Accelerated fragility: exploring the supply–demand nexus in health facilities in rural Burkina Faso

Africa ◽  
2020 ◽  
Vol 90 (5) ◽  
pp. 934-951
Author(s):  
Helle Samuelsen
Keyword(s):  
Burkina Faso ◽  
Diagnostic Procedures ◽  
Healthcare Services ◽  
The State ◽  
Local Health ◽  
Health Seeking ◽  
Global Trends ◽  
Research Engagement ◽  
Global Pandemic ◽  
Political Turmoil

AbstractIn Burkina Faso, political turmoil, escalating insecurity and a looming pandemic challenge the population's trust in the state. This article contributes to the debates about state–citizen relationships in fragile countries by connecting local health-seeking practices with the global trends of datafication and a strong focus on the fight against malaria in this part of Africa. Drawing on long-term research engagement in Burkina Faso, I examine the health-seeking practices of rural citizens and look into diagnostic routines and reporting in two rural dispensaries. I show how the routinization of diagnostic procedures combined with a strong national and global political focus on the fight against malaria create what I term a ‘supply–demand nexus’ in which rural citizens selectively ask for the health services that they know the system can supply. I argue that the routinized diagnostic practices that mainly focus on malaria serve as a ‘technology of invisibility’ by not capturing other important diseases among the rural population. Finally, I ask whether the limited healthcare services in the current context of political insecurity, instability and a global pandemic spur a process of further fragilization of the social contract between rural citizens and the state.

scholarly journals Standard Survey Data: Insights Into Private Sector Utilization

2021 ◽  
Vol 8 ◽  
Author(s):  
Dominic Montagu ◽  
Nirali Chakraborty
Keyword(s):  
Private Sector ◽  
Inpatient Care ◽  
Healthcare Services ◽  
Health Coverage ◽  
Outpatient Services ◽  
Health Seeking ◽  
Data Set ◽  
Middle Income ◽  
Global Trends ◽  
Private Care

Universal Health Coverage in Low- and Middle-Income Countries is increasingly expanding through incorporation of private clinics, pharmacies, and hospitals into an overall health system funded in whole or part through government-managed health insurance. This underscores the importance of policies on health provision which apply across the whole delivery system regardless of ownership status. To advance understanding of private-sector policies, and to facilitate sharing of lessons across countries with similar public-private distributions, we have analyzed data on the source of inpatient and outpatient care from 65 countries. While past studies have conducted similar analysis, ours advances the field in two ways. First, we limit our analysis to data sets from 2010 through 2019, making our study more up-to-date than past studies, while changing health seeking patterns for maternal health since 2010 means that our data set is more representative of overall inpatient care. Second, while past multi-country analysis of public-private ownership have been based on the Demographic Health Surveys, we have added to this data from the Multiple Indicator Cluster Surveys, significantly increasing the countries in our analysis. We have aggregated our analysis by WHO's regions. Outside of the EURO region, where the private sector delivers just 4% of all healthcare services, the private sector remains significant, and in many countries represents more than half of all care. The private sector provides nearly 40% of all healthcare in PAHO, AFRO, and WPRO regions, 57% in SEARO, and 62% in EMRO. While specific countries with two recent surveys show variation in the scale of both inpatient and outpatient private provision, we did not find regional or global trends toward or away from private care within LMICs. Private inpatient care is most important for the wealthy in many countries; public vs. private care varies less, by wealth, for outpatient services.

State, religion and the marginalisation of traditional healing in Gwadar, Pakistan

2020 ◽  
Vol 46 (4) ◽  
pp. 444-453
Author(s):  
Shakir Ullah ◽  
He Guoqiang ◽  
Usman Khan ◽  
Komal Niazi
Keyword(s):  
Participant Observation ◽  
Healthcare Services ◽  
The State ◽  
Health Needs ◽  
Legal Consciousness ◽  
Fishing Community ◽  
Health Seeking ◽  
Negative Effects ◽  
State Laws ◽  
Traditional Health

This ethnographic encounter explores suppression and domination faced by traditional health seekers in Gwadar, Pakistan. The study aimed to provide an insight into the ways in which practicing traditional healthcare becomes a challenge when it conflicts with the assimilationist project of the state. Qualitative research methods, including in-depth interviews and participant observation, were used to collect data on the encounters of traditional health seekers with the state and dominant religion. The findings show that traditional health seeking behaviour was stereotyped as non-civilised and archaic by medical staff, and labelled as non-religious, and thus, suppressed by radical Islamist groups and other state apparatuses. This situation has further negative effects on the health of traditional health seekers as the national healthcare system does not efficiently provide the services required by this population. State laws, a general environment of fear, and threats have led this population to legal consciousness and contextual awareness; they have further adopted multiple resistance strategies to navigate and circumvent oppressive laws and domination in order to follow their traditional healthcare practices. This study suggests that national cosmopolitan healthcare services provided to the fishing community should be tailored to and not suppress the culturally specific health needs of that population. Members of the fishing community should not be compelled to abstain from their traditional healthcare and health-seeking behaviours; traditional healthcare practices should be merged with cosmopolitan ones in order to address the sociocultural issues and meet the health needs of this marginalised population.

scholarly journals Trend of COVID-19 cases and health sector response in Nepal

2020 ◽  
Vol 1 (1) ◽  
pp. 51-57
Author(s):  
Meghnath Dhimal ◽  
Tamanna Neupane ◽  
Samir Kumar Adhikari ◽  
Pradip Gyanwali
Keyword(s):  
Health Sector ◽  
Joint Effort ◽  
Virus Diseases ◽  
Public Places ◽  
Global Trends ◽  
Epidemic Curve ◽  
Global Pandemic ◽  
First Case ◽  
Government Documents ◽  
Isolation Facilities

We are facing global pandemic of novel corona virus diseases COVID-19 which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This paper is aimed to assess trend of COVID-19 cases and health sector response in Nepal. We reviewed WHO databases to observe the global trends and epidemiology of COVID-19 as well as daily situation updated reports of Health Emergency and Operation Centre (HEOC), guidelines, national and international government documents. The first case of COVID was reported in Nepal on 23 January 2020 and number of cases reached 454 on 21 May 2020. In order to address the increasing number of cases of COVID-19, Government of Nepal is adopting various preventive measures like extending lockdown period, setting up quarantine and isolation facilities, sealing borders, suspending flights, closing public places etc. There is need of joint effort by individuals, communities and government to prevent the further spread and flatten epidemic curve in Nepal.

scholarly journals Effects of terrorist attacks on access to maternal healthcare services: a national longitudinal study in Burkina Faso

2020 ◽  
Vol 5 (9) ◽  
pp. e002879
Author(s):  
Thomas Druetz ◽  
Lalique Browne ◽  
Frank Bicaba ◽  
Matthew Ian Mitchell ◽  
Abel Bicaba
Keyword(s):  
Antenatal Care ◽  
Burkina Faso ◽  
Negative Binomial ◽  
Terrorist Attack ◽  
Healthcare Services ◽  
Terrorist Attacks ◽  
Cesarean Sections ◽  
Maternal Healthcare ◽  
District Hospitals ◽  
The Impact

IntroductionMost of the literature on terrorist attacks’ health impacts has focused on direct victims rather than on distal consequences in the overall population. There is limited knowledge on how terrorist attacks can be detrimental to access to healthcare services. The objective of this study is to assess the impact of terrorist attacks on the utilisation of maternal healthcare services by examining the case of Burkina Faso.MethodsThis longitudinal quasi-experimental study uses multiple interrupted time series analysis. Utilisation of healthcare services data was extracted from the National Health Information System in Burkina Faso. Data span the period of January 2013–December 2018 and include all public primary healthcare centres and district hospitals. Terrorist attack data were extracted from the Armed Conflict Location and Event Data project. Negative binomial regression models were fitted with fixed effects to isolate the immediate and long-term effects of terrorist attacks on three outcomes (antenatal care visits, of facility deliveries and of cesarean sections).ResultsDuring the next month of an attack, the incidence of assisted deliveries in healthcare facilities is significantly reduced by 3.8% (95% CI 1.3 to 6.3). Multiple attacks have immediate effects more pronounced than single attacks. Longitudinal analysis show that the incremental number of terrorist attacks is associated with a decrease of the three outcomes. For every additional attack in a commune, the incidence of cesarean sections is reduced by 7.7% (95% CI 4.7 to 10.7) while, for assisted deliveries, it is reduced by 2.5% (95% CI 1.9 to 3.1) and, for antenatal care visits, by 1.8% (95% CI 1.2 to 2.5).ConclusionTerrorist attacks constitute a new barrier to access of maternal healthcare in Burkina Faso. The exponential increase in terrorist activities in West Africa is expected to have negative effects on maternal health in the entire region.

scholarly journals Assessment of health seeking behaviour and self-medication among general public in the state of Penang, Malaysia

2017 ◽  
Vol 15 (3) ◽  
pp. 991-991 ◽  
Author(s):  
Omar T. Dawood ◽  
Mohamed A. Hassali ◽  
Fahad Saleem ◽  
Inas R. Ibrahim ◽  
Aseel H. Abdulameer ◽  
...  
Keyword(s):  
General Public ◽  
The State ◽  
Health Seeking Behaviour ◽  
Health Seeking ◽  
Self Medication

Abstract 047: Using Geospatial Data To Eliminate Disparities In Covid-19 Testing

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Gregory W Heath ◽  
Tim Moreland ◽  
Shannon Stephenson ◽  
Jesse A Houser ◽  
Colleen Schmitt
Keyword(s):  
Community Health Centers ◽  
Effective Means ◽  
Age Distribution ◽  
Healthcare Services ◽  
Health Concern ◽  
Behavioral Risk ◽  
Local Health ◽  
Social Vulnerability Index ◽  
First Case ◽  
Black Residents

Introduction: The first case of COVID-19 in Chattanooga/Hamilton County, Tennessee (CHC) was identified on March 13, 2020. By early April, 51 RT-PCR confirmed cases were identified, with white, non-Hispanic males and females representing 82% (41/51) of positive cases and remaining cases representing black residents (18%; 9/51). That few people from racial/ethnic minorities were being tested became a key public health concern. We hypothesized that local mapping of health-related data would identify regions where individuals at greater risk for COVID-19 live and work and have limited access to testing and healthcare services. Methods: The CDC 500 Cities data was used to generate layered maps of prevalence estimates for cardiovascular disease, type 2 diabetes mellitus, chronic lung disease, and the behavioral risk factors of physical inactivity and obesity. Layers also included the CDC Social Vulnerability Index, age distribution, gender, race, ethnicity, and zip codes. Maps were shared with intersectoral collaborators representing the black and Hispanic/Latinx communities who provided specific neighborhood information to the maps. Collaborators included hospital systems, the local health department, community health centers, the private sector, and non-profit organizations. Maps were used to identify geographic sites for mobile and strategic testing within communities at higher risk for the spread of the coronavirus. Specific diverse neighborhoods along with worksites were then provided with testing beginning in early May and ongoing. Results: Strategic and mobile testing beginning in early May increased three-fold the number of identified new cases of COVID-19. Seventy percent (652/932) of these positive tests were among ethnically Hispanic/Latinx and 16% (149/932) among black residents. Positive tests continued to increase at a greater rate among Hispanic/Latinx and black residents compared with white residents through the months of May-July (68/10K vs. 2.6/10K, OR = 4.85, 95% CI 2.66, 9.02). Conclusions: This example of inter-sectoral collaboration, data sharing, and data use through strategic mapping of vulnerable populations for COVID-19 was an effective means to enhance COVID-19 testing and identification of positive cases throughout CHC. This expanded partnering resulting in targeted testing may be a useful approach among similar communities and subsequent outbreaks.

Assassination threatens to destabilise Haiti further

2021 ◽  
Keyword(s):  
Dominican Republic ◽  
Security Council ◽  
Prime Minister ◽  
Public Support ◽  
The State ◽  
Gang Violence ◽  
Content Type ◽  
Un Security Council ◽  
Political Turmoil

Significance The assassination follows months of political turmoil and rising gang violence and comes just weeks before elections, scheduled for September 26. Interim Prime Minister Claude Joseph, who has taken charge of the country, said yesterday that measures were being taken “to guarantee the continuity of the state and to protect the nation". Impacts Further political assassinations would exacerbate unrest. The Dominican Republic has closed its border, fearing a migrant surge; the situation will bolster public support there for a border wall. The UN Security Council meets today and may authorise emergency action in Haiti; any substantial redeployment, however, would take time.

scholarly journals Emerging challenges in the health systems of Kerala, India: qualitative analysis of literature reviews

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Manesh Muraleedharan ◽  
Alaka Omprakash Chandak
Keyword(s):  
Health Care ◽  
Health Economic ◽  
Health System ◽  
Health Systems ◽  
Significant Proportion ◽  
Vital Statistics ◽  
The State ◽  
Future Research ◽  
Health Seeking ◽  
Content Type

PurposeThe substantial increase in non-communicable diseases (NCDs) is considered a major threat to developing countries. According to various international organizations and researchers, Kerala is reputed to have the best health system in India. However, many economists and health-care experts have discussed the risks embedded in the asymmetrical developmental pattern of the state, considering its high health-care and human development index and low economic growth. This study, a scoping review, aims to explore four major health economic issues related to the Kerala health system.Design/methodology/approachA systematic review of the literature was performed using PRISMA to facilitate selection, sampling and analysis. Qualitative data were collected for thematic content analysis.FindingsChronic diseases in a significant proportion of the population, low compliance with emergency medical systems, high health-care costs and poor health insurance coverage were observed in the Kerala community.Research limitations/implicationsThe present study was undertaken to determine the scope for future research on Kerala's health system. Based on the study findings, a structured health economic survey is being conducted and is scheduled to be completed by 2021. In addition, the scope for future research on Kerala's health system includes: (1) research on pathways to address root causes of NCDs in the state, (2) determine socio-economic and health system factors that shape health-seeking behavior of the Kerala community, (3) evaluation of regional differences in health system performance within the state, (4) causes of high out-of-pocket expenditure within the state.Originality/valueGiven the internationally recognized standard of Kerala's vital statistics and health system, this review paper highlights some of the challenges encountered to elicit future research that contributes to the continuous development of health systems in Kerala.

scholarly journals Official Reporting of Religious Organizations as a Source of Empirical Data on the Activities of the Church: Some Questions of Theory and Practice of the Evangelical Lutheran Church of Sweden

2020 ◽  
pp. 135-145
Author(s):  
O. A. Balabeikina ◽  
N. M. Mezhevich ◽  
A. A. Iankovskaia
Keyword(s):  
Academic Research ◽  
Partial Solution ◽  
The State ◽  
Theory And Practice ◽  
Public Attention ◽  
Reference Case ◽  
Global Trends ◽  
The World ◽  
The Relationship ◽  
The Church

The relevance of any material offered to the scientific and expert community depends on many factors. Objectively, the presence of this or that issue in the center of public attention has a positive effect on the actualization of this or that article. However, there is an obvious danger. Academic approaches that accidentally find themselves in resonance with global trends can fall victim to political conjuncture. Relevance in this case can fall victim to the political moment. Moreover, this or that topic, being in the center of public discussion, negatively affects the academic understanding of the problem. All this fully relates to the question of the relationship between the state and the church in modern Europe and Russia.A few words about global trends. Their essence boils down to the growing confrontation between supporters of new ideological approaches and traditionalists, among whom are many adherents.The relationship between religion and the state testifies to the fact that states and societies have not yet learned to draw an effective line between their interests and those of adherents. This fact presupposes careful state and public participation in the affairs of the church. However, acknowledging this circumstance is not enough. The state must clearly know what, where and how is happening in the church sphere of the life of society in cases where church affairs can affect public and state security.It is also known that almost all the leading churches, to a greater or lesser extent, provide official reporting to the state. However, working with this reporting, its scientific analysis is not always representative.Objective. The presented article is aimed at a partial solution of the problem of increasing the effectiveness of academic research of the church` activities. Moreover, it is made based on official church statistics.The author’s position is the following. States and societies have no right to let go of this vital sphere of life. The functions of the state, in this case, are at least controlling. The ineffective execution of its functions by the state can be revealed in many countries of the world. The situation in France is nothing more than a reference case of a problem that, to one degree or another, exists in most of the countries of the world, which are distinguished by ethnic and confessional heterogeneity.

scholarly journals Digi-HTA: Health technology assessment framework for digital healthcare services

2019 ◽  
Vol 11 (4) ◽  
Author(s):  
Jari Haverinen ◽  
Niina Keränen ◽  
Petra Falkenbach ◽  
Anna Maijala ◽  
Timo Kolehmainen ◽  
...  
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
State Of The Art ◽  
Health Technology ◽  
Healthcare Services ◽  
The State ◽  
Systematic Evaluation ◽  
Health Technologies ◽  
Digital Healthcare ◽  
And Robotics

Health technology assessment (HTA) refers to the systematic evaluation of the properties, effects, and/or impacts of health technology. The main purpose of the assessment is to inform decisionmakers in order to better support the introduction of new health technologies. New digital healthcare solutions like mHealth, artificial intelligence (AI), and robotics have brought with them a great potential to further develop healthcare services, but their introduction should follow the same criteria as that of other healthcare methods. They must provide evidence-based benefits and be safe to use, and their impacts on patients and organizations need to be clarified. The first objective of this study was to describe the state-of-the-art HTA methods for mHealth, AI, and robotics. The second objective of this study was to evaluate the domains needed in the assessment. The final aim was to develop an HTA framework for digital healthcare services to support the introduction of novel technologies into Finnish healthcare. In this study, the state-of-the-art HTA methods were evaluated using a literature review and interviews. It was noted that some good practices already existed, but the overall picture showed that further development is still needed, especially in the AI and robotics fields. With the cooperation of professionals, key aspects and domains that should be taken into account to make fast but comprehensive assessments were identified. Based on this information, we created a new framework which supports the HTA process for digital healthcare services. The framework was named Digi-HTA.

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