Public Hospitals in Developing Countries: Resource Use, Cost, Financing

12042 Background: The COVID-19 pandemic has impacted the well-being of people not only due to the disease but also because of stay-at-home orders, social distancing, unemployment, and different kinds of loses. Older adults have particularly suffered during the pandemic, with increased health-related concerns and anxiety leading to increased vulnerability. However, little is known about the effects of the pandemic on older adults with cancer living in developing countries. They are facing issues related to their diagnosis and treatment, as well as the effects of the pandemic on their care and on the well-being of their families. To improve care for this vulnerable population, we studied the concerns and difficulties associated with COVID-19 among older Mexican adults with cancer. Methods: We included patients age ≥65 with the 10 most common tumors in Mexico according to GLOBOCAN and within 3-24 months of cancer diagnosis at two public hospitals in Mexico City. Patients were contacted telephonically and asked to complete a survey reporting the difficulties encountered during the COVID-19 pandemic and to rate their concerns associated with cancer care management using a 0-10 Likert-type scale, with higher ratings meaning increased concerns. Focused interviews were used to describe the individual experience of selected patients and their relatives related to COVID-19 and cancer care. Results: Between April 20, 2020 and December 1, 2021, 67 patients (mean age 71.9, min 65, max 90; 35.8% female; 62.7% living with a partner) were included. The most common tumors were prostate (43%), colon (16%), and lung (12%). 46% had Stage IV disease, and 61% had a life expectancy of more than a year. Twenty-five percent of patients reported encountering at least one difficulty in obtaining cancer care due to the COVID-19 pandemic. 43% of the patients reported difficulties with accessing follow-up cancer care; 39% reported issues with obtaining medications, including chemotherapy; and 34% reported problems obtaining medical care in general, including oncology visits. Regarding concerns, 33% of the patients reported being “very worried” or “extremely worried” about the COVID-19 pandemic. The most relevant concerns were related to getting infected with COVID-19 (or having a family member who became infected) (mean rating 7.9, SD 2.9); not being able to pay for cancer treatments or medical care (mean rating 6.9, SD 3.5); and worsening of cancer due to delayed care during the pandemic (mean rating 6.6, SD 3.7). Conclusions: A significant proportion of older adults with cancer in Mexico faced difficulties obtaining cancer treatment and follow-up care during the COVID-19 pandemic. Their most relevant concerns included getting infected, financial losses, and progression of disease. Creating systems to provide continued cancer care for vulnerable populations in developing countries is essential to face the COVID-19 pandemic.

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Poverty, Energy, and Resource Use in Developing Countries

Annals of the New York Academy of Sciences ◽

10.1196/annals.1425.030 ◽

2008 ◽

Vol 1136 (1) ◽

pp. 348-357 ◽

Cited By ~ 31

Author(s):

Daniel M. Kammen ◽

Charles Kirubi

Keyword(s):

Developing Countries ◽

Resource Use

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Conflicting Treasures: contrasting resource use governance in two artisanal gemstone mining sites in Madagascar

Journal of Political Ecology ◽

10.2458/v19i1.21728 ◽

2012 ◽

Vol 19 (1) ◽

pp. 221 ◽

Cited By ~ 1

Author(s):

Merrill S.A. Baker-Médard

Keyword(s):

Developing Countries ◽

Resource Use ◽

Protected Area ◽

Mineral Resources ◽

Resource Extraction ◽

Community Management ◽

Mining Sites ◽

Natural Resource Extraction ◽

Great Pressure ◽

Key Drivers

Conflict over property and resource rights is a common product of the convergence of biodiversity conservation and natural resource extraction and is especially pronounced in resource rich developing countries. Madagascar, a country well known for its unique and threatened biodiversity as well as its wealth of mineral resources is under great pressure to reconcile the conflict between these two treasures. This article, utilizing research conducted from 2004-2008, explores how resource claims are exercised, by whom, and by what means in two artisanal gemstone mining sites in Madagascar. It argues that the practices and discourses associated with conservation intervention have influenced both the way in which people understand as well as act upon their property rights. The alienation and dispossession accompanying a fortress modeled state-managed protected area is contrasted with a decentralized self-governing communitymanaged model and are posited as key drivers of observed differences in people's claims to resources in two gemstone mining sites. The research shows that community-managed conservation had an unexpected influence on a community's assertion of greater authority over gem resources. Key words: Community management, conservation, mining, Madagascar, governance

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Insight into the knowledge, attitude and practices of hand hygiene with alcohol based hand rubs in a public sector tertiary care hospital of a developing country

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20213762 ◽

2021 ◽

Vol 8 (10) ◽

pp. 4685

Author(s):

Fizra Balkhi ◽

Aamna Nasir ◽

Ayesha Asghar ◽

Farhan Patel ◽

Marium Zafar ◽

...

Keyword(s):

Health Care ◽

Developing Countries ◽

Public Sector ◽

Hand Hygiene ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Public Hospitals ◽

Care Hospital ◽

Patient Contact ◽

Dirty Hands

Background: Health care worker’s hands are mostly responsible for transmission of healthcare associated infections (HCAI). In such instances, alcohol based hand rubs have been endorsed by WHO as the gold standard for hand hygiene for visibly clean hands; whereas, for visibly dirty hands soap and water is recommended. In developing countries (like Pakistan), affected people frequently exceed 25%. However, limited infrastructure in these countries hinders the performance of hand hygiene, but the use of alcohol-based hand rubs in such adverse situations is a practical solution to these constraints.Methods: In January 2021, we initiated a 12 week cross-sectional study in a public sector tertiary care hospital of Karachi, Pakistan. All participants were given a self-designed questionnaire with a consent form thereby giving us permission to use the data. Data was analyzed using statistical package for the social sciences (SPSS version 23).Results: 84.3% of the participants had received prior instructions on hand hygiene; however 71.7% respondents did not have access to alcohol based hand rubs. When questioned if they followed WHO’s five moments of hand hygiene, only 50.5% use alcohol based hand rubs before patient contact; 88.6% used it after patient contact; 83.2% after body fluid exposure risk; 77% before an aseptic task and 78.6% after contact with patient’s surroundings.Conclusions: There is a dire need for concerned authorities to enforce proper hand hygiene in public hospitals of developing countries in order to curb health care associated infections and prolonged hospital stays.

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Bridging the Health Inequality and Strengthening Public Health System Through Public Private Partnership

Adhyayan A Journal of Management Sciences ◽

10.21567/adhyayan.v2i1.10239 ◽

2016 ◽

Vol 2 (1) ◽

Author(s):

Dr. Rajesh Kumar Shastri ◽

Mr. Rinki Verma

Keyword(s):

Health Care ◽

Developing Countries ◽

Private Sector ◽

Health Care System ◽

Urban Poor ◽

Developing Economies ◽

Public Private Partnership ◽

Public Hospitals ◽

Private Partnership ◽

Care System

India stands on 67<sup>th</sup> position out of 133 (approx) developing countries with regard to the number of doctors, while stands on 75<sup>th</sup> position with respect to number of nurses. Out of total healthcare spending in India, the government owned health facilities accounts for only 20% in comparison to 80% of private sector. Over 72.2% of Indian population lives in rural areas under poor and unsatisfactory environmental conditions, with high levels of openness to diseases and ill health. A significant proportion of poor in India are destitute due to lack of affordability to the services of private hospitals, characterized by highly qualified doctors and costly equipments, whereas public hospitals are noticeable by insufficient number of facilities, lack of personnel, medicines along with long queues which further highlights economical disparity problems of Indian people to thrash about the health related problems. As per the NFHS 2 data, only 43% of the urban poor children are fully immunized by the completion of one year of age. The percentage of severely underweight children among the urban poor is 23.0 which is twice the urban average (11.6%) and five times (4.5%) that of urban high income group. The vast majority of the country suffers from a poor standard of healthcare infrastructure which has not kept up with the growing economy. The only hope for the improvement in condition of the health care system of developing countries can be the mixture of public –private through Public Private Partnership. This paper aims to examine the current status of health infrastructure in developing countries like India, about the challenges lying in front of Government in developing health care system, identifying critical gap and requirements in Health services besides the comparison with other developing economies. It also seeks to examine the socio-economic environment of developing country, attracted towards private sector participation in health care development and review of potential benefits and risk involved, to ensure success and sustainability of Public Private Partnership.

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FACTORS THAT AFFECTING COLLABORATION AMONG PHYSICIANS USING HEALTHCARE INFORMATION SYSTEM IN DEVELOPING COUNTRIES

Journal of Advanced Sciences and Engineering Technologies ◽

10.32441/jaset.v1i2.116 ◽

2018 ◽

Vol 1 (2) ◽

pp. 14-23

Author(s):

Luma Fawaz, Jarallah ◽

MASRAH AZRIFAH AZMI MURAD ◽

MARZANAH A JABAR

Keyword(s):

Information System ◽

Developing Countries ◽

Data Sharing ◽

Distribution Systems ◽

Public Hospitals ◽

Time Sharing ◽

Healthcare Information ◽

Lack Of Information ◽

Independent Information ◽

Efficient Information

The analyse and propose the factors that affect the current levels of collaboration which exist among physicians in sharing healthcare information in the selected hospitals in developing countries using HISs , A quantitative method of enquiry was used for this study in the two public hospitals in Selangor state in Malaysia, by using questionnaire instrument. The responses received and analysed using Statistical Package for the Social Science (SPSS). Using the descriptive statistics (e.g., percentage, standard deviations, and means), and five point Likert scales in order to describe the features of data collection to analyse the factors that affect the collaboration among physicians in the selected hospitals. The result of the analysis showed the current level of collaboration among physicians within the hospitals with regard sharing information using HIS, which was very weak according to many factors. An analysis of the seven kinds of collaboration that exists among physicians was conducted and a mean score of 2.6130 was obtained reflecting minimal collaboration which in other words can be regarded as weak collaboration. The lack of collaboration was found to be as a result of lack of information distribution systems alongside the independent information technology support. In this study it was also found that collaboration occurred only in the form of regular verbal meetings with no form of data sharing through the use of the system. Low rating was also recorded for collaboration among physicians in terms of information sharing among hospitals for the purpose of improving medical research as well as medical activities. This implies the absence of an efficient information system which enhances data sharing within the hospitals and with other hospitals. Furthermore, the results imply that the real-time sharing of new activity in the hospital and with other hospitals through an information system is yet to be achieved.

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