scholarly journals (A252) Impact of Protracted, Intrastate Conflict on Population Health in Manipur, India

2011 ◽  
Vol 26 (S1) ◽  
pp. s69-s69
Author(s):  
V. Kaushik ◽  
S. Nair ◽  
Y. Tanwar ◽  
S. Sinha ◽  
N. Roy

IntroductionManipur is a state in northeastern India and in civil war for > 45 years. Healthcare delivery and access is affected due to poor security, restricted accessibility, and the incapacity of this fragile state.MethodsThe burden of morbidity and mortality in the conflict area of Manipur was estimated using data sources (hospital attendance, hospital inpatient, and death registries, national family and health registries, and in-depth interviews of healthcare providers) and compared to national averages. These findings were co-related with violent events reported in the local newspaper.ResultsExcess mortality was observed in the 21–50 year age group, but not in females or the elderly. The major causes of deaths were non-communicable diseases, cerebrovascular accidents, and chronic pulmonary disease. Chronic conflict increased the burden of alcohol liver disease and of mental health diseases. Suicidal deaths were common in the mid-twenty age group and usually due to agricultural pesticide consumption. These deaths were higher in men, and suicide attempts were higher in women. The prevalence of intravenous drug users and of HIV was reported to be five times as higher than the national average. High rates of disappearances, mutilation, torture, kidnapping, and hostage-taking, spousal physical violence and attacks on healthcare facilities and medical personnel were events of concern. There were no reported events of suicide bombers.ConclusionsProtracted conflict dramatically changes the demographics and disease burden. Humanitarian space constantly is under threat of attack and the insecurity interferes with the provision of sustained preventive and curative services. Recommendations to be implemented would measures to continue treatment in the insecure environment through telephonic or online medical helplines, vaccination, and drug supplies during negotiated ceasefires or curfew times and protecting humanitarian spaces. However, militarization of healthcare may not be favorable solution.

2020 ◽  
Vol 18 (S1) ◽  
Author(s):  
Deborah Carvalho Malta ◽  
Adauto Martins Soares Filho ◽  
Isabella Vitral Pinto ◽  
Maria Cecília de Souza Minayo ◽  
Cheila Marina Lima ◽  
...  

Abstract Background Brazil leads the world in number of firearm deaths and ranks sixth by country in rate of firearm deaths per 100,000 people. This study aims to analyze trends in and burden of mortality by firearms, according to age and sex, for Brazil, and the association between these deaths and indicators of possession and carrying of weapons using data from the global burden of diseases, injuries, and risk factors study (GBD) 2017. Methods We used GBD 2017 estimates of mortality due to physical violence and self-harm from firearms for Brazil to analyze the association between deaths by firearms and explanatory variables. Results Deaths from firearms increased in Brazil from 25,819 in 1990 to 48,493 in 2017. Firearm mortality rates were higher among men and in the 20–24 age group; the rate was 20 times higher than for women in the same age group. Homicide rates increased during the study period, while mortality rates for suicides and accidental deaths decreased. The group of Brazilian federation units with the highest firearm collection rate (median = 7.5) showed reductions in the rate of total violent deaths by firearms. In contrast, the group with the lowest firearm collection rate (median = 2.0) showed an increase in firearm deaths from 2000 to 2017. An increase in the rate of voluntary return of firearms was associated with a reduction in mortality rates of unintentional firearm deaths (r = −0.364, p < 0.001). An increase in socio-demographic index (SDI) was associated with a reduction in all firearm death rates (r = −0.266, p = 0.008). An increase in the composite index of firearms seized or collected was associated with a reduction in rates of deaths by firearm in the subgroup of females, children, and the elderly (r = −0.269, p = 0.005). Conclusions There was a change in the trend of firearms deaths after the beginning of the collection of weapons in 2004. Federation units that collected more guns have reduced rates of violent firearm deaths.


2020 ◽  
Vol 79 (47-48) ◽  
pp. 36077-36089
Author(s):  
Francesco Panico ◽  
Gennaro Cordasco ◽  
Carl Vogel ◽  
Luigi Trojano ◽  
Anna Esposito

AbstractAssistive Ambient Living (AAL) in ageing refers to any device used to support ageing related psychological and physical changes aimed at improving seniors’ quality of life and reducing caregivers’ burdens. The diffusion of these devices opens the ethical issues related to their use in the human personal space. This is particularly relevant when AAL technologies are devoted to the ageing population that exhibits special bio-psycho-social aspects and needs. In spite of this, relatively little research has focused on ethical issues that emerge from AAL technologies. The present article addresses ethical issues emerging when AAL technologies are implemented for assisting the elderly population and is aimed at raising awareness of these aspects among healthcare providers. The overall conclusion encourages a person-oriented approach when designing healthcare facilities. This process must be fulfilled in compliance with the general principles of ethics and individual nature of the person devoted to. This perspective will develop new research paradigms, paving the way for fulfilling essential ethical principles in the development of future generations of personalized AAL devices to support ageing people living independently at their home.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wan-Chun Huang ◽  
Ngoc Yen Pham ◽  
Thu Anh Nguyen ◽  
Van Giap Vu ◽  
Quy Chau Ngo ◽  
...  

Abstract Background Attendance at healthcare facilities provides an opportunity for smoking cessation interventions. However, the smoking behaviours of patients seeking healthcare in Vietnam are not well-understood. We aimed to evaluate behaviours related to smoking among patients presenting to health facilities in Vietnam. Methods We conducted a cross-sectional study in 4 provinces of Vietnam. Consecutive patients aged ≥15 years presenting to 46 health facilities were assessed. Current smokers were randomly selected to complete a full survey about smoking behaviour, quit attempts, and preparedness to quit. Results Among 11,245 patients who sought healthcare, the prevalence of current smoking was 18.6% (95% CI: 17.8–19.4%) overall, 34.6% (95% CI: 33.2–36.0%) among men and 1.1% (95% CI: 0.8–1.3%) among women. Current smokers who were asked about smoking by healthcare providers in the last 12 months were more likely to make quit attempts than those not asked (40.6% vs 31.8%, p = 0.017). Current smokers who attempted to quit in the past 12 months made limited use of cessation aids: counselling (1.9%) and nicotine replacement therapy (10%). A higher proportion of patients wanted to quit in the next month at national/provincial hospitals (30.3%) than those visiting district hospitals (11.3%, p < 0.001) and commune health centres (11.1%, p = 0.004). Conclusions Smoking is common among male patients presenting to healthcare facilities in Vietnam. Formal smoking cessation supports are generally not used or offered. This population is likely to benefit from routine smoking cessation interventions that are integrated within the routine healthcare delivery system.


2002 ◽  
Vol 5 (3) ◽  
Author(s):  
Alison Marie Kenner

Aging in place, the option to grow old in one's home instead of institutional healthcare facilities, is predicated on the development of technologies and resources that network patients, caregivers, medical personnel, and third party interlocutors. Monitoring systems and other information technologies are broadly considered to be the most promising means to establish these connections, and home care technologies for elderly people with dementia comprise one of the fastest growing areas of commercial development. Grounded in the political economy of aging and understood as surveillance, monitoring technologies for the elderly highlight sociopolitical responses to aging and dementia and raise critical questions about caregiving, quality of life, and the way technological design engages with everyday rights. This paper will analyze surveillance technologies for the elderly with attention to issues of power and inequality, and how these dynamics may or may not be considered in technological design for the oldest populations


Author(s):  
Ebenezer Dassah ◽  
Heather M. Aldersey ◽  
Mary Ann McColl ◽  
Colleen Davison

Abstract Background: A growing body of evidence has shown that persons with physical disabilities experience substantial barriers in accessing primary healthcare (PHC) services in rural areas. Negative attitudes from healthcare providers and inaccessible healthcare facilities and equipment are common experiences that negatively affect access to quality healthcare for persons with physical disabilities. However, there is limited research that explores this issue from the perspectives of healthcare providers. This qualitative study explores the perspectives of healthcare providers in delivering PHC services to persons with physical disabilities in rural Ghana. Understanding healthcare providers’ perspectives could help leverage previous findings from clients’ experiences to more fully inform the development of specific and actionable research and interventions to improve healthcare delivery for disabled people. Methods: We conducted in-depth interviews with 15 healthcare providers and used thematic analysis to analyze the data. Results: Participants reported their perspectives in three major themes: challenges in providing healthcare (eg, limited availability of drugs and medical equipment, limited healthcare providers, financial constraints, and inaccessible facilities and equipment); strategies in navigating the challenges (eg, improvising techniques and employing professional values, referring clients, and providing financial assistance to clients); and positive experience in providing healthcare (eg, feeling rewarded and appreciated). Conclusion: The findings reinforce the need to consider the availability of rehabilitation professionals and services to address the specific healthcare needs of disabled people at the PHC level in Ghana. The findings also point to a need for further research on the perspectives of healthcare policymakers about how to navigate the systemic barriers encountered by providers in providing care to persons with physical disabilities in rural Ghana in particular, and other similar rural areas.


PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249334
Author(s):  
Abiola Olubusola Komolafe ◽  
Adekemi Eunice Olowokere ◽  
Omolola Oladunni Irinoye

The integration of emergency obstetric and newborn care (EmONC) into maternal and newborn care is essential for its effectiveness to avert preventable maternal and newborn deaths in healthcare facilities. This study used a theory-oriented quantitative approach to document the reported extent of EmONC integration, and its relationship with EmONC training, guidelines availability and level of healthcare facility. A descriptive cross-sectional study was conducted among five hundred and five (505) healthcare providers and facility managers across the three levels of healthcare delivery. An adapted questionnaire from NoMad instrument was used to collect data on the integration of EmONC from the study participants. Ethical approval was obtained and informed consents taken from the participants. Both descriptive (frequency, percentage, mean and median) and inferential analyses (Kruskal Wallis and Mann Whitney tests) were done with statistical significance level of p<0.05 using STATA 14. The mean age of respondents was 38.68±8.27. The results showed that the EmONC integration median score at the three levels of healthcare delivery was high (77 (IQR = 83–71)). The EmONC integration median score were 76 (IQR = 84–70), 76 (IQR = 80–68) and 78 (IQR = 84–74) in the primary, secondary and tertiary healthcare facilities respectively. Integration of EmONC was highest (83 (IQR = 87–78)) among healthcare providers who had EmONC training and also had EmONC guidelines made available to them. There were significant differences in EmONC integration at the three levels of healthcare delivery (p = 0.046), among healthcare providers who had EmONC training and those with EmONC guidelines available in their maternity units (p = 0.001). EmONC integration was reportedly high and significantly associated with EmONC training and availability of guidelines. However, the congruence of reported and actual extent of integration of EmONC at the three levels of healthcare delivery still need validation as such would account for the implementation success and maternal-neonatal outcomes.


Crisis ◽  
1999 ◽  
Vol 20 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Annie Mino ◽  
Arnaud Bousquet ◽  
Barbara Broers

The high mortality rate among drug users, which is partly due to the HIV epidemic and partly due to drug-related accidental deaths and suicides, presents a major public health problem. Knowing more about prevalence, incidence, and risk factors is important for the development of rational preventive and therapeutic programs. This article attempts to give an overview of studies of the relations between substance abuse, suicidal ideation, suicide, and drug-related death. Research in this field is hampered by the absence of clear definitions, and results of studies are rarely comparable. There is, however, consensus about suicidal ideation being a risk factor for suicide attempts and suicide. Suicidal ideation is also a predictor of suicide, especially among drug users. It is correlated with an absence of family support, with the severity of the psychosocial dysfunctioning, and with multi-drug abuse, but also with requests for treatment. Every clinical examination of a drug user, not only of those who are depressed, should address the possible presence of suicidal ideation, as well as its intensity and duration.


1970 ◽  
Vol 7 (2) ◽  
pp. 113-116
Author(s):  
Amimah Fatima Asif

Quality healthcare delivery is the bedrock to exponentially accelerate the development of a country. Unfortunately, in Pakistan healthcare has been neglected since a long time, with the common man bearing the brunt of this acute situation. There are critical challenges in health care, with paucity of trained human resource and deficit of regulated infrastructure and service delivery being the predominant dilemmas. Primary and secondary healthcare are in an unseemly state, to say the least. Maternal and child health care, accident, and emergency departments and mental health are among the most undermined and forsaken areas of healthcare, primarily in the far flung Gilgit Baltistan region of Pakistan. The only way forward is if the political regime, administration and the medical personnel work in concurrence to revise the health infrastructure of the country.


2020 ◽  
Vol 54 (6) ◽  
pp. 410-416
Author(s):  
Joyce M. Hansen ◽  
Scott Weiss ◽  
Terra A. Kremer ◽  
Myrelis Aguilar ◽  
Gerald McDonnell

The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2, has challenged healthcare providers in maintaining the supply of critical personal protective equipment, including single-use respirators and surgical masks. Single-use respirators and surgical masks can reduce risks from the inhalation of airborne particles and microbial contamination. The recent high-volume demand for single-use respirators and surgical masks has resulted in many healthcare facilities considering processing to address critical shortages. The dry heat process of 80°C (176°F) for two hours (120 min) has been confirmed to be an appropriate method for single-use respirator and surgical mask processing.


2018 ◽  
Vol 20 (2) ◽  
Author(s):  
Winnie Thembisile Maphumulo ◽  
Busisiwe Bhengu

The National Department of Health in South Africa has introduced the National Core Standards (NCS) tool to improve the quality of healthcare delivery in all public healthcare institutions. Knowledge of the NCS tool is essential among healthcare providers. This study investigated the level of knowledge on NCS and how the NCS tool was communicated among professional nurses. This was a cross-sectional survey study. Purposive sampling technique was used to select hospitals that only offered tertiary services in KwaZulu-Natal. Six strata of departments were selected using simple stratified sampling. The population of professional nurses in the selected hospitals was 3 050. Systematic random sampling was used to recruit 543 participants. The collected data were analysed using SPSS version 25. The study showed that only 16 (3.7%) respondents had knowledge about NCS, using McDonald’s standard of learning outcome measured criteria regarding the NCS tool. The Pearson correlation coefficient between the communication and knowledge was r = 0.055. The results revealed that although the communication scores for the respondents were high their knowledge scores remained low. This study concluded that there is a lack of knowledge regarding the NCS tool and therefore healthcare institutions need to commit themselves to the training of professional nurses regarding the NCS tool. The findings suggest that healthcare institutions implement the allocation of incentives for nurses that attend the workshops for NCS.


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