Health Services and Infrastructure Recovery of a Major Public Hospital in Liberia During the 2014–2016 Ebola Epidemic

2018 ◽  
Vol 13 (4) ◽  
pp. 767-773
Author(s):  
Paul Ochieng Ndede ◽  
Jude Kimbowa Senkungu ◽  
John K. Shakpeh ◽  
Theresa E. Jones ◽  
Rebecca Sky ◽  
...  

ABSTRACTDuring the 2014–2016 Ebola outbreak, health services in Liberia collapsed. Health care facilities could not support effective infection prevention and control (IPC) practices to prevent Ebola virus disease (EVD) transmission necessitating their closure. This report describes the process by which health services and infrastructure were recovered in the public hospital in Monrovia, Liberia. The authors conducted an assessment of the existing capacity for health care provision, including qualitative interviews with community members, record reviews in Ebola treatment units, and phone calls to health facilities. Assessment information was used to determine necessary actions to re-establish services, including building and environmental renovations, acquiring IPC supplies, changing health care practices, hiring additional staff, developing and using an EVD screening tool, and implementing psychosocial supports. On-site monitoring was continued for 2 years to assess what changes were sustained. Described in the report are 2 cases that highlight the challenge of safely re-establishing services with only a symptom-based screening tool and no laboratory tests available on-site. Despite fears among the public, health workers, and the international community, the actions taken enabled basic health care services to be provided during EVD transmission and led to sustainable improvements. This experience suggests that providing routine medical needs helps limit the morbidity and mortality during times of disease outbreak. (Disaster Med Public Health Preparedness. 2018;13:767–773)

Author(s):  
T.H. Tulchinsky ◽  
Yakov Adler

AbstractFollowing the June 1982 war in South Lebanon, the Israel Ministry of Health sent a medical team to assess health conditions in the area, to assist in the restoration of local health services, and to provide additional medical assistance as needed in public health and specialized medical services. For the approximately 600,000 population of the area, public health sanitary conditions were restored by local authorities, with some external assistance. Sanitation and housing for the refugee camp populations were difficult to solve because of extensive damage in the camps; but United Nations activities, supported by international and Israeli sources, were effective. Epidemic conditions did not occur. Monitoring for specific infectious diseases showed increases not exceeding usual summer conditions. Child nutrition status was satisfactory. Medical needs for specialty services, not available in South Lebanon, were arranged through screening and referral to Israeli hospitals. Renal dialysis needs were met by establishing a dialysis unit using local personnel in a damaged and non-functioning government hospital. Private medical and hospital services, the bulk of health care in the area, functioned except for minor dislocations throughout the war and post-war period. Israeli medical aid, managed by a small multidisciplinary team, was designed to assist and, where necessary, augment rather than replace local health services.


2012 ◽  
Vol 20 (3) ◽  
pp. 453-461 ◽  
Author(s):  
Beatriz Rosana Gonçalves de Oliveira ◽  
Neusa Collet ◽  
Débora Falleiros de Mello ◽  
Regina Aparecida Garcia de Lima

This study's purpose was to identify the therapeutic journey of families seeking health care for their children with respiratory diseases. This qualitative study had the participation of parents of children younger than five years old who were hospitalized with respiratory diseases. Path mapping was used as an instrument to collect data, which was analyzed through thematic analysis. The findings indicate that families sought the health services as soon as they perceived symptoms and had access to medical care, however such care was not decisive in resolving their health issues. Even though the families returned to the service at least another three times, the children had to be hospitalized. The attributes of primary health care were not observed in the public health services, while therapeutic encounters had no practical success.


2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ngoako Solomon Marutha ◽  
Olefhile Mosweu

Purpose This study sought to investigate a framework for ensuring the confidentiality and security of information at the public health-care facilities to curb HIV/AIDS trauma among patients in Africa. In most instances, trauma to HIV/AIDS patients accelerate because of their personal information relating to the state of illness leaks to public people. Design/methodology/approach This qualitative study used literature to study confidentiality and security of information at the public health-care facilities to curb HIV/AIDS trauma among patients in Africa. Findings The study revealed that confidentiality and security of information has been neglected, in most instances, at the health-care facilities, and this has, to some extent, affected HIV/AIDS patients negatively, leading to trauma, stigma and skipping of treatment by patients resulting in accelerated mortality among chronic patients. The study recommends that patients’ information be always strictly controlled and kept confidential and secured at all the times, especially that of HIV/AIDS patients. Practical implications The proposed framework can be used by health-care facilities to guide the management and promotion of the confidentiality and security of information in the public health-care facilities to curb additional trauma to HIV/AIDS patients in the context of Africa, and even beyond. Originality/value The study provides a framework to ensure the confidentiality and security of information at the public health-care facilities to curb additional trauma to HIV/AIDS patients.


2012 ◽  
Vol 17 (1) ◽  
Author(s):  
Gavin George ◽  
Timothy Quinlan ◽  
Candice Reardon ◽  
Jean-François Aguilera

This review showed that thinking about the shortage of health care personnel merely in terms of insufficient numbers prevents sound strategic interventions to solve the country’s human resources for health (HRH) problem. It revealed that the numbers shortage was one facet of a broader problem that included the mal distribution of HRH, production of the wrong skills in the nursing care, the attrition of staff from the public health services and, contextually, the ever-changing demands on the health services. The challenge in South Africa was furthermore to train and retain health care personnel with skills and expertise that are commensurate with the changing demands on the public health services.Uit hierdie oorsig het dit duidelik geblyk dat die tekort van gesondheidsorgpersoneel slegs in terme van ontoereikende getalle val en ’n omvattende strategiese ingryping om die land se menslike gesondheidshulpbron krisis op te los, belemmer. Dit het aangedui dat die getalletekort  maar slegs een fasset van ’n groter probleem uitmaak, wat onder andere die volgende insluit: die oneweredige verspeiding van menslike gesondheidshulpbronne, ’n fokus op ontoepaslike vaardighede in die opleiding van verpleegpersoneel, die behoud van personeel in die openbare gesondheidsektor, asook die konstant-veranderlike eise van die gesondheidsdienste. Verder was die uitdaging in Suid Afrika die opleiding en behoud van gesondheidsorgpersoneel met kennis en vaardighede wat tred hou met die veranderlike eise van die openbare gesondheidsdienste.


2018 ◽  
Vol 18 (3) ◽  
pp. 522
Author(s):  
Ratu Kusuma

Safe childbirth is childbirth that helped by health personnel in health care facilities. Coverage of childbirth in health care facilities in Jambi province did not reach strategic plan target yet (77.00%), achievement (63.03%), Jambi city (93.86%) and the public health center did not reach target province yet (90%) that is the public health center Talang Bakung (79.00%) and Pal Merah II (78.00%). This study aimed to determine the correlation of knowledge and postpartum mothers attitude about childbirth in health care facilities with a selection of helping in childbirth at the public health center Talang Bakung. This is an analytic descriptive research; with total populations were 32 postpartum mothers, it used total sampling technique. Instrument test was conducted at the public health center Pal Merah II toward 10 postpartum mothers; an instrument used demographic data instrument, knowledge instrument, attitude instrument, and selection of helping in childbirth instrument, with fisher exact test and contingency coefficient. The findings indicated that there is no significant correlation between knowledge and attitudes of childbirth in healthcare facilities with a selection of helping in childbirth with each score p is (p=0.444 p=1.000), contingency coefficient (p=0.399, p=1.000). It is concluded that knowledge and attitude of the postpartum mother about childbirth in healthcare facilities did not affect in a selection of childbirth place chosen by the mother. For the next researcher to research about childbirth in healthcare facilities with the different method.


1994 ◽  
Vol 24 (3) ◽  
pp. 535-548 ◽  
Author(s):  
Sally Guttmacher

The single known instance of transmission of HIV from a health care provider to a patient raised issues concerning the responsibility of clinicians to their patients, and sparked debate over policies to prevent the spread of HIV in health care facilities. The intensity and politicization of the debate were reflected in revision of the Centers for Disease Control guidelines to control the spread of infection at health care facilities, and in legislation proposed in Congress. The guidelines and proposed legislation provoked responses by public health and medical organizations, several of which considered the measures to be unnecessarily restrictive and too costly in terms of potential benefits. This article describes the events and responses that took place during 1991–1992 after the public was made aware of the case involving transmission from provider to patient. The author examines the situation in the context of public health efforts to control the spread of HIV.


2021 ◽  
Author(s):  
◽  
Adella Campbell

<p>The negative impact of user fees on the utilisation of the health services by the poor in developing countries such as Uganda and Jamaica is well documented. Therefore, various governments have been engaged in reforming public health systems to increase access by underserved populations. One such reform is the introduction of free health services. In Jamaica, user fees were abolished in the public health sector in 2007 for children under 18 years and in 2008 free health care was introduced for all users of the public health system. This study evaluated the impact of the 2008 reform on the Jamaican public health system at 1) the national level, 2) the provider level, and 3) the user level. Perspectives were sought on access to care, the care provided, and the work of the professional nurse. Participants were selected from the Ministry of Health (MOH), the four Regional Health Authorities (RHAs), and urban and rural health facilities. Data collection was done during March – August 2010, using a multi-layered mixed methods evaluation approach, incorporating both qualitative and quantitative methods. Methods included individual interviews with key policymakers (eight) at the MOH and the four RHAs, as well as a senior medical officer of health (one) and pharmacists (three); focus groups with representatives of the main practitioners in the health system including nurses (six groups), pharmacists (one group) and doctors (two groups); document reviews of the MOH and RHAs‘ annual reports, and a survey of patients (200). Views on the impact of the abolition of user charges differed across the three levels and among the health authorities, facilities, and perspectives (policymakers, practitioners and users). Patient utilisation of the public health system increased exponentially immediately following the abolition of user fees, then declined, but remained above the pre-policy level. The work of health care providers, especially the professional nurse, was affected in that they had to provide the expected and required services to the patients despite an increase in workload and constraints such as inadequate resources. The research found that, while policymakers were optimistic about the policy, providers had concerns but patients were satisfied with the increased access and the quality care they were now receiving. Users also encountered challenges that constituted barriers to access. In addition to providing further evidence about the abolition of user fees in the public health system, this research provides important new insights into the impact of the nationwide abolition of user fees, as well as the impact of the policy change on the work of the professional nurse. Equally, the findings highlighted the potential benefits, gaps, and failures of the abolition of user fees‘ policy, and will serve as a catalyst to improve the policy process regarding access to health services and the work of the professional nurse. The findings of this research will be valuable in the planning of health-related programmes for the consumers of health care in developing countries. Despite the need for further research in this area, this research has contributed to the body of knowledge regarding user fees and access to health care in developing countries.</p>


2021 ◽  
Author(s):  
◽  
Adella Campbell

<p>The negative impact of user fees on the utilisation of the health services by the poor in developing countries such as Uganda and Jamaica is well documented. Therefore, various governments have been engaged in reforming public health systems to increase access by underserved populations. One such reform is the introduction of free health services. In Jamaica, user fees were abolished in the public health sector in 2007 for children under 18 years and in 2008 free health care was introduced for all users of the public health system. This study evaluated the impact of the 2008 reform on the Jamaican public health system at 1) the national level, 2) the provider level, and 3) the user level. Perspectives were sought on access to care, the care provided, and the work of the professional nurse. Participants were selected from the Ministry of Health (MOH), the four Regional Health Authorities (RHAs), and urban and rural health facilities. Data collection was done during March – August 2010, using a multi-layered mixed methods evaluation approach, incorporating both qualitative and quantitative methods. Methods included individual interviews with key policymakers (eight) at the MOH and the four RHAs, as well as a senior medical officer of health (one) and pharmacists (three); focus groups with representatives of the main practitioners in the health system including nurses (six groups), pharmacists (one group) and doctors (two groups); document reviews of the MOH and RHAs‘ annual reports, and a survey of patients (200). Views on the impact of the abolition of user charges differed across the three levels and among the health authorities, facilities, and perspectives (policymakers, practitioners and users). Patient utilisation of the public health system increased exponentially immediately following the abolition of user fees, then declined, but remained above the pre-policy level. The work of health care providers, especially the professional nurse, was affected in that they had to provide the expected and required services to the patients despite an increase in workload and constraints such as inadequate resources. The research found that, while policymakers were optimistic about the policy, providers had concerns but patients were satisfied with the increased access and the quality care they were now receiving. Users also encountered challenges that constituted barriers to access. In addition to providing further evidence about the abolition of user fees in the public health system, this research provides important new insights into the impact of the nationwide abolition of user fees, as well as the impact of the policy change on the work of the professional nurse. Equally, the findings highlighted the potential benefits, gaps, and failures of the abolition of user fees‘ policy, and will serve as a catalyst to improve the policy process regarding access to health services and the work of the professional nurse. The findings of this research will be valuable in the planning of health-related programmes for the consumers of health care in developing countries. Despite the need for further research in this area, this research has contributed to the body of knowledge regarding user fees and access to health care in developing countries.</p>


2004 ◽  
Vol 1 (6) ◽  
pp. 6-8
Author(s):  
Wanda Langiewicz ◽  
Elzbieta Slupczynska-Kossobudzka

Changes in the Polish health care system, introduced by a Parliamentary Act in 1999, resulted from an urgent need for a more effective provision of health services, which were held in poor esteem by the public. Public expenditure on health care at the time of the reform was equivalent to 4.19% of gross national product, or US$363 at purchasing power parity (PPP) per capita. This amount was considerably lower than in the most developed countries (i.e. members of the Organisation for Economic Cooperation and Development, OECD). The reformers’ main modification consisted of replacing state financing of health services with insurance-based financing. Statutory health insurance covers 99.4% of Poland's 38.2 million citizens. The insurance fee is to be increased from 7.0% of personal income at the beginning of the reforms to 9.0% (at present it has reached 8.25%). The aim was also to achieve relatively stable health care expenditure, independent of the annual political budget allocation. A special administrator was appointed for the Sickness or National Health Fund and was authorised to contract for health services. These market-oriented developments were paralleled by the implementation of special programmes, financed from the Ministry of Health budget, which were aimed at restructuring health care facilities.


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