Controlling Infant Formula Promotion in Ho Chi Minh City, Vietnam: Barriers to Policy Implementation in the Health Sector

2000 ◽  
Vol 6 (1) ◽  
pp. 27
Author(s):  
Nguyen Thanh Son ◽  
Simon Barraclough ◽  
Martha Morrow ◽  
Duong Quang Trung
Keyword(s):  
Infant Formula ◽  
Health Sector ◽  
Health Facilities ◽  
Bottle Feeding ◽  
Ho Chi Minh City ◽  
Health Staff ◽  
Structured Interviews ◽  
Economic Changes ◽  
Young Infants ◽  
Breast Milk Substitutes

Despite the irrefutable evidence of the dangers of bottle feeding and international recommendations for exclusive breastfeeding of young infants, breast milk substitutes are widely used and continue to be promoted. National and international codes to restrict marketing activities of formula companies have had little effect in many countries. Breastfeeding is nearly universally practised in Vietnam, but rarely in accordance with current guidelines for optimal infant outcomes, and infant formula is easily available, especially in large cities, where socio-economic changes linked to transition to a market economy are most visible. Although Vietnam has enacted its own legally binding code, poorly paid health staff remain potential targets for companies wishing to increase sales through inducements. This paper reports findings from a study investigating adherence to the Vietnamese Code and attitudes of a range of health staff to its objectives and provisions in a sample of health facilities. An audit and semi-structured interviews were used to gather data from 22 health facilities in Ho Chi Minh City. Results suggest gifts and inducements are commonplace, awareness of the content of the Code is low, and there is considerable resistance to its provisions, based on financial considerations as well as ambivalence about the merits of breastfeeding. Further investigation to determine prevalence of violations, stricter enforcement of the existing Code, and in-service breastfeeding education are recommended to strengthen breastfeeding promotion in Vietnam.

scholarly journals The psychosocial response to a terrorist attack at Manchester Arena, 2017: a process evaluation

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Daniel Hind ◽  
Kate Allsopp ◽  
Prathiba Chitsabesan ◽  
Paul French
Keyword(s):  
Young People ◽  
Process Evaluation ◽  
Terrorist Attack ◽  
Health Sector ◽  
Routine Data ◽  
Recovery Phase ◽  
Normalisation Process Theory ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Response Phase

Abstract Background A 2017 terrorist attack in Manchester, UK, affected large numbers of adults and young people. During the response phase (first seven weeks), a multi-sector collaborative co-ordinated a decentralised response. In the subsequent recovery phase they implemented a centralised assertive outreach programme, ‘The Resilience Hub’, to screen and refer those affected. We present a process evaluation conducted after 1 year. Methods Case study, involving a logic modelling approach, aggregate routine data, and semi-structured interviews topic guides based on the Inter-Agency Collaboration Framework and May’s Normalisation Process Theory. Leaders from health, education and voluntary sectors (n = 21) and frontline Resilience Hub workers (n = 6) were sampled for maximum variation or theoretically, then consented and interviewed. Framework analysis of transcripts was undertaken by two researchers. Results Devolved government, a collaborative culture, and existing clinical networks meant that, in the response phase, a collaboration was quickly established between health and education. All but one leader evaluated the response positively, although they were not involved in pre-disaster statutory planning. However, despite overwhelming positive feedback there were clear difficulties. (1) Some voluntary sector colleagues felt that it took some time for them to be involved. (2) Other VCSE organisations were accused of inappropriate, harmful use of early intervention. (3) The health sector were accused of overlooking those below the threshold for clinical treatment. (4) There was a perception that there were barriers to information sharing across organisations, which was particularly evident in relation to attempts to outreach to first responders and other professionals who may have been affected by the incident. (5) Hub workers encountered barriers to referring people who live outside of Greater Manchester. After 1 year of the recovery phase, 877 children and young people and 2375 adults had completed screening via the Resilience Hub, 79% of whom lived outside Greater Manchester. Conclusions The psychosocial response to terrorist attacks and other contingencies should be planned and practiced before the event, including reviews of communications, protocols, data sharing procedures and workforce capacity. Further research is needed to understand how the health and voluntary sectors can best collaborate in the wake of future incidents.

scholarly journals Role of community health volunteers in identifying people with elevated blood pressure for diagnosis and monitoring of hypertension in Malawi: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elvis Safary ◽  
Micrina Mwandeti ◽  
Beatrice Matanje ◽  
Claudia Beiersmann ◽  
Caroline Mtaita ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Community Health ◽  
Communicable Diseases ◽  
Health Facilities ◽  
Elevated Blood Pressure ◽  
Elevated Blood ◽  
Structured Interviews ◽  
Community Health Volunteers ◽  
Provision Of Services

Abstract Background In recent years, there has been greater recognition of the important role of community health volunteers in many countries and their important role informs many health programs. This include health education, provision of services such as screening, monitoring and referral to health facilities. Their roles are better understood in the areas of communicable diseases like HIV infection, Tuberculosis and Malaria however little is known about their role in non-communicable diseases. This study seeks to explore perception of CHVs’ functions, tasks, and their fulfilment in identifying people with elevated blood pressure for diagnosis and monitoring of hypertension in Lilongwe, Malawi. Methods This was a qualitative naturalistic research design utilizing observation and semi-structured interviews with community health volunteers working in Lilongwe, Malawi. Interviews were carried out with the researcher. Participants were recruited from the ZaMaC project. An interview guide was developed with a category-guided deductive approach. The interviews were recorded through note taking. Data analysis was performed using content analysis approach. Results Community health volunteers have multiple roles in prevention and monitoring of hypertension. They act as health educators and provide lifestyle counselling. They screened for hypertension and monitored blood pressure and assisted community members to navigate the health system such as linkage to health facilities. These roles were shaped in response to community needs. Conclusion This study indicates the complexities of the roles of community health volunteer in identifying people with elevated BP for diagnosis and monitoring of hypertension. Understanding community health volunteers’ roles provides insight into their required competencies in provision of their daily activities as well as required training to fill in their knowledge gaps.

‘[The pediatrician] said that maybe my milk, instead of doing good, no longer helped’: the ecology of infant formula in rural communities in Central Mexico

2021 ◽  
pp. 1-13
Author(s):  
Paulina Luna ◽  
Tania Valdes ◽  
Alberto Zelocuatecatl-Aguilar ◽  
Gerónimo Medrano-Loera ◽  
Bárbara Guerrero ◽  
...  
Keyword(s):  
Rural Communities ◽  
Infant Formula ◽  
Breast Feeding ◽  
Conflicts Of Interest ◽  
Healthcare Providers ◽  
Indigenous Communities ◽  
Central Mexico ◽  
Economic Changes ◽  
Cultural Traditions ◽  
Social And Cultural Factors

Abstract Objective: As Mexico continues to develop, an epidemiological and nutritional transition has led to an increase in infant formula use in its rural and indigenous communities. Our objective was to determine the social and cultural factors that influence the use of formula in such populations in Central Mexico. Design: Qualitative study using a data collection instrument based on the socio-ecological framework. Setting: Two rural and indigenous communities in Central Mexico. Participants: Mothers, fathers, grandparents and healthcare providers. Results: Breast-feeding was favoured in both communities; however, several cultural traditions hindered exclusive breast-feeding. As these communities became more developed, emerging ideas of modernity led to negative connotations about breast-feeding and many mothers began to view formula as a complement for breast-feeding. Formula was seen as a convenient solution for breast pain, insufficient milk and body image. Healthcare providers promoted the use of formula through their own beliefs, information, communication and conflicts of interest with formula industry representatives. The recent social and economic changes in these communities combined with the increased advertising and availability of breast milk substitutes have facilitated the preference for formula. Conclusions: Women in rural, indigenous communities in Central Mexico are increasingly using formula. Efforts at the policy and institutional levels are needed to protect mothers and their children from the detrimental consequences of unregulated formula promotion and the formula culture that it brings with it.

Breastmilk or infant formula? Content analysis of infant feeding advice on breastmilk substitute manufacturer websites

2021 ◽  
pp. 1-9
Author(s):  
Jennifer L Pomeranz ◽  
Xiangying Chu ◽  
Oana Groza ◽  
Madeline Cohodes ◽  
Jennifer L Harris
Keyword(s):  
Content Analysis ◽  
Infant Feeding ◽  
Infant Formula ◽  
Breast Feeding ◽  
Feeding Problems ◽  
The Us ◽  
Us Government ◽  
Breast Milk Substitutes ◽  
Breastmilk Substitute ◽  
Consumer Marketing

Abstract Objective: To evaluate messages about infant feeding on breastmilk substitute (BMS) manufacturer websites directed at US caregivers and compare information and portrayals of breast-feeding/breastmilk with that of infant formula (IF) feeding. Design: We conducted a content analysis of US BMS companies’ websites. A codebook was created through an iterative process to identify messages and images about breast-feeding/breastmilk and IF feeding, including benefits or issues associated with each, and direct-to-consumer marketing practices that could discourage breast-feeding. Setting: Data were collected in 2019–2020 and analysed in 2020–2021 for US websites of five IF manufacturers. Participants: The websites of Similac, Enfamil and Gerber, which collectively represent approximately 98 % of the US IF market, and two US organic brands, Earth’s Best and Happy Baby. Results: Websites contained more messages about breast-feeding/breastmilk than IF but were significantly more likely to mention benefits to baby of IF (44 %) than breast-feeding/breastmilk (<26 %), including significantly more statements that IF provides brain, neural and gastrointestinal benefits; 40 % of breast-feeding/breastmilk content was dedicated to breast-feeding problems (e.g. sore nipples). Twice as many screenshots compared IF brands favourably to breastmilk than as superior to other brands. Certain companies displayed images indicating ease of IF feeding and difficulty of breast-feeding. Conclusions: Substantial messaging on BMS manufacturer websites encouraged IF feeding and discouraged breast-feeding. Health professionals should discourage their patients from visiting these websites and the US government should regulate misleading claims. Companies should refrain from providing breast-feeding advice and align their US marketing with the International Code of Marketing of Breast-milk Substitutes.

scholarly journals Changing Neighborhoods and Residents’ Health Perceptions: The Heart Healthy Hoods Qualitative Study

2018 ◽  
Vol 15 (8) ◽  
pp. 1617 ◽  
Author(s):  
Paloma Conde ◽  
Marta Gutiérrez ◽  
María Sandín ◽  
Julia Díez ◽  
Luisa Borrell ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Cultural Values ◽  
Health Perceptions ◽  
Social Changes ◽  
Structured Interviews ◽  
Positive Health ◽  
Family Responsibilities ◽  
Economic Changes ◽  
Positive Effects ◽  
Constant Change

Cities, and therefore neighborhoods, are under constant change. Neighborhood changes may affect residents’ health in multiple ways. The Heart Healthy Hoods (HHH) project studies the association between neighborhood and residents’ health. Focusing on a middle–low-socioeconomic neighborhood in Madrid (Spain), our aim was to describe qualitatively its residents’ perceptions on the urban changes and their impacts on health. We designed a qualitative study using 16 semi-structured interviews including adult residents and professionals living or working in the area. Firstly, we described the perceived main social and neighborhood changes. Secondly, we studied how these neighborhood changes connected to residents’ health perceptions. Perceived major social changes were new demographic composition, new socio–cultural values and economic changes. Residents’ negative health perceptions were the reduction of social relationships, increase of stress and labor precariousness. Positive health perceptions were the creation of supportive links, assimilation of self-care activities and the change in traditional roles. Neighborhood changes yielded both negative and positive effects on residents’ health. These effects would be the result of the interrelation of different elements such as the existence or absence of social ties, family responsibilities, time availability, economic resources and access and awareness to health-promoting programs. These qualitative research results provide important insight into crafting urban health policies that may ultimately improve health outcomes in communities undergoing change.

scholarly journals Ethical problems experienced by oncology nurses

2015 ◽  
Vol 23 (6) ◽  
pp. 1187-1194 ◽  
Author(s):  
Kely Regina da Luz ◽  
Mara Ambrosina de Oliveira Vargas ◽  
Pablo Henrique Schmidtt ◽  
Edison Luiz Devos Barlem ◽  
Jamila Geri Tomaschewski-Barlem ◽  
...  
Keyword(s):  
Oncology Nurses ◽  
Qualitative Approach ◽  
Health Staff ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Ethical Problems ◽  
Oncological Treatment ◽  
Treatment Information ◽  
Oncological Patients ◽  
Inpatient Units

Objective: to know the ethical problems experienced by oncology nurses. Method: descriptive and exploratory study with a qualitative approach, performed in inpatient units and in chemotherapy out-patients units that provide assistance to oncological patients in two capitals in the South region of Brazil. Eighteen nurses participated in this study, selected by snowball sampling type. For data collection, semi-structured interviews were carried out, which were recorded and transcribed, and then analyzed by thematic analysis. Results: two categories were established: when informing or not becomes a dilemma - showing the main difficulties related to oncological treatment information regarding health staff, health system, and infrastructure; to invest or not - dilemmas related to finitude - showing situations of dilemmas related to pain and confrontation with finitude. Conclusion: for the effective confrontation of the ethical problems experienced by oncology nurses to occur, it is important to invest in the training of these professionals, preparing them in an ethical and human way to act as lawyers of the patient with cancer, in a context of dilemmas related mainly to the possibility of finitude.

scholarly journals ICT Framework to Support a Patient-Centric approach in Public Healthcare

2020 ◽  
Vol 16 ◽  
pp. 45-76
Author(s):  
Richard Pankomera ◽  
Darelle Van Greunen
Keyword(s):  
Public Health ◽  
Information And Communication Technologies ◽  
Health Sector ◽  
Cost Effective ◽  
Healthcare Services ◽  
Healthcare Sector ◽  
Public Healthcare ◽  
Structured Interviews ◽  
Poor Countries ◽  
Patient Centric

Although Information and Communication Technologies (ICTs) in the healthcare sector are extensively deployed globally, they are not used effectively in developing countries. Many resource poor countries face numerous challenges in implementing the ICT interventions. For instance, many health applications that have been deployed are not user-centric. As a result, such ICT interventions do not benefit many health consumers. The lack of an ICT framework to support patient-centric healthcare services in Malawi renders the e-health and mhealth interventions less sustainable and less cost effective. The aim of the study was therefore to develop an ICT Framework that could support patient-centric healthcare services in the public health sector in Malawi. The comprehensive literature review and semi-structured interviews highlighted many challenges underlying ICT development in Malawi. An ICT framework for patient-centric healthcare services is therefore proposed to ensure that eHealth and mobile health interventions are more sustainable and cost effective. The framework was validated by five experts selected from different areas of expertise including mhealth application developers, ICT policy makers and public health practitioners. Results show that the framework is relevant, useful and applicable within the setting of Malawi. The framework can also be implemented in various countries with similar settings.

scholarly journals Interventions in increasing availability of skilled healthcare providers in rural areas: A Case Study of Bihar (India)

2021 ◽  
Vol 24 ◽  
pp. 853-864
Author(s):  
Dilip Kumar
Keyword(s):  
Rural Health ◽  
Rural Areas ◽  
Service Providers ◽  
State Level ◽  
The State ◽  
Health Facilities ◽  
Working Environment ◽  
Health Staff ◽  
Personal Support ◽  
Rural Service

Population of rural areas face distinct health challenges due to economic conditions, cultural/behavioural factors, and health provider shortages that combine to impose striking disparities in health outcomes among them. The process of recruitment takes about four to six months for Recruitment of Medical officers and paramedics. The number of applicants is quite limited because of dearth of doctors and paramedics in the State. It was felt that the health staffs incentives will help to increase the turnover of health staffs to some extent in the rural and remote areas. Monitoring cell has been constituted at the state level. The trainings are being monitored at regular intervals of time. The motivational level of health staff at all levels seems to be low. Continuous communication and feedback by state level programme officers is needed on regular basis. Placement of the suitable trained personnel is needed at those health facilities where sufficient infrastructure is available. Since 2010-11, there has been a continuous focus on the capacity building of the existing manpower in  the  state.  Trainings  as  per  GOI  guidelines  on  Immunization,  IMNCI,  EmOC,  LSAS,  SBA  and Minilap/MVA etc. have been taken up with full strength. In addition, the State wide training on immunization for Medical Officers, IPC skills for breast feeding and basic training in neonatal resuscitation also has been taken up at various levels. More than four-fifth of the total staffs in the health facilities were agreed on all the educational interventions for retention of health staffs in rural areas. For the regulatory interventions such as enhanced scope of practice, different types of health workers; multi skilling of alternate service providers, compulsory rural service which may be mandatory for obtaining license to practice or can be a prerequisite for entry into specialization and subsidized education in return of assured services were agreed by four-fifth of the total staffs. For the interventions related to professional and personal support such as better living conditions (water, sanitation, electricity, telecommunications, schools, etc.), safe and supportive working environment, outreach activities to facilitate cooperation between health workforce from better served and underserved areas; use of tele-health, designing career development programmes linked with rural service: more senior posts in rural areas and professional networks for rural areas such as rural health professional associations, rural health journals, etc. about 88 percent of the HR categories of Staffs were agreed in the health facilities

SATISFACTION OF HEALTH STAFF AT HEALTH FACILITIES IN VIETNAM SYSTEM OVERVIEW STUDY, PERIOD 2010-2020

2021 ◽  
Vol 62 (6) ◽  
Author(s):  
Tran Thi Ly ◽  
Tran Quoc Thang ◽  
Duong Duy Luong
Keyword(s):  
Systematic Review ◽  
Medical Staff ◽  
Health Facilities ◽  
Average Score ◽  
Health Staff ◽  
Staff Satisfaction ◽  
Satisfaction Level ◽  
High Satisfaction ◽  
Satisfaction Rates ◽  
Relevant Factors

Background: A famous hospital manager Joe Jansante said that "It is impossible to have patient’s satisfaction without medical staff’s satisfaction", satisfaction with the work of health workers will ensure that adequate human resources are maintained and improved quality of health services at health facilities. Objective: A systematic review to review research findings on the the satisfaction level and relevant factors, analysis of strengths, weaknesses and deficiencies that need to be supplemented by further studies. Methods: Systematic review. Results: Searched and analyzed 25 national studies related to medical staff’s satisfaction. The results show that studies were carried out on many different subjects and locations with  different levels of satisfaction.Conclusion: The satisfaction level of patients is quite high (satisfaction rate is over 50%, average score is over 3.0). Factors with high satisfaction rates include: Relationship with leaders, colleagues (61,3%-88,6%); Opportunities for learning and advancement (55.56%-2.5%) and job position (81.8%-93.3%) . Factors with not high satisfaction rates include: Salary (16.7%-31.11%); Non-salary (25.1%-42.3%); Management mechanism (20.3%); Facilities (23.7% -50.4%) and records (26.8%-40%). Relevant factors: Medical staff satisfaction is not/very little related to demographic factors such as: Age, gender, region of residence. Factors related to the medical staff  satisfaction level include: social relationships and mechanisms for management and operation of the unit.

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