to an increased public interest in the general framework of compilation and evaluation of clean air plans and actions plans. While the surveys of the ''old'' clean air plans of the 80ies and 90ies of the last century relied on assessment of direct and indirect effects of air pollution on human health (and ecology), theses surveys are not part of the ''new'' clean air plans according to European law. This reduction of surveys and actions directed at threshold compliance only, abandons assessing, i.e., documentation and evaluation the health status and quality of life of populations. Assessment of individual and focus group specific sensibility and vulnerability becomes possible once health related, sociodemographic and environmental data are combined. By this, unequal life chance, i.e., unimpaired health as well as reasonable strategies towards minimizing environmental injustice can be identified. As of yet it is unclear, to what extend quality of life and quality of environment of populations living in air polluted areas are attributable to socioeconomic factors. Likewise, it is not known to which degree the environmental quality of individuals and families is self determined. This has to be considered especially for children, immigrants and women. These issues i.e., environmental justice/injustice should be considered in future projects on the development of clean air plans and especially actions plans derived thereof. Scientists, government officials and physicians working in field of preventive or environmental medicine cannot agree to a limitation of the cautionary principle to the bare compliance with thresholds. (orig.)

  8. Personalised Care Plan Management Utilizing Guideline-Driven Clinical Decision Support Systems.

    Science.gov (United States)

    Laleci Erturkmen, Gokce Banu; Yuksel, Mustafa; Sarigul, Bunyamin; Lilja, Mikael; Chen, Rong; Arvanitis, Theodoros N

    2018-01-01

    Older age is associated with an increased accumulation of multiple chronic conditions. The clinical management of patients suffering from multiple chronic conditions is very complex, disconnected and time-consuming with the traditional care settings. Integrated care is a means to address the growing demand for improved patient experience and health outcomes of multimorbid and long-term care patients. Care planning is a prevalent approach of integrated care, where the aim is to deliver more personalized and targeted care creating shared care plans by clearly articulating the role of each provider and patient in the care process. In this paper, we present a method and corresponding implementation of a semi-automatic care plan management tool, integrated with clinical decision support services which can seamlessly access and assess the electronic health records (EHRs) of the patient in comparison with evidence based clinical guidelines to suggest personalized recommendations for goals and interventions to be added to the individualized care plans.

  9. Existing roles of traditional healers (mor baan) in southern Thailand.

    Science.gov (United States)

    Suwankhong, Dusanee; Liamputtong, Pranee; Rumbold, Bruce

    2011-06-01

    Traditional healers (mor baan) played an important role in Thai health long before the introduction of Western medicine. Although modern health professional play a key role of health care provider of Thai health care system, traditional healers and their practice still exist in most rural areas of Thailand. In this article, we address the roles and practices of traditional healers in southern Thailand. An ethnographic method was employed. This approach is the hallmark method used to describe the role and the practice of traditional healers and to grasp in-depth understanding of their everyday life. Participation observation and unstructured interview with 18 traditional healers were conducted. Thematic analysis method was used to analyse the data. Most of the traditional healers chose their role because they were influenced by their ancestors, although a few others chose it because of individual interests and a desire to help ill people. All are trained in multiple skills, using supernatural spirits, ceremonies and natural plant products as resources for counteracting various health problems. They refer patients to modern hospitals or other healers if they cannot adequately manage illness themselves. Their service provision is flexible and based on a holistic approach that suits people's lifestyles and needs. The role of traditional healer tends not to attract the interest of younger generations, although traditional healers have contributed greatly to people's health. Their presence improves people's access to healthcare and offers an alternative to modern medicine, which often has a limited role. We conclude that the services of traditional healers should be incorporated into contemporary healthcare provision of Thai health care system.

  10. The evolving role of traditional birth attendants in maternal health in post-conflict Africa: A qualitative study of Burundi and northern Uganda

    OpenAIRE

    Chi, Primus Che; Urdal, Henrik

    2018-01-01

    Objectives: Many conflict-affected countries are faced with an acute shortage of health care providers, including skilled birth attendants. As such, during conflicts traditional birth attendants have become the first point of call for many pregnant women, assisting them during pregnancy, labour and birth, and in the postpartum period. This study seeks to explore how the role of traditional birth attendants in maternal health, especially childbirth, has evolved in two post-conflict settings in...

  11. The role of community health centers in assessing the social determinants of health for planning and policy: the example of frontier New Mexico.

    Science.gov (United States)

    Bruna, Sean; Stone, Lisa Cacari; Wilger, Susan; Cantor, Jeremy; Guzman, Carolina

    2014-01-01

    This article examines the experience of a frontier-based community health center when it utilized the Tool for Health and Resilience in Vulnerable Environments (THRIVE) for assessing social determinants of health with a local health consortium. Community members (N = 357) rated safety, jobs, housing, and education among the top health issues. Community leaders integrated these health priorities in a countywide strategic planning process. This example of a frontier county in New Mexico demonstrates the critical role that community health centers play when engaging with local residents to assess community health needs for strategic planning and policy development.

  12. NIF conventional facilities construction health and safety plan

    International Nuclear Information System (INIS)

    Benjamin, D W

    1998-01-01

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

  13. Health Aspects of Climate Change in Cities with Mediterranean Climate, and Local Adaptation Plans.

    Science.gov (United States)

    Paz, Shlomit; Negev, Maya; Clermont, Alexandra; Green, Manfred S

    2016-04-21

    Cities with a Mediterranean-type climate (Med-cities) are particularly susceptible to health risks from climate change since they are located in biogeographical hot-spots that experience some of the strongest effects of the changing climate. The study aims to highlight health impacts of climate change in Med-cities, analyze local climate adaptation plans and make adaptation policy recommendations for the Med-city level. We identified five Med-cities with a climate change adaptation plan: Adelaide, Barcelona, Cape Town, Los Angeles and Santiago. Beyond their similar Med-climate features (although Santiago's are slightly different), the cities have different socio-economic characteristics in various aspects. We analyzed each plan according to how it addresses climate change-related drivers of health impacts among city dwellers. For each driver, we identified the types of policy adaptation tools that address it in the urban climate adaptation plans. The surveyed cities address most of the fundamental climate change-related drivers of risks to human health, including rising temperatures, flooding and drought, but the policy measures to reduce negative impacts vary across cities. We suggest recommendations for Med-cities in various aspects, depending on their local needs and vulnerability challenges: assessment of health risks, extreme events management and long-term adaptation, among others.

  14. [Methodology for an appreciative, dynamic and collaborative process: 3rd Canary Islands (Spain) Health Plan].

    Science.gov (United States)

    O'Shanahan Juan, José Joaquín; Hernández Rodríguez, Miguel Ángel; Del Otero Sanz, Laura; Henríquez Suárez, José Andrés; Mahtani Chugani, Vinita

    The need for new approaches to strategic planning by incorporating the perspectives of professionals and inhabitants has led to a new model for the 3rd Canary Islands (Spain) Health Plan (IIIPSC). A dual-phase participatory process using qualitative techniques is proposed: 1) local phase: a quantitative and qualitative study based on training and a research-action-participation initiative; and 2) insular phase: health conferences with face-to-face discussion of results in each health area (island) and proposals for action. The process prioritises problems and establishes a specific action plan for each island through initiatives that are considered to be viable, grouped by themes and weighted according to the potential impact on priority problems. This process of interaction may help to guide planning model changes and health policy decision-making, and was included in the IIIPSC Project for its parliamentary procedure. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. The Traditional Birth Attendant in Maternal and Child Health and Family Planning: A Guide to Her Training and Utilization.

    Science.gov (United States)

    Verderese, Maria de Lourdes; Turnbull, Lily M.

    The publication provides guidelines for assisting developing countries in determining strategies for the utilization and training of traditional birth attendants (TBAs). TBA's are persons (usually women in rural areas) who assist the mother at childbirth and who initially acquired their skills through experience rather than formal training. After…

  16. 42 CFR 417.155 - How the HMO option must be included in the health benefits plan.

    Science.gov (United States)

    2010-10-01

    ... printed materials that meet the requirements of § 417.124(b). (ii) Access may not be more restrictive or... benefits plan. 417.155 Section 417.155 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT... Organizations in Employee Health Benefits Plans § 417.155 How the HMO option must be included in the health...

  17. Staff competence in dealing with traditional approaches

    DEFF Research Database (Denmark)

    Kastrup, M.

    2008-01-01

    backgrounds of patients there is a need for mental health professionals to recognize the existence of traditional approaches and be aware of the parallel systems of care. Competent treatment of such patients requires that mental health professionals are aware of this and exhibit a willingness and ability...... to bridge between the more traditional and the Western approaches to treatment. The delineations and various aspects of the concept cultural competence and its dimensions will be discussed from a clinical perspective. Comparative studies of the various Western and the traditional approaches respectively...

  18. Site health and safety plan/work plan for further characterization of waste drums at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    Abston, J.P.; Burman, S.N.; Jones, D.L.

    1995-10-01

    The health and safety plan/work plan describes a strategy for characterizing the contents of 172 liquid waste and 33 solid waste drums. It also addresses the control measures that will be taken to (1) prevent or minimize any adverse impact on the environment or personnel safety and health and (2) meet standards that define acceptable management of hazardous and radioactive materials and wastes. When writing this document, the authors considered past experiences, recommendations, and best management practices to minimize possible hazards to human health or the environment from events such as fires, explosions, falls, mechanical hazards, or unplanned releases of hazardous or radioactive materials to air, soil, or surface water

  19. High-Cost Patients Had Substantial Rates Of Leaving Medicare Advantage And Joining Traditional Medicare.

    Science.gov (United States)

    Rahman, Momotazur; Keohane, Laura; Trivedi, Amal N; Mor, Vincent

    2015-10-01

    Medicare Advantage payment regulations include risk-adjusted capitated reimbursement, which was implemented to discourage favorable risk selection and encourage the retention of members who incur high costs. However, the extent to which risk-adjusted capitation has succeeded is not clear, especially for members using high-cost services not previously considered in assessments of risk selection. We examined the rates at which participants who used three high-cost services switched between Medicare Advantage and traditional Medicare. We found that the switching rate from 2010 to 2011 away from Medicare Advantage and to traditional Medicare exceeded the switching rate in the opposite direction for participants who used long-term nursing home care (17 percent versus 3 percent), short-term nursing home care (9 percent versus 4 percent), and home health care (8 percent versus 3 percent). These results were magnified among people who were enrolled in both Medicare and Medicaid. Our findings raise questions about the role of Medicare Advantage plans in serving high-cost patients with complex care needs, who account for a disproportionately high amount of total health care spending. Project HOPE—The People-to-People Health Foundation, Inc.

  20. Traditional Occupations in a Modern World: Implications for Career Guidance and Livelihood Planning

    Science.gov (United States)

    Ratnam, Anita

    2011-01-01

    This article is an attempt to examine the place and significance of traditional occupations as careers in today's world. The areas of tension and compatibility between ideas and values that signify modernity and the practice of traditional occupations are reviewed. The meaning of "traditional occupations" is unravelled, the potential that…

  1. Breckinridge Project, initial effort. Report VII, Volume 4. Safety and health plan

    Energy Technology Data Exchange (ETDEWEB)

    None

    1982-01-01

    The Safety and Health Plan recognizes the potential hazards associated with the Project and has been developed specifically to respond to these risks in a positive manner. Prevention, the primary objective of the Plan, starts with building safety controls into the process design and continues through engineering, construction, start-up, and operation of the Project facilities and equipment. Compliance with applicable federal, state, and local health and safety laws, regulations, and codes throughout all Project phases is required and assured. The Plan requires that each major Project phase be thoroughly reviewed and analyzed to determine that those provisions required to assure the safety and health of all employees and the public, and to prevent property and equipment losses, have been provided. The Plan requires followup on those items or situations where corrective action needs were identified to assure that the action was taken and is effective. Emphasis is placed on loss prevention. Exhibit 1 provides a breakdown of Ashland Synthetic Fuels, Inc.'s (ASFI's) Loss Prevention Program. The Plan recognizes that the varied nature of the work is such as to require the services of skilled, trained, and responsible personnel who are aware of the hazards and know that the work can be done safely, if done correctly. Good operating practice is likewise safe operating practice. Training is provided to familiarize personnel with good operational practice, the general sequence of activities, reporting requirements, and above all, the concept that each step in the operating procedures must be successfully concluded before the following step can be safely initiated. The Plan provides for periodic review and evaluation of all safety and loss prevention activities at the plant and departmental levels.

  2. Using a 401(h) account to fund retiree health benefits from your pension plan.

    Science.gov (United States)

    Lee, David; Singerman, Eduardo

    2003-06-01

    If a health and welfare plan covering retirees faces financial shortfalls, administrators and trustees can fund retiree health benefit payments from a related pension plan that may be in better condition. This method is legal and ethical, but it requires sophisticated accounting techniques for creating an account that provides retiree members with promised benefits while meeting statutory and regulatory requirements.

  3. Perception and utilization of traditional birth attendants by pregnant women attending primary health care clinics in a rural Local Government Area in Ogun State, Nigeria.

    Science.gov (United States)

    Ebuehi, Olufunke M; Akintujoye, Ia

    2012-01-01

    In developing countries, most childbirth occurs at home and is not assisted by skilled attendants. This situation increases the risk of death for both mother and child and has severe maternal and neonatal health complications. The purpose of this study was to explore pregnant women's perceptions and utilization of traditional birth attendant (TBA) services in a rural Local Government Area (LGA) in Ogun State, southwest Nigeria. A quantitative design was used to obtain information using a structured questionnaire from 250 pregnant women attending four randomly selected primary health care clinics in the LGA. Data were analyzed using Epi Info (v 3.5.1) statistical software. Almost half (48.8%) of the respondents were in the age group 26-35 years, with a mean age of 29.4 ± 7.33 years. About two-thirds (65.6%) of the respondents had been pregnant 2-4 times before. TBA functions, as identified by respondents, were: "taking normal delivery" (56.7%), "providing antenatal services" (16.5%), "performing caesarean section" (13.0%), "providing family planning services" (8.2%), and "performing gynaecological surgeries" (5.6%). About 6/10 (61.0%) respondents believed that TBAs have adequate knowledge and skills to care for them, however, approximately 7/10 (69.7%) respondents acknowledged that complications could arise from TBA care. Services obtained from TBAs were: routine antenatal care (81.1%), normal delivery (36.1%), "special maternal bath to ward off evil spirits" (1.9%), "concoctions for mothers to drink to make baby strong" (15.1%), and family planning services (1.9%). Reasons for using TBA services were: "TBA services are cheaper" (50.9%), "TBA services are more culturally acceptable in my environment" (34.0%), "TBA services are closer to my house than hospital services" (13.2%), "TBAs provide more compassionate care than orthodox health workers" (43.4%), and "TBA service is the only maternity service that I know" (1.9%). Approximately 8/10 (79.2%) of the users (past

  4. OBSTACLES TO FAMILY PLANNING USE AMONG RURAL WOMEN IN ATIAK HEALTH CENTER IV, AMURU DISTRICT, NORTHERN UGANDA

    Science.gov (United States)

    Ouma, S.; Turyasima, M.; Acca, H.; Nabbale, F.; Obita, K. O.; Rama, M.; Adong, C. C.; Openy, A.; Beatrice, M. O.; Odongo-Aginya, E. I.; Awor, S.

    2016-01-01

    Background Uganda’s rapid population growth (3.2%) since 1948 has placed more demands on health sector and lowered living standard of Ugandans resulting into 49% of people living in acute poverty especially in post conflict Northern Uganda. The population rise was due to low use of contraceptive methods (21% in rural areas and 43% in urban areas) and coupled with high unmet need for family planning (41%). This indicated poor access to reproductive health services. Effective use of family planning could reduce the rapid population growth. Objective To determine obstacles to family planning use among rural women in Northern Uganda. Design A descriptive cross-sectional analytical study. Setting Atiak Health Centre IV, Amuru District, rural Northern Uganda. Subjects Four hundred and twenty four females of reproductive ages were selected from both Inpatient and Outpatient Departments of Atiak Health Centre IV. Results There was high level of awareness 418 (98.6%), positive attitude 333 (78.6%) and fair level of utilisation 230 (54.2%) of family planning. However, significant obstacles to family planning usage included; long distance to Health facility, unavailability of preferred contraceptive methods, absenteeism of family planning providers, high cost of managing side effects, desire for big family size, children dying less than five years old, husbands forbidding women from using family planning and lack of community leaders’ involvement in family planning programme. Conclusions In spites of the high level of awareness, positive attitude, and free family planning services, there were obstacles that hindered family planning usage among these rural women. However, taking services close to people, reducing number of children dying before their fifth birthday, educating men about family planning, making sure family planning providers and methods are available, reducing cost of managing side effects and involving community leaders will improve utilisation of family

  5. OBSTACLES TO FAMILY PLANNING USE AMONG RURAL WOMEN IN ATIAK HEALTH CENTER IV, AMURU DISTRICT, NORTHERN UGANDA.

    Science.gov (United States)

    Ouma, S; Turyasima, M; Acca, H; Nabbale, F; Obita, K O; Rama, M; Adong, C C; Openy, A; Beatrice, M O; Odongo-Aginya, E I; Awor, S

    Uganda's rapid population growth (3.2%) since 1948 has placed more demands on health sector and lowered living standard of Ugandans resulting into 49% of people living in acute poverty especially in post conflict Northern Uganda. The population rise was due to low use of contraceptive methods (21% in rural areas and 43% in urban areas) and coupled with high unmet need for family planning (41%). This indicated poor access to reproductive health services. Effective use of family planning could reduce the rapid population growth. To determine obstacles to family planning use among rural women in Northern Uganda. A descriptive cross-sectional analytical study. Atiak Health Centre IV, Amuru District, rural Northern Uganda. Four hundred and twenty four females of reproductive ages were selected from both Inpatient and Outpatient Departments of Atiak Health Centre IV. There was high level of awareness 418 (98.6%), positive attitude 333 (78.6%) and fair level of utilisation 230 (54.2%) of family planning. However, significant obstacles to family planning usage included; long distance to Health facility, unavailability of preferred contraceptive methods, absenteeism of family planning providers, high cost of managing side effects, desire for big family size, children dying less than five years old, husbands forbidding women from using family planning and lack of community leaders' involvement in family planning programme. In spites of the high level of awareness, positive attitude, and free family planning services, there were obstacles that hindered family planning usage among these rural women. However, taking services close to people, reducing number of children dying before their fifth birthday, educating men about family planning, making sure family planning providers and methods are available, reducing cost of managing side effects and involving community leaders will improve utilisation of family planning and thus reduce the rapid population growth and poverty.

  6. Federal employees health program experiences lack of competition in some areas, raising cost concerns for exchange plans.

    Science.gov (United States)

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

    2012-06-01

    The Affordable Care Act calls for creation of health insurance exchanges designed to provide private health insurance plan choices. The Federal Employees Health Benefits Program is a national model that to some extent resembles the planned exchanges. Both offer plans at the state level but are also overseen by the federal government. We examined the availability of plans and enrollment levels in the Federal Employees Health Benefits Program throughout the United States in 2010. We found that although plans were widely available, enrollment was concentrated in plans owned by just a few organizations, typically Blue Cross/Blue Shield plans. Enrollment was more concentrated in rural areas, which may reflect historical patterns of enrollment or lack of provider networks. Average biweekly premiums for an individual were lowest ($58.48) in counties where competition was extremely high, rising to $65.13 where competition was extremely low. To make certain that coverage sold through exchanges is affordable, policy makers may need to pay attention to areas where there is little plan competition and take steps through risk-adjustment policies or other measures to narrow differences in premiums and out-of-pocket expenses for consumers.

  7. Plan de negocio Gimnasio Health-Fit Chinchón

    OpenAIRE

    Bravo Fuentes, Alejandro

    2018-01-01

    Este trabajo de Fin de Grado consiste en la realización de un plan de negocio de un gimnasio en la localidad de Chinchón (Madrid). El gimnasio se llamará Health-Fit Chinchón y a partir de los resultados de este plan de negocio se verificará la viabilidad del proyecto. Para ello, en primer lugar se ha realizado un estudio de mercado en el que se ha podido ver la situación del sector tanto a un nivel del macroentorno como del microentorno. Gracias al análisis PEST(M) se ha podido observar conte...

  8. Health effects of smoke from planned burns: a study protocol

    Directory of Open Access Journals (Sweden)

    David O’Keeffe

    2016-02-01

    Full Text Available Abstract Background Large populations are exposed to smoke from bushfires and planned burns. Studies investigating the association between bushfire smoke and health have typically used hospital or ambulance data and been done retrospectively on large populations. The present study is designed to prospectively assess the association between individual level health outcomes and exposure to smoke from planned burns. Methods/design A prospective cohort study will be conducted during a planned burn season in three locations in Victoria (Australia involving 50 adult participants who undergo three rounds of cardiorespiratory medical tests, including measurements for lung inflammation, endothelial function, heart rate variability and markers of inflammation. In addition daily symptoms and twice daily lung function are recorded. Outdoor particulate air pollution is continuously measured during the study period in these locations. The data will be analysed using mixed effect models adjusting for confounders. Discussion Planned burns depend on weather conditions and dryness of ‘fuels’ (i.e. forest. It is potentially possible that no favourable conditions occur during the study period. To reduce the risk of this occurring, three separate locations have been identified as having a high likelihood of planned burn smoke exposure during the study period, with the full study being rolled out in two of these three locations. A limitation of this study is exposure misclassification as outdoor measurements will be conducted as a measure for personal exposures. However this misclassification will be reduced as participants are only eligible if they live in close proximity to the monitors.

  9. Hurricane Hugo: Emergency Preparedness Planning and Response for Mental Health Services.

    Science.gov (United States)

    Carter, Nancy C.; And Others

    This report describes how, in the aftermath of Hurricane Hugo, the South Carolina Department of Mental Health activated its Emergency Preparedness Plan to assist mental health centers and their staff in providing crisis counseling services to the general public. The first section explains the history and structure of the involvement by the…

  10. A historical overview of traditional medicine practices and policy in ...

    African Journals Online (AJOL)

    The health and drug policies of the Ethiopian Ministry of Health recognize the important role traditional health systems play in health care. Unfortunately, little has ... Conclusion: The Ethiopian government firmly supports and encourages traditional medicine through its policies as part of the national heritage. Despite these ...

  11. Recognition and respect for African traditional medicine | IDRC ...

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

    2011-02-01

    Feb 1, 2011 ... ... where he presented recommendations from traditional healers on how traditional medicine ... Recognizing that traditional medicine is “the most affordable and accessible system of health care for the .... Related articles ...

  12. 78 FR 25909 - Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance...

    Science.gov (United States)

    2013-05-03

    ... Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance Premium.... SUMMARY: This document contains proposed regulations relating to the health insurance premium tax credit... who enroll in qualified health plans through Affordable Insurance Exchanges (Exchanges) and claim the...

  13. Natural and accelerated bioremediation research program plan

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-09-01

    This draft plan describes a ten-year program to develop the scientific understanding needed to harness and develop natural and enhanced biogeochemical processes to bioremediate contaminated soils, sediments and groundwater at DOE facilities. The Office of Health and Environmental Research (OHER) developed this program plan, with advice and assistance from DOE`s Office of Environmental Management (EM). The program builds on OHER`s tradition of sponsoring fundamental research in the life and environmental sciences and was motivated by OHER`s and Office of Energy Research`s (OER`s) commitment to supporting DOE`s environmental management mission and the belief that bioremediation is an important part of the solution to DOE`s environmental problems.

  14. Perception of orthodox health care centers among pregnant women attending traditional birth attendants clinics in two local government areas of Lagos State

    Directory of Open Access Journals (Sweden)

    A Okewole

    2013-01-01

    Full Text Available Background and Objective: Adequate antenatal care and skilled obstetric assistance during delivery are important strategies that significantly reduce maternal mortality and morbidity. This study aimed to assess the awareness, attitudes and perception of orthodox health care centres among pregnant women patronizing traditional birth attendants in Mushin and Lagos Island local government areas of Lagos state. Methods: The survey was a community-based descriptive cross-sectional survey that employed interviews to collect data from 300 antenatal care attendees of seven traditional birth attendants′ clinics in Lagos Island and Mushin local government areas between December 2010 and January 2011 using a structured questionnaire. Results: The women ranged in age from 17-43 years with a mean age of 27.6 ± 4.6 SD and most of them were primigravidas (41.5%, married (88% and traders (44.1%. Most of the women (61% and their husbands (56.7% had completed their secondary education. The majority (81.7% of respondents were aware of a modern health facility around where they lived, the most commonly known being private hospitals (43.7%. Most of them (67.3% were aware of antenatal care services provided at these facilities but only 31.3% had ever made use of the antenatal services. Most of the women were not willing to deliver in hospitals because they didn′t like the attitude of the health workers (37.3% and because it was far from their houses (12.7%; the majority (75% preferring to deliver with traditional birth attendants because they give good service. However, almost all (98.5% of the women that had children took them to the orthodox health facilities for immunization, primarily the primary health care centers (55.7%. Conclusion: Traditional birth attendants are patronized by a wide array of women who are aware of orthodox health facilities but have a negative attitude towards their services. Improvements in communication and interpersonal skills of

  15. Mental health care in Nepal: current situation and challenges for development of a district mental health care plan.

    Science.gov (United States)

    Luitel, Nagendra P; Jordans, Mark Jd; Adhikari, Anup; Upadhaya, Nawaraj; Hanlon, Charlotte; Lund, Crick; Komproe, Ivan H

    2015-01-01

    Globally mental health problems are a serious public health concern. Currently four out of five people with severe mental illness in Low and Middle Income Countries (LMIC) receive no effective treatment. There is an urgent need to address this enormous treatment gap. Changing the focus of specialist mental health workers (psychiatrists and psychologists) from only service delivery to also designing and managing mental health services; building clinical capacity of the primary health care (PHC) workers, and providing supervision and quality assurance of mental health services may help in scaling up mental health services in LMICs. Little is known however, about the mental health policy and services context for these strategies in fragile-state settings, such as Nepal. A standard situation analysis tool was developed by the PRogramme for Improving Mental health carE (PRIME) consortium to systematically analyze and describe the current gaps in mental health care in Nepal, in order to inform the development of a district level mental health care plan (MHCP). It comprised six sections; general information (e.g. population, socio-economic conditions); mental health policies and plans; mental health treatment coverage; district health services; and community services. Data was obtained from secondary sources, including scientific publications, reports, project documents and hospital records. Mental health policy exists in Nepal, having been adopted in 1997, but implementation of the policy framework has yet to begin. In common with other LMICs, the budget allocated for mental health is minimal. Mental health services are concentrated in the big cities, with 0.22 psychiatrists and 0.06 psychologists per 100,000 population. The key challenges experienced in developing a district level MHCP included, overburdened health workers, lack of psychotropic medicines in the PHC, lack of mental health supervision in the existing system, and lack of a coordinating body in the Ministry

  16. Improving reproductive health in rural China through participatory planning.

    Science.gov (United States)

    Kaufman, Joan; Liu, Yunguo; Fang, Jing

    2012-01-01

    China's new health reform initiative aims to provide quality accessible health care to all, including remote rural populations, by 2020. Public health insurance coverage for the rural poor has increased, but rural women have fared worse because of lower status and lack of voice in shaping the services they need. Use of prenatal care, safe delivery and reproductive tract infections (RTIs) services is inadequate and service seeking for health problems remains lower for men. We present findings from a study of gender and health equity in rural China from 2002 to 2008 and offer recommendations from over a decade of applied research on reproductive health in rural China. Three studies, conducted in poor counties between 1994 and 2008, identified problems in access and pilot tested interventions and mechanisms to increase women's participation in health planning. They were done in conjunction with a World Bank programme and the global Gender and Health Equity Network (GHEN). Reproductive health service-seeking improved and the study interventions increased local government commitment to providing such services through new health insurance mechanisms. Findings from the studies were summarised into recommendations on gender and health for inclusion in new health reform efforts.

  17. White plan and crisis management. Help guide for the elaboration of extended white plans and of white plans for health establishments. Issue 2006, appendix to circular nr DHOS/CGR/2006/401 of 2006 September 14

    International Nuclear Information System (INIS)

    2006-01-01

    White plans are specific emergency plans to be implemented in public and private health establishments. While introducing necessary modifications and taking public health policy effects into account, this document first defines crises and their management (levels of intervention from the local to the national level, typology of emergency plans, emergency medical chain, extended white plans). The second part proposes a set of sheets which aim to be a support in the elaboration of the extended white plan and of the white plan. The third part, based on professional contributions and lessons learned, addresses two important issues: firstly, the crisis management exercise, and secondly the hospital under tension and white plan triggering thresholds

  18. The effect of administration family planning policy on maternal and child health.

    Science.gov (United States)

    Zabin, L S

    1983-09-01

    Several ideologies of the present Administration appear to converge as they impinge upon family planning--themes which are not restricted to reproductive health but which interact in ways particularly threatening to its achievements of the last decade. Most of these ideologies are clear, articulated objectives of the present government such as overall budget reduction and the return of budgetary control to the states. Others are responsive to the influence of the so called "moral mojority." Essentially, the federal government can affect family planning delivery through 4 different routes: through the allocation of funds; through specific legislation; and through regulation or organizational structure (areas in the hands of the executive branch alone). There have been recent and prime examples of all 4 routes, all directed at weakening the federal family planning program which has grown steadily stronger with bipartisan support in the last decades. Major sources of family planning support are reviewed in order to indicate the areas of change or of serious risk to the field. By retaining the categorical funding of Title 10 (half of the federal money in the family planning field has, for some years, come through Title 10 of the Public Health Service Act) in 1981, Congress reasserted the importance it places upon fertility regualtion against Administration pressure to block-grant. Despite an approximately 23% cut, this funding remains the single best hope for the field in these tight money times. In the language of the House Budget Committee report, Congress expressed its intention that an emphasis upon family planning be retained in the Maternal and Child Health block grant. It is no surprise that under the pressure of funding cuts that intention has not been honored. An upsurge in the use of Medicaid funding by family planning providers has increased the proportion of family planning funds from this source. In Title 20 of the Social Security Act (Social Services) it

  19. Public health communications for safe motherhood.

    Science.gov (United States)

    Kessel, E

    1994-03-30

    Public health communication aims to influence health practices of large populations, including maternal health care providers (traditional birth attendants, (TBAs), nurse-midwives, other indigenous practitioners, and physicians). A quality assurance process is needed to give public sector health providers feedback. Computerized record keeping is needing for quality assurance of maternal health programs. The Indian Rural Medical Association has trained more than 20,000 rural indigenous practitioners in West Bengal. Training of TBAs is expensive and rarely successful. However, trained health professional leading group discussions of TBAs is successful at teaching them about correct maternity care. Health education messages integrated into popular songs and drama is a way to reach large illiterate audiences. Even though a few donor agencies and governments provide time and technical assistance to take advantage of the mass media as a means to communicate health messages, the private sector has most of the potential. Commercial advertisements pay for Video on Wheels, which, with 100 medium-sized trucks each fitted with a 100-inch screen, plays movies for rural citizens of India. They are exposed to public and family planning messages. Jain Satellite Television (JST) broadcasts 24 hours a day and plans to broadcast programs on development, health and family planning, women's issues, and continuing education for all health care providers (physicians, nurses, TBAs, community workers, and indigenous practitioners). JST and the International Federation for Family Health plan to telecast courses as part of an Open University of Health Sciences.

  20. Trying for Association Health Plans Again and Again and Again.

    Science.gov (United States)

    Kirkner, Richard Mark

    2017-07-01

    Business groups like the U.S. Chamber of Commerce and the National Federation of Independent Business endorse association health plans (AHPs) as a way to give employers more options beyond the strictures of the Affordable Care Act.

  1. 42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Health information technology implementation... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.338 Health information technology implementation advance planning document...

  2. Providing general and preconception health care to low income women in family planning settings: perception of providers and clients.

    Science.gov (United States)

    Bronstein, Janet M; Felix, Holly C; Bursac, Zoran; Stewart, M Kathryn; Foushee, H Russell; Klapow, Joshua

    2012-02-01

    This study examines both provider and client perceptions of the extent to which general health concerns are addressed in the context of publicly supported family planning care. A mail survey of family planning providers (n = 459) accepting Medicaid-covered clients in Arkansas and Alabama gathered data on reported actions and resource referral availability for ten categories of non-contraceptive health concerns. A telephone survey of recent family planning clients of these providers (n = 1991) gathered data on the presence of 16 health concerns and whether and how they were addressed by the family planning provider. Data were collected in 2006-2007. More than half (56%) of clients reported having one or more general health concerns. While 43% of those concerns had been discussed with the family planning providers, only 8% had been originally identified by these providers. Women with higher trust in physicians and usual sources of general health care were more likely to discuss their concerns. Of those concerns discussed, 39% were reportedly treated by the family planning provider. Similarly, over half of responding providers reported providing treatment for acute and chronic health conditions and counseling on health behaviors during family planning visits. Lack of familiarity with referral resources for uninsured clients was identified as a significant concern in the provision of care to these clients. Greater engagement by providers in identifying client health concerns and better integration of publicly supported family planning with other sources of health care for low income women could expand the existing potential for delivering preconception or general health care in these settings.

  3. Kent County Health Department: Using an Agency Strategic Plan to Drive Improvement.

    Science.gov (United States)

    Saari, Chelsey K

    The Kent County Health Department (KCHD) was accredited by the Public Health Accreditation Board (PHAB) in September 2014. Although Michigan has had a state-level accreditation process for local health departments since the late 1990s, the PHAB accreditation process presented a unique opportunity for KCHD to build on successes achieved through state accreditation and enhance performance in all areas of KCHD programs, services, and operations. PHAB's standards, measures, and peer-review process provided a standardized and structured way to identify meaningful opportunities for improvement and to plan and implement strategies for enhanced performance and established a platform for being recognized nationally as a high-performing local health department. The current case report highlights the way in which KCHD has developed and implemented its strategic plan to guide efforts aimed at addressing gaps identified through the accreditation process and to drive overall improvement within our agency.

  4. The coexistence of traditional medicine and biomedicine: A study with local health experts in two Brazilian regions.

    Science.gov (United States)

    Zank, Sofia; Hanazaki, Natalia

    2017-01-01

    This study investigated the combined use of traditional medicine and biomedicine by local experts in Chapada do Araripe communities (Ceará State) and maroon communities (Santa Catarina State), Brazil. The objective was to understand the perception of local health specialists regarding the number of healers, demand for healers and use of medicinal plants, and the dependence of different environments to obtain such plants. We also aimed to understand the role of medicinal plants to treat different categories of diseases and if there is a complementary use of medicinal plants and allopathic biomedicine, according to the context of each group. The research was conducted with local health specialists that answered structured interviews, created free lists and participated in guided tours to collect cited plants. Sixty-six local health specialists were identified in the Araripe communities and 22 specialists in the maroon communities. In the maroon communities, a greater number of specialists thought there was a decrease in the number and demand for healers, as well as the use of medicinal plants, due to changes in traditional livelihoods, since they are located in a region where the effects of the modernization were more intense. In the Chapada do Araripe communities the specialists knew more plants extracted from native vegetation, whereas in the maroon communities cultivated plants were better known, which may reflect the environmental conditions and the history of each region. Medicinal plants are preferred to treat simpler health problems that do not require medical care, such as gastrointestinal problems, general pain, flues and colds. The biomedicine is used principally for problems with blood pressure, general pains and endocrine and nutritional diseases. Even with the particularities of each region, in general the use of medicinal plants and biomedicines occurred in a complementary form in both regions; however, this coexistence may result from these different

  5. The coexistence of traditional medicine and biomedicine: A study with local health experts in two Brazilian regions

    Science.gov (United States)

    Zank, Sofia; Hanazaki, Natalia

    2017-01-01

    This study investigated the combined use of traditional medicine and biomedicine by local experts in Chapada do Araripe communities (Ceará State) and maroon communities (Santa Catarina State), Brazil. The objective was to understand the perception of local health specialists regarding the number of healers, demand for healers and use of medicinal plants, and the dependence of different environments to obtain such plants. We also aimed to understand the role of medicinal plants to treat different categories of diseases and if there is a complementary use of medicinal plants and allopathic biomedicine, according to the context of each group. The research was conducted with local health specialists that answered structured interviews, created free lists and participated in guided tours to collect cited plants. Sixty-six local health specialists were identified in the Araripe communities and 22 specialists in the maroon communities. In the maroon communities, a greater number of specialists thought there was a decrease in the number and demand for healers, as well as the use of medicinal plants, due to changes in traditional livelihoods, since they are located in a region where the effects of the modernization were more intense. In the Chapada do Araripe communities the specialists knew more plants extracted from native vegetation, whereas in the maroon communities cultivated plants were better known, which may reflect the environmental conditions and the history of each region. Medicinal plants are preferred to treat simpler health problems that do not require medical care, such as gastrointestinal problems, general pain, flues and colds. The biomedicine is used principally for problems with blood pressure, general pains and endocrine and nutritional diseases. Even with the particularities of each region, in general the use of medicinal plants and biomedicines occurred in a complementary form in both regions; however, this coexistence may result from these different

  6. Traditional medicine for the rich and knowledgeable

    DEFF Research Database (Denmark)

    Thorsen, Rikke Stamp; Pouliot, Mariéve

    2016-01-01

    Traditional medicine is commonly assumed to be a crucial health care option for poor households in developing countries. However, little research has been done in Asia to quantify the reliance on traditional medicine and its determinants. This research contributes to filling in this knowledge gap...... show that traditional medicine, and especially self-treatment with medicinal plants, prevail as treatment options in both rural and peri-urban populations. Contrarily to what is commonly assumed, high income is an important determinant of use of traditional medicine. Likewise, knowledge of medicinal...... plants, age, education, gender and illness chronicity were also significant determinants. The importance of self-treatment with medicinal plants should inform the development of health policy tailored to people’s treatment-seeking behaviour....

  7. 77 FR 72721 - Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes...

    Science.gov (United States)

    2012-12-06

    ... 1545-BK59 Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes... Patient Protection and Affordable Care Act on issuers of certain health insurance policies and plan... arrangements) or Rebecca L. Baxter at (202) 622-3970 (regarding health insurance policies). SUPPLEMENTARY...

  8. Four aspects of the scope and quality of family planning services in US publicly funded health centers: Results from a survey of health center administrators.

    Science.gov (United States)

    Carter, Marion W; Gavin, Loretta; Zapata, Lauren B; Bornstein, Marta; Mautone-Smith, Nancy; Moskosky, Susan B

    2016-10-01

    This study aims to describe aspects of the scope and quality of family planning services provided by US publicly funded health centers before the release of relevant federal recommendations. Using nationally representative survey data (N=1615), we describe four aspects of service delivery: family planning services provided, contraceptive methods provided onsite, written contraceptive counseling protocols and youth-friendly services. We created a count index for each issue and used multivariable ordered logistic regression to identify health center characteristics associated with scoring higher on each. Half of the sample received Title X funding and about a third each were a community health center or health department clinic. The vast majority reported frequently providing contraceptive services (89%) and STD services (87%) for women in the past 3 months. Service provision to males was substantially lower except for STD screening. A total of 63% and 48% of health centers provided hormonal IUDs and implants onsite in the past 3 months, respectively. Forty percent of health centers included all five recommended contraceptive counseling practices in written protocols. Of youth-friendly services, active promotion of confidential services was among the most commonly reported (83%); offering weekend/evening hours was among the least (42%). In multivariable analyses, receiving Title X funding, having larger volumes of family planning clients and being a Planned Parenthood clinic were associated with higher scores on most indices. Many services were consistent with the recommendations for providing quality family planning services, but there was room for improvement across domains and health centers types. As assessed in this paper, the scope and quality of these family planning services was relatively high, particularly among Planned Parenthood clinics and Title X-funded centers. However, results point to important areas for improvement. Future studies should assess

  9. 41 CFR 60-300.25 - Health insurance, life insurance and other benefit plans.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life... VETERANS, AND ARMED FORCES SERVICE MEDAL VETERANS Discrimination Prohibited § 60-300.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service company, health...

  10. 41 CFR 60-250.25 - Health insurance, life insurance and other benefit plans.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life... SEPARATED VETERANS, AND OTHER PROTECTED VETERANS Discrimination Prohibited § 60-250.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service company, health...

  11. Operating plan for the Office of International Health Programs

    International Nuclear Information System (INIS)

    1996-01-01

    In this report unified ideas are presented about what the Office of International Health Programs does, what the individual contributions are, and how the organization connects to the Department of Energy. The planning efforts have focused on the office's three areas of responsibility: Europe, Japan, and the Marshall Islands. Common to each technical program area are issues related to the following: health of populations exposed to radiation incidents and the associated medical aspects of exposure; dose reconstruction; training; and public involvement. Each of the program areas, its customers, and primary customer interests are described

  12. 77 FR 47573 - Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes...

    Science.gov (United States)

    2012-08-09

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Parts 40 and 46 [REG-136008-11] RIN 1545-BK59 Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes... on issuers of certain health insurance policies and plan sponsors of certain self-insured health...

  13. Obstructed labour: A public health problem in Sokoto, Nigeria

    Directory of Open Access Journals (Sweden)

    El Nwobodo

    2011-01-01

    Conclusion : Obstructed labour is relatively common in the health institution and is associated with higy maternal and perinatal mortality. Measures to reduce the its incidence will include health education of th% populace on the importance of prenatal care/ hospital delivery and utilization of available family planning services. In addition, the primary health care providers and traditional birth attendants should be educated on need for prompt referral of abnormal labour.

  14. Agricultural biodiversity as a link between traditional food systems and contemporary development, social integrity and ecological health.

    Science.gov (United States)

    Johns, Timothy; Powell, Bronwen; Maundu, Patrick; Eyzaguirre, Pablo B

    2013-11-01

    Traditional food systems offer a key link between the social and economic resilience of smallholder farmers and pastoralists and the sustainable food and nutrition security of global populations. This paper addresses issues related to socio-cultural diversity and the continuing complex engagement of traditional and modern communities with the plants and animals that sustain them. In light of some of the unhealthful consequences of the 'nutrition transition' to globalized modern diets, the authors define and propose a process for a more successful food system transition that balances agro-biodiversity and processed commodities to support diet diversity, health and social equity alongside sustainable economic growth. We review empirical research in support of practice and policy changes in agriculture, economic development and health domains as well as cross-sectoral and community-based innovation. High-value food crops within domestic and global value chains can be an entry point for smallholders' participation as contributors and beneficiaries of development, while sustainable small farms, as purveyors of environmental and public health services, diversify global options for long-term adaptation in the face of environmental uncertainty. © 2013 Society of Chemical Industry.

  15. Summarized Costs, Placement Of Quality Stars, And Other Online Displays Can Help Consumers Select High-Value Health Plans.

    Science.gov (United States)

    Greene, Jessica; Hibbard, Judith H; Sacks, Rebecca M

    2016-04-01

    Starting in 2017, all state and federal health insurance exchanges will present quality data on health plans in addition to cost information. We analyzed variations in the current design of information on state exchanges to identify presentation approaches that encourage consumers to take quality as well as cost into account when selecting a health plan. Using an online sample of 1,025 adults, we randomly assigned participants to view the same comparative information on health plans, displayed in different ways. We found that consumers were much more likely to select a high-value plan when cost information was summarized instead of detailed, when quality stars were displayed adjacent to cost information, when consumers understood that quality stars signified the quality of medical care, and when high-value plans were highlighted with a check mark or blue ribbon. These approaches, which were equally effective for participants with higher and lower numeracy, can inform the development of future displays of plan information in the exchanges. Project HOPE—The People-to-People Health Foundation, Inc.

  16. Population-based health promotion perspective for older driver safety: Conceptual framework to intervention plan

    Directory of Open Access Journals (Sweden)

    Sherrilene Classen

    2008-01-01

    Full Text Available Sherrilene Classen1,2, Ellen DS Lopez3, Sandra Winter2, Kezia D Awadzi4, Nita Ferree5, Cynthia W Garvan61Department of Occupational Therapy, College of Public Health and Health Professions (CPHHP, University of Florida (UF, Gainesville, FL, USA; 2PhD Program in Rehabilitation Science, CPHHP, UF Gainesville, FL, USA; 3Department of Behavioral Science and Community Health, CPHHP, UF, Gainesville, FL, USA; 4Department of Health Services Research, Management, and Policy, CPHHP, UF, Gainesville, FL, USA; 5Health Science Center Libraries, UF, Gainesville, FL, USA; 6Division of Biostatistics, College of Medicine, UF, Gainesville, FL, USAAbstract: The topic of motor vehicle crashes among the elderly is dynamic and multi-faceted requiring a comprehensive and synergistic approach to intervention planning. This approach must be based on the values of a given population as well as health statistics and asserted through community, organizational and policy strategies. An integrated summary of the predictors (quantitative research, and views (qualitative research of the older drivers and their stakeholders, does not currently exist. This study provided an explicit socio-ecological view explaining the interrelation of possible causative factors, an integrated summary of these causative factors, and empirical guidelines for developing public health interventions to promote older driver safety. Using a mixed methods approach, we were able to compare and integrate main findings from a national crash dataset with perspectives of stakeholders. We identified: 11 multi-causal factors for safe elderly driving; the importance of the environmental factors - previously underrated in the literature- interacting with behavioral and health factors; and the interrelatedness among many socio-ecological factors. For the first time, to our knowledge, we conceptualized the fundamental elements of a multi-causal health promotion plan, with measurable intermediate and long

  17. Impact of animal health and welfare planning on medicine use, herd health and production in European organic dairy farms

    DEFF Research Database (Denmark)

    Ivemeyer, S; Smolders, G; Brinkmann, J

    2012-01-01

    medicine use through animal health and welfare planning (AHWP). Medicine use (excluding complementary treatments such as homeopathic remedies) was assessed as the total number of treatments and as the number of treatments of various disease categories (udder, fertility, metabolism, locomotion and others...... acidosis and imbalanced energy supply, respectively. Calving interval was used as an indicator for fertility. Milk recording data and treatment data were retrospectively collected for a one year period before and after the first farm visit. Focus areas of animal health and welfare plans were either...

  18. Health and family planning services in Bangladesh: a study in inequality.

    Science.gov (United States)

    Gish, O

    1981-01-01

    The development of health and family planning services in Bangladesh is examined in the context of the country's political economy. Inequities of power, influence, opportunity, and the ownership and distribution of assets and income are seen to lie at the root of the "Bangladesh crisis." In this, the country is not unlike many others in the Third World, only more so. The internal and external pressures which have contributed to a coercive attitude toward the problem of too rapid population growth are discussed. The allocation of Bangladeshi health service resources is examined in terms of expenditure, manpower, and facilities; they are found to be both inequitably distributed and inefficiently applied. Some alternatives to present patterns of development are touched upon. It is concluded that despite the country's poverty, most people do not have to go without basic primary health care (including family planning), which can be afforded even by countries as economically impoverished as Bangladesh.

  19. Merging long range transportation planning with public health: a case study from Utah's Wasatch Front.

    Science.gov (United States)

    Burbidge, Shaunna K

    2010-01-01

    US transportation systems have been identified as a problem for public health, as they often encourage automobile transportation and discourage physical activity. This paper provides a case study examination of the Public Health Component of the Wasatch Front Regional Council's Regional Transportation Plan. This plan provides an example of what transportation planners at Utah's largest metropolitan planning organization (MPO) are doing to encourage physical activity through transportation. Existing active living research was used to guide recommendations using a process that included a comprehensive literature review and a review of existing state programs, advisory group and stakeholder meetings, and policy recommendations based on existing local conditions. Stakeholders from a diversity of background and interests came together with one common goal: to improve public health. Based on this collaborative process, nine policy approaches were specifically recommended for approval and integration in the Wasatch Front Regional Transportation Plan. By using current research as a guide and integrating a variety of interests, the Wasatch Front Regional Council is setting a new standard for a collaborative multi-modal focus in transportation planning, which can be replicated nationwide.

  20. Do not fear the supernatural! : the relevance of ritual plant use for traditional culture, nature conservation, and human health in western Africa

    NARCIS (Netherlands)

    Quiroz, D.

    2015-01-01

    Summary

    Plants still play an overriding role in African traditional medicine, as large sectors of the continent’s population prefer or considerably rely on herbal treatments as their primary source of health care. Traditional medicine, which is defined as the sum of

  1. Context-specific, evidence-based planning for scale-up of family planning services to increase progress to MDG 5: health systems research.

    Science.gov (United States)

    Byrne, Abbey; Morgan, Alison; Soto, Eliana Jimenez; Dettrick, Zoe

    2012-11-12

    Unmet need for family planning is responsible for 7.4 million disability-adjusted life years and 30% of the maternity-related disease burden. An estimated 35% of births are unintended and some 200 million couples state a desire to delay pregnancy or cease fertility but are not using contraception. Unmet need is higher among the poorest, lesser educated, rural residents and women under 19 years. The barriers to, and successful strategies for, satisfying all demand for modern contraceptives are heavily influenced by context. Successfully overcoming this to increase the uptake of family planning is estimated to reduce the risk of maternal death by up to 58% as well as contribute to poverty reduction, women's empowerment and educational, social and economic participation, national development and environmental protection. To strengthen health systems for delivery of context-specific, equity-focused reproductive, maternal, newborn and child health services (RMNCH), the Investment Case study was applied in the Asia-Pacific region. Staff of local and central government and non-government organisations analysed data indicative of health service delivery through a supply-demand oriented framework to identify constraints to RMNCH scale-up. Planners developed contextualised strategies and the projected coverage increases were modelled for estimates of marginal impact on maternal mortality and costs over a five year period. In Indonesia, Philippines and Nepal the constraints behind incomplete coverage of family planning services included: weaknesses in commodities logistic management; geographical inaccessibility; limitations in health worker skills and numbers; legislation; and religious and cultural ideologies. Planned activities included: streamlining supply systems; establishment of Community Health Teams for integrated RMNCH services; local recruitment of staff and refresher training; task-shifting; and follow-up cards. Modelling showed varying marginal impact and costs

  2. Context-specific, evidence-based planning for scale-up of family planning services to increase progress to MDG 5: health systems research

    Directory of Open Access Journals (Sweden)

    Byrne Abbey

    2012-11-01

    Full Text Available Abstract Background Unmet need for family planning is responsible for 7.4 million disability-adjusted life years and 30% of the maternity-related disease burden. An estimated 35% of births are unintended and some 200 million couples state a desire to delay pregnancy or cease fertility but are not using contraception. Unmet need is higher among the poorest, lesser educated, rural residents and women under 19 years. The barriers to, and successful strategies for, satisfying all demand for modern contraceptives are heavily influenced by context. Successfully overcoming this to increase the uptake of family planning is estimated to reduce the risk of maternal death by up to 58% as well as contribute to poverty reduction, women’s empowerment and educational, social and economic participation, national development and environmental protection. Methods To strengthen health systems for delivery of context-specific, equity-focused reproductive, maternal, newborn and child health services (RMNCH, the Investment Case study was applied in the Asia-Pacific region. Staff of local and central government and non-government organisations analysed data indicative of health service delivery through a supply–demand oriented framework to identify constraints to RMNCH scale-up. Planners developed contextualised strategies and the projected coverage increases were modelled for estimates of marginal impact on maternal mortality and costs over a five year period. Results In Indonesia, Philippines and Nepal the constraints behind incomplete coverage of family planning services included: weaknesses in commodities logistic management; geographical inaccessibility; limitations in health worker skills and numbers; legislation; and religious and cultural ideologies. Planned activities included: streamlining supply systems; establishment of Community Health Teams for integrated RMNCH services; local recruitment of staff and refresher training; task-shifting; and follow

  3. Market characteristics and awareness of managed care options among elderly beneficiaries enrolled in traditional Medicare.

    Science.gov (United States)

    Mittler, Jessica N; Landon, Bruce E; Zaslavsky, Alan M; Cleary, Paul D

    2011-10-14

    Medicare beneficiaries' awareness of Medicare managed care plans is critical for realizing the potential benefits of coverage choices. To assess the relationships of the number of Medicare risk plans, managed care penetration, and stability of plans in an area with traditional Medicare beneficiaries' awareness of the program. Cross-sectional analysis of Medicare Current Beneficiary Survey data about beneficiaries' awareness and knowledge of Medicare managed care plan availability. Logistic regression models used to assess the relationships between awareness and market characteristics. Traditional Medicare beneficiaries (n = 3,597) who had never been enrolled in Medicare managed care, but had at least one plan available in their area in 2002, and excluding beneficiaries under 65, receiving Medicaid, or with end stage renal disease. Traditional Medicare beneficiaries' knowledge of Medicare managed care plans in general and in their area. Having more Medicare risk plans available was significantly associated with greater awareness, and having an intermediate number of plans (2-4) was significantly associated with more accurate knowledge of Medicare risk plan availability than was having fewer or more plans. Medicare may have more success engaging consumers in choice and capturing the benefits of plan competition by more actively selecting and managing the plan choice set. Public Domain.

  4. Tobacco Surcharges on 2015 Health Insurance Plans Sold in Federally Facilitated Marketplaces: Variations by Age and Geography and Implications for Health Equity.

    Science.gov (United States)

    Liber, Alex C; Drope, Jeffrey M; Graetz, Ilana; Waters, Teresa M; Kaplan, Cameron M

    2015-11-01

    In 2014, few health insurance plans sold in the Affordable Care Act's Federally Facilitated Marketplaces had age-dependent tobacco surcharges, possibly because of a system glitch. The 2015 tobacco surcharges show wide variation, with more plans implementing tobacco surcharges that increase with age. This underscores concerns that older tobacco users will find postsubsidy health insurance premiums difficult to afford. Future monitoring of enrollment will determine whether tobacco surcharges cause adverse selection by dissuading tobacco users, particularly older users, from buying health insurance.

  5. Marketing a managed care plan: achieving product differentiation.

    Science.gov (United States)

    Romeo, N C

    1996-01-01

    The health care marketplace is changing dramatically, even without federal reform measures. This is a volatile, yet promising, time to market a managed care plan. Before marketing the product, it is critical that the competition is thoroughly evaluated and consumer and employer needs are researched. The final product should be distinguishable from the competition and address market needs. Promotion can then begin, utilizing a proactive public relations and advertising campaign in addition to traditional methods of marketing.

  6. Self-esteem, stress and self-rated health in family planning clinic patients

    Directory of Open Access Journals (Sweden)

    Young Rodney

    2004-06-01

    Full Text Available Abstract Background The independent effects of stress on the health of primary care patients might be different for different types of clinic populations. This study examines these relationships in a low-income female population of patients attending a family planning clinic. Methods This study investigated the relevance of different sources of personal stress and social support to self-rated health, adjusting for mental health, health behavior and demographic characteristics of subjects. Five hundred women who attended family planning clinics were surveyed and 345 completed the form for a response rate of 72 percent. Results Multiple logistic regression analysis revealed that liking oneself was related to good self-rated health (Odds ratio = 7.11, but stress or support from children, parents, friends, churches or spouses were not significant. White non-Hispanic and non-white non-Hispanic respondents had lower odds of reporting good self-rated health than Hispanic respondents (odds ratios were 2.87 and 2.81, respectively. Exercising five or more days per week also was related to good self-rated health. Smoking 20 or more cigarettes per day, and obese III were negatively related to good self-rated health (odds ratios were .19 and .22, respectively with corresponding p-values equal to .0043 and .0332. Conclusions Among younger low-income women, addressing low self-esteem might improve health status.

  7. Health, healthcare access, and use of traditional versus modern medicine in remote Peruvian Amazon communities: a descriptive study of knowledge, attitudes, and practices.

    Science.gov (United States)

    Williamson, Jonathan; Ramirez, Ronald; Wingfield, Tom

    2015-04-01

    There is an urgent need for healthcare research, funding, and infrastructure in the Peruvian Amazon. We performed a descriptive study of health, health knowledge and practice, and healthcare access of 13 remote communities of the Manatí and Amazon Rivers in northeastern Peru. Eighty-five adults attending a medical boat service were interviewed to collect data on socioeconomic position, health, diagnosed illnesses, pain, healthcare access, and traditional versus modern medicine use. In this setting, poverty and gender inequality were prevalent, and healthcare access was limited by long distances to the health post and long waiting times. There was a high burden of reported pain (mainly head and musculoskeletal) and chronic non-communicable diseases, such as hypertension (19%). Nearly all participants felt that they did not completely understand their diagnosed illnesses and wanted to know more. Participants preferred modern over traditional medicine, predominantly because of mistrust or lack of belief in traditional medicine. Our findings provide novel evidence concerning transitional health beliefs, hidden pain, and chronic non-communicable disease prevalence in marginalized communities of the Peruvian Amazon. Healthcare provision was limited by a breach between health education, knowledge, and access. Additional participatory research with similar rural populations is required to inform regional healthcare policy and decision-making. © The American Society of Tropical Medicine and Hygiene.

  8. Intelligence in Construction between Contemporary and Traditional Architecture

    Directory of Open Access Journals (Sweden)

    Khalid abdul wahab

    2016-10-01

    Full Text Available The authentic traditional architecture proved that it is very convenient to the environmental and social regulations where it appeared and lasted for hundred of years. This traditional architecture got the intelligence in providing thermal comfort for their occupants by the intelligent usage of the building materials and the intelligent planning and designs which took in consideration the climatic condition and the aerodynamics of the whole city as one ecological system starting from the cold breeze passing through its narrow streets till it enters the dwelling units and glides out through the wind catchers. This architecture had been neglected and replaced by modern imported architecture which had collapsed within few decades not in our region only but all over the world. Now a days the increasing awareness of the global environmental crisis the green or sustainable architecture appeared as a new type of architecture by the eighties of the last century. Today these types of buildings began to enter Arab countries in general and Arabian Gulf countries especially like Masdar city, where smart building can be seen with inelegant treatments which will replace the modern high rise towers with its glass facades. This will lead to the general research problem which concerns the shortage of knowledge about the inelegance in design and planning used in the traditional architecture, and the special research problem concerning the shortage of knowledge concerning the ability to use the inelegant traditional architectural and planning concepts as a base for the future sustainable modern buildings and cites as the aim of this research.

  9. Traditional Postpartum Practices Among Malaysian Mothers: A Review.

    Science.gov (United States)

    Fadzil, Fariza; Shamsuddin, Khadijah; Wan Puteh, Sharifa Ezat

    2016-07-01

    To briefly describe the postpartum practices among the three major ethnic groups in Malaysia and to identify commonalities in their traditional postpartum beliefs and practices. This narrative review collated information on traditional postpartum practices among Malaysian mothers through a literature search for published research papers on traditional postpartum practices in Malaysia. This review shows that Malaysian mothers have certain postpartum practices that they considered to be important for preventing future ill health. Despite the perceived differences in intra-ethnic postpartum practices, most Malaysian mothers, although from different ethnicities, share similarities in their postpartum regimens and practices in terms of beliefs and adherence to food taboos, use of traditional postpartum massage and traditional herbs, and acknowledgment of the role of older female family members in postpartum care. Health care providers should be aware of multiethnic traditional postpartum practices and use the commonalities in these practices as part of their postpartum care regimen.

  10. Factors that negatively influence consumption of traditionally ...

    African Journals Online (AJOL)

    Factors that negatively influence consumption of traditionally fermented milk ... in various countries of sub-Saharan Africa and a number of health benefits to human ... influence consumption of Mursik, a traditionally fermented milk product from ...

  11. Planning and management for health in periods of economic stringency and instability: a contingency approach.

    Science.gov (United States)

    van der Werff, A

    1986-01-01

    The mid-1970s marked the end of the longest period of uninterrupted economic growth in history, and initiated in Europe--and other parts of the world--a period of economic stagnation and instability. Along with the prosperity explosion of the past, the pattern of health problems has changed and is still changing. Moreover, the demand for health care has kept on rising, without much improvement of health status in general. Thus, there is a critical need to rethink policies, and to ensure that future changes occur within the limits of shrinking resources and the allotted time-span. In particular, the change in priorities envisaged by the Health for All 2000 (HFA 2000) strategies will need to take place against the background of an ageing population, social instability, and continuing development of new lifestyles and persistent economic scarcity. It is by analysing that background that this article seeks to make recommendations as to how health planning and management might successfully cope with the policy reorientation of the HFA 2000 strategy. The structure of this article is as follows. Firstly, the changes taking place in planning conditions will be reviewed, and form the basis of a framework for subsequent analysis of the planning environment. Following this framework, some of the conflicts likely to be faced in planning and management will be discussed, many of which are the consequence of economic stringency and instability. Also the requirements for an improvement of the effectiveness and efficiency of planning will be identified. Finally, a limited number of approaches to planning will be considered, for their appropriateness to the present-day economic circumstances. The point of view elucidated throughout is that there is no single solution which is 'best' under all circumstances. The conclusion, rather, is that the selection of particular theory or method of planning and management should depend both on the objectives of the decision maker and on the

  12. SALUD: A spatial microsimulation application to support regional health planning in Austria

    OpenAIRE

    Tomintz, Melanie N.; Kosar, B.; Garcia-Barrios, Victor M.

    2013-01-01

    The Austrian Federal Ministry of Health aims to improve the health of all people living in Austria and to decrease health and social inequalities. This leads to a careful planning and distribution of the available health care resources to meet government aims. The research project SALUD, funded by the Federal Ministry for Transport, Innovation and Technology and the Austrian Science Fund, focuses on building a Spatial Microsimulation Model for Austria by combining survey and census data to mo...

  13. Use of a radiation therapy treatment planning computer in a hospital health physics program

    International Nuclear Information System (INIS)

    Addison, S.J.

    1984-01-01

    An onsite treatment planning computer has become state of the art in the care of radiation therapy patients, but in most installations the computer is used for therapy planning a diminutive amount of the day. At St. Mary's Hospital, arrangements have been negotiated for part time use of the treatment planning computer for health physics purposes. Computerized Medical Systems, Inc. (CMS) produces the Modulex radiotherapy planning system which is programmed in MUMPS, a user oriented language specially adapted for handling text string information. St. Mary's Hospital's CMS computer has currently been programmed to assist in data collection and write-up of diagnostic x-ray surveys, meter calibrations, and wipe/leak tests. The computer is setup to provide timely reminders of tests and surveys, and billing for consultation work. Programs are currently being developed for radionuclide inventories. Use of a therapy planning computer for health physics purposes can enhance the radiation safety program and provide additional grounds for the acquisition of such a computer system

  14. Implementing primary health care: some problems of creating national programmes.

    Science.gov (United States)

    Vaughan, J P; Walt, G

    1984-07-01

    While there is a great deal of agreement about the principles underlying Primary Health Care (PHC), there exist many problems, political, planning and management, involved in putting the approach into effect. Some of these difficulties are discussed. It is clear that the PHC approach is essentially political; the way it is implemented in each country will reflect the political priorities and systems of that country. Moreover, ministries of health are not known for their strong position in the ministerial pecking order. Finance and planning ministeries would have to be won over to the importance of the concept of PHC to try to eexpand the health budget and to change the emphasis of existing resource allocation patterns. Costs incurred by a PHC approach ( e.g., expensive transport and communication systems), and resources needed to finance it may be available; however, they may not be channelled to the politically less articulate groups in rural areas. Political implications are not limited to national levels; considerable conflict may exist between different status groups and classes at the village level, thus sabotaging PHC plans. Professional politics will also be played at all levels. It is equally essential to recognize the historical context in which PHC is being introduced. Many countries have inherited colonial infrastructures. Changing the values, perceptions, expectations, administration and organization that accompany such systems is extremely hard, and to put PHC into effect demands radical changes. The planning difficulties which beset PHC are related to the still large private provision of social services like health, and to a flourishing traditional private sector in many developing countries. These may limit the implementation of a national health policy and PHC may thus result in a very patchy service throughout the country. The level of centralized planning will also affect resource allocation and therefore the policy, planning and implementation

  15. Cyber and traditional bullying victimization as a risk factor for mental health problems and suicidal ideation in adolescents

    NARCIS (Netherlands)

    R. Bannink (Rienke); S.M.L. Broeren (Suzanne); P.M. van de Looij-Jansen (Petra); F. de Waart (Frouwkje); H. Raat (Hein)

    2014-01-01

    textabstractPurpose: To examine whether traditional and cyber bullying victimization were associated with adolescent's mental health problems and suicidal ideation at two-year follow-up. Gender differences were explored to determine whether bullying affects boys and girls differently. Methods: A

  16. Internal marketing within a health care organization: developing an implementation plan.

    Science.gov (United States)

    Hallums, A

    1994-05-01

    This paper discusses how the concept of internal marketing can be applied within a health care organization. In order to achieve a market orientation an organization must identify the needs and wants of its customers and how these may change in the future. In order to achieve this, internal marketing is a necessary step to the implementation of the organizations marketing strategy. An outline plan for the introduction of an internal marketing programme within an acute hospital trust is proposed. The plan identifies those individuals and departments who should be involved in the planning and implementation of the programme. The benefits of internal marketing to the Trust are also considered.

  17. Noodles, traditionally and today

    Directory of Open Access Journals (Sweden)

    Na Zhang

    2016-09-01

    Full Text Available Chinese noodles originated in the Han dynasty, which has more than 4,000 years of history. There are many stories about the origin of noodles. To a certain extent, noodles also reflect the cultural traditions and customs of China, which essentially means “human nature” and “worldly common sense”. There are thousands of varieties of noodles in China, according to the classification of the shape of noodles, seasoning gravy, cooking craft, and so on. Many noodles have local characteristics. Noodles are accepted by people from all over the world. The industrial revolution and the development of the food industry realized the transition from a traditional handicraft industry to mass production using machinery. In addition, the invention of instant noodles and their mass production also greatly changed the noodle industry. In essence, noodles are a kind of cereal food, which is the main body of the traditional Chinese diet. It is the main source of energy for Chinese people and the most economical energy food. Adhering to the principle of “making cereal food the main food”, is to maintain our Chinese good diet tradition, which can avoid the disadvantages of a high energy, high fat, and low carbohydrate diet, and promote health. The importance of the status of noodles in the dietary structure of residents in our country and the health impact should not be ignored.

  18. [Local health promotion plans: intersetoralities created in the territory].

    Science.gov (United States)

    Moysés, Simone Tetu; Franco de Sá, Ronice

    2014-11-01

    The article highlights the importance of considering the specificities of spaces/territories/ locations of individual and collective life in creating health promotion actions. It explores how this approach has conceptually consolidated respect for territoriality and territorial actions as a principle and an operational health promotion strategy. Based on the literature, the article also points to the need to envision the territory occupied as a locus to put intersetorialities into practice, giving a voice to people who live there, seek to and solve their complex problems, to existing and emerging social networks. It also presents a nationally and internationally validated strategy/method (Bamboo Method) for the development of local health promotion plans, which enables the prioritization of actions by listening to the people and to the managers.

  19. Local health care expenditure plans and their opportunity costs.

    Science.gov (United States)

    Karlsberg Schaffer, Sarah; Sussex, Jon; Devlin, Nancy; Walker, Andrew

    2015-09-01

    In the UK, approval decisions by Health Technology Assessment bodies are made using a cost per quality-adjusted life year (QALY) threshold, the value of which is based on little empirical evidence. We test the feasibility of estimating the "true" value of the threshold in NHS Scotland using information on marginal services (those planned to receive significant (dis)investment). We also explore how the NHS makes spending decisions and the role of cost per QALY evidence in this process. We identify marginal services using NHS Board-level responses to the 2012/13 Budget Scrutiny issued by the Scottish Government, supplemented with information on prioritisation processes derived from interviews with Finance Directors. We search the literature for cost-effectiveness evidence relating to marginal services. The cost-effectiveness estimates of marginal services vary hugely and thus it was not possible to obtain a reliable estimate of the threshold. This is unsurprising given the finding that cost-effectiveness evidence is rarely used to justify expenditure plans, which are driven by a range of other factors. Our results highlight the differences in objectives between HTA bodies and local health service decision makers. We also demonstrate that, even if it were desirable, the use of cost-effectiveness evidence at local level would be highly challenging without extensive investment in health economics resources. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. Healthy, wealthy, and wise: retirement planning predicts employee health improvements.

    Science.gov (United States)

    Gubler, Timothy; Pierce, Lamar

    2014-09-01

    Are poor physical and financial health driven by the same underlying psychological factors? We found that the decision to contribute to a 401(k) retirement plan predicted whether an individual acted to correct poor physical-health indicators revealed during an employer-sponsored health examination. Using this examination as a quasi-exogenous shock to employees' personal-health knowledge, we examined which employees were more likely to improve their health, controlling for differences in initial health, demographics, job type, and income. We found that existing retirement-contribution patterns and future health improvements were highly correlated. Employees who saved for the future by contributing to a 401(k) showed improvements in their abnormal blood-test results and health behaviors approximately 27% more often than noncontributors did. These findings are consistent with an underlying individual time-discounting trait that is both difficult to change and domain interdependent, and that predicts long-term individual behaviors in multiple dimensions. © The Author(s) 2014.

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