Funding models and expenditures with primary healthcare in Salvador, Bahia, Brazil metropolitan area

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
T Vivas ◽  
M Duarte ◽  
A Pitta ◽  
B Christovam
Keyword(s):  
Public Health ◽  
Metropolitan Area ◽  
Primary Healthcare ◽  
Healthcare Services ◽  
Ministry Of Health ◽  
Healthcare Budget ◽  
Health Budget ◽  
The Public ◽  
Before And After ◽  
The Government

Abstract Background The government investments in quality primary healthcare are the basis to strengthening the health systems and monitoring the public expenditure in this area is a way to assess the effectiveness and efficiency of the public health policies. The Brazil Ministry of Health changed, in 2017, the method of onlending federal resources to states and cities seeking to make the public funds management more flexible. This change, however, suppressed mandatory investments in primary healthcare. This research aims to determine the difference of expenditures on primary healthcare in Salvador, Bahia, Brazil metropolitan area before and after this funding reform, seeking to verify how it can impact the quality of primary healthcare services and programs. Methods This is an ecological time-series study that used data obtained in the Brazil Ministry of Health budget reports. The median and interquartile range of expenditures on primary healthcare (set as the percentage of total public health budget applied in primary care services and programs) of the 13 cities in the Salvador metropolitan area were compared two years before and after the reform. Results The median of expenditures on primary healthcare in Salvador metropolitan area was 25.5% (13,9% - 32,2%) of total public health budget before and 24.8% (20.8% - 30.0%) of total public health budget after the reform (-0.7% difference). Seven cities decreased the expenditures on primary healthcare after the reform, ranging from 1.2% to 10.8% reduction in the primary healthcare budget in five years. Conclusions Expenditures on primary healthcare in Salvador metropolitan area decreased after the 2017 funding reform. Seven of 13 cities reduced the government investments on primary healthcare services and programs in this scenario. Although the overall difference was -0.7%, the budget cuts ranged from 1.2% to 10.8% in the analyzed period and sample. More studies should assess these events in wide areas and with long time ranges. Key messages Public health funding models can impact the primary healthcare settings regardless of the health policy. Reforms in the funding models should consider the possible benefits before implementation. Funding models and methods that require mandatory investments in primary healthcare may be considered over more flexible ones.

Corrupt Practices in the Public Health Sector: A Focus on Metropolitan Local Government Areas of Kano State, Nigeria

2020 ◽  
Vol 18 (2) ◽  
pp. 149
Author(s):  
Mohammed Mustapha Namadi
Keyword(s):  
Public Health ◽  
Local Government ◽  
Health Sector ◽  
Sampling Technique ◽  
Healthcare Services ◽  
Healthcare Sector ◽  
Healthcare Provision ◽  
The Public ◽  
Public Health Sector ◽  
The Government

Corruption is pervasive in Nigeria at all levels. Thus, despite recent gains in healthcare provision, the health sector faces numerous corruption related challenges. This study aims at examining areas of corruption in the health sector with specific focus on its types and nature. A sample size of 480 respondents aged 18 years and above was drawn from the eight Metropolitan Local Government Areas of Kano State, using the multistage sampling technique. The results revealed evidence of corrupt practices including those related to unnecessary-absenteeism, diversion of patients from the public health facilities to the private sector, diverting money meant for the purchase of equipment, fuel and diesel, bribery, stealing of medications, fraud, misappropriation of medications and unjustifiable reimbursement claims. In order to resolve the problem of corrupt practices in the healthcare sector, the study recommended the need for enforcement of appropriate code of ethics guiding the conduct of the health professionals, adoption of anti-corruption strategies, and strengthening the government monitoring system to check corruption in public health sector in order to ensure equitable access to healthcare services among the under-privileged people in the society.

scholarly journals Changes of Walking Activity During the First Cycle Phases of COVID-19 Pandemic: A Case Study of Seoul, Korea

2021 ◽  
pp. 193758672110265
Author(s):  
Youngjun Park ◽  
Haekwon Chung ◽  
Sohyun Park
Keyword(s):  
Public Health ◽  
Physical Inactivity ◽  
Voluntary Participation ◽  
Walking Activity ◽  
Significant Difference ◽  
Before And After ◽  
Acceleration And Deceleration ◽  
Preliminary Study ◽  
The Government

Aim: This study explores the changes in regular walking activities during the phases of the pandemic. Background: With the spread of COVID-19 transmission, people are refraining from going out, reducing their physical activity. In South Korea, COVID-19 broke out in the 4th week of 2020 and experienced the first cycle phases of the pandemic, such as outbreak, widespread, and decline. In response to the pandemic, the government encouraged voluntary participation in social distancing campaigns, and people reduced their outside activities. Methods: This article examines the decrease and increase of the Prevalence of Regular Walking (≥30 min of moderate walking a day, on ≥5 days a week) by the COVID-19 phases. This study is based on weekly walking data for 15 weeks in 2020, via the smartphone healthcare app, which is managed by 25 public health offices of the Seoul government. Results: According to the findings, the level of prevalence of regular walking (PRW) has a significant difference before and after the outbreak, and every interval of the four-stage COVID-19 phases, that is, pre-pandemic, initiation, acceleration, and deceleration. The level of PRW sharply decreased during initiation and acceleration intervals. In the deceleration interval of COVID-19, the PRW kept increasing, but it has not yet reached the same level as the previous year when the COVID-19 did not exist. Conclusions: As a preliminary study, this study explains empirically how COVID-19 changed PRW in Seoul. It would be helpful to enhance our understanding of the changes in physical inactivity in the pandemic period.

Reducing the public health budget

1933 ◽  
Vol 22 (9) ◽  
pp. 437-444
Author(s):  
George Folger Canfield ◽  
Matthias Nicoll ◽  
Kendall Emerson
Keyword(s):  
Public Health ◽  
Health Budget ◽  
The Public

scholarly journals UPAYA PENCEGAHAN PEMUTUSAN HUBUNGAN KERJA PEKERJA DI SEKTOR FORMAL BERDASARKAN KEADAAN MEMAKSA PANDEMI COVID-19

2021 ◽  
Vol 7 (1) ◽  
pp. 139-161
Author(s):  
Steven Suprantio
Keyword(s):  
Public Health ◽  
Job Creation ◽  
Public Health Emergency ◽  
State Of Emergency ◽  
Business World ◽  
The Public ◽  
Economic Slowdown ◽  
The Government ◽  
Economic Necessity ◽  
Government Workers

The business world everywhere including those in Indonesia cannot but felt the brunt of economic slowdown caused by the public health emergency (the COVID 19 pandemic). Quite a few national and local businesses have had to close their operation and lay off all its employees. Although the consensus between the government, workers (individuals and unions) as well as employers is to prevent and avoid termination of employment at all costs, the Law No. 11 of 2020, re. Job Creation allows massive dismissal of employees due to economic necessity or state of emergency. This article shall critically examine how the prevailing law, Law No. 11 of 2020 re. Job Creation regulates termination of employment in case of state of emergency.  

Benzodiazepines Today and Tomorrow

2020 ◽  
pp. 193-215
Author(s):  
John J. Coleman
Keyword(s):  
Public Health ◽  
Drug Abuse ◽  
Data Collection ◽  
Evidence Base ◽  
The Public ◽  
Drug Substances ◽  
The Government ◽  
Public Health Strategies ◽  
Effective Public Health

Benzodiazepines (BZDs) and related drugs are widely used for treating a variety of conditions (with varying degrees of evidence-base), but their long-term use (more than 2–4 weeks) can be problematic. They were originally thought (or claimed) to be nonproblematic substitutes for barbiturates, but it is now clear that they have their own set of problems. In addition, they are commonly, albeit ill-advisedly, co-prescribed or used nonmedically in combination with other drug substances. The result of such combinations, particularly with the opioids, can be lethal. Administrative and statutory actions notwithstanding, it appears that reducing problems with BZDs will depend on a comprehensive approach that includes improved education for patients, prescribers, regulators, insurers, and the public. First and foremost, however, there is a pressing need for the government to improve its drug-abuse data collection, specifically how it monitors drug-related morbidity and mortality. This chapter reviews the information that demonstrates how an understanding of all of the dynamics is essential for designing effective public-health strategies to reduce BZD-associated problems.

scholarly journals KEWENANGAN BADAN PENGAWAS OBAT DAN MAKANAN TERHADAP PERDA PROVINSI BALI NO 5 TAHUN 2012 TENTANG PENGENDALIAN PEREDARAN MINUMAN BERALKOHOL

2013 ◽  
Vol 2 (3) ◽  
Author(s):  
I Putu Mahentoro
Keyword(s):  
Drug Administration ◽  
Food And Drug Administration ◽  
Alcoholic Beverage ◽  
Provincial Government ◽  
Alcoholic Beverages ◽  
Ministry Of Health ◽  
The Public ◽  
The Republic ◽  
The Government ◽  
Imported Foods

ABSTRACTThe research was conducted based on the same authority which is ownedby the two institutions, namely Food and Drug Administration of the Republic ofIndonesia and Bali Provicial Government in monitoring and controlling ofalcoholic beverages in Bali.The results of this study demonstrate the Food and Drug Administrationand the Provincial Government of Bali have the same authority to supervise andcontrol alcoholic beverages in Bali. Bali Local Government Regulation Number 5of 2012 on the Circulation of Alcoholic Beverage Control only requires each hasa label on alcoholic beverages issued by the Government of Bali has to bedistributed to the public, while the authority of the Food and Drug Administrationis regulated in the Regulation of Minister of Health of the Republic of IndonesiaNumber 382/MENKES/PER/VI/1989 on Registration of Food that requires allfood produced both by local producers and imported foods are required to beregistered to the Ministry of Health through the Food and Drug Administration.In the Regulation Number 5 Year 2012 did not include the authority of theFood and Drug Administration (the Empty Norms) so that the Food and DrugAdministration can not perform optimally the law enforcement againstmanufacturers, distributors and sellers of alcoholic beverages in violation. Tocope with the condition it should be a amendment in the Bali ProvincialRegulation Number 5 of 2012 by stating firmly and clearly the authority of theFood and Drug Administration related to the registration of food, which requiresthat for all foods and beverages that will be distributed to the public must beregistered to the Ministry of Health through the Food and Drug Administration.

No Change in Surgical and Hospitalization Trends Despite Higher Exposure to Anti-Tumor Necrosis Factor in Inflammatory Bowel Disease in the Québec Provincial Database From 1996 to 2015

2020 ◽  
Author(s):  
Christine Verdon ◽  
Jason Reinglas ◽  
Janie Coulombe ◽  
Lorant Gonczi ◽  
Talat Bessissow ◽  
...  
Keyword(s):  
Public Health ◽  
Inflammatory Bowel Disease ◽  
Tumor Necrosis Factor ◽  
Tumor Necrosis ◽  
Major Surgery ◽  
Newly Diagnosed ◽  
The Public ◽  
Before And After ◽  
Inflammatory Bowel ◽  
Necrosis Factor

Abstract Background Crohn disease (CD) and ulcerative colitis (UC) have high health care expenditures because of medications, hospitalizations, and surgeries. We evaluated disease outcomes and treatment algorithms of patients with inflammatory bowel disease (IBD) in Québec, comparing periods before and after 2010. Methods The province of Québec’s public health administrative database was used to identify newly diagnosed patients with IBD between 1996 and 2015. The primary and secondary outcomes included time to and probability of first and second IBD-related hospitalizations, first and second major surgery, and medication exposures. Medication prescriptions were collected from the public prescription database. Results We identified 34,644 newly diagnosed patients with IBD (CD = 59.5%). The probability of the first major surgery increased after 2010 in patients with CD (5 years postdiagnosis before and after 2010: 8% [SD = 0.2%] vs 15% [SD = 0.6%]; P < 0.0001) and patients with UC (6% [SD = 0.2%] vs 10% [SD = 0.6%] ;P < 0.0001). The probability of the second major surgery was unchanged in patients with CD. Hospitalization rates remained unchanged. Patients on anti-tumor necrosis factor (anti-TNF) medications had the lowest probability of hospitalizations (overall 5-year probability in patients with IBD stratified by maximal therapeutic step: 5-aminosalicylic acids 37% [SD = 0.6%]; anti-TNFs 31% [SD = 1.8%]; P < 0.0001). Anti-TNFs were more commonly prescribed for patients with CD after 2010 (4% [SD = 0.2%] vs 16% [SD = 0.6%]; P < 0.0001) in the public health insurance plan, especially younger patients. Corticosteroid exposure was unchanged before and after 2010. Immunosuppressant use was low but increased after 2010. The use of 5-ASAs was stable in patients with UC but decreased in patients with CD. Conclusions The probability of first and second hospitalizations remained unchanged in Québec and the probability of major surgery was low overall but did increase despite the higher and earlier use of anti-TNFs.

Public health challenges during the COVID-19 outbreak in Nepal: a commentary

2020 ◽  
Vol 34 (4) ◽  
pp. 373-376 ◽  
Author(s):  
Sharmistha Sharma ◽  
Jeevan Bhatta
Keyword(s):  
Public Health ◽  
Design Methodology ◽  
Health Workers ◽  
Health Interventions ◽  
Content Type ◽  
The Public ◽  
Public Health Challenges ◽  
Current Scenario ◽  
Public Health Officials ◽  
The Government

PurposeThe purpose of this paper is to depict the current scenario of coronavirus diseases 2019 (COVID-19) in Nepal, how the government is tackling this pandemic as well as look at the public health challenges that Nepal is facing and might face in the future.Design/methodology/approachThis paper is a viewpoint of COVID-19 activities conducted in Nepal.FindingsNepal is vulnerable to COVID-19, as it shares borders with China and India. Cases have started to be seen in different parts of Nepal. Government of Nepal has started various measures to control the spread of the virus such as deploying health workers, information sharing via different mediums. However, there are still many challenges that the government and public health officials need to be concerned about as well.Originality/valueThis paper provides information about the situation of COVID-19 in Nepal, how the government is handling, and public health challenges that may arise. This paper can be beneficial for further public health interventions.

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