scholarly journals Effect of household relocation on child vaccination and health service utilisation in Dhaka, Bangladesh: a cross-sectional community survey

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e026176
Author(s):  
Lily Horng ◽  
Nadira Sultana Kakoly ◽  
Jaynal Abedin ◽  
Stephen P Luby
Keyword(s):  
Health Services ◽  
Respiratory Illness ◽  
Community Survey ◽  
Service Utilisation ◽  
Medical Provider ◽  
Cross Sectional ◽  
Total N ◽  
Household Relocation ◽  
The Impact ◽  
Children Under 5

ObjectiveTo explore the relationship between household relocation and use of vaccination and health services for severe acute respiratory illness (ARI) among children in Dhaka, Bangladesh.DesignAnalysis of cross-sectional community survey data from a prior study examining the impact ofHaemophilus influenzaetype b vaccine introduction in 2009 on meningitis incidence in Bangladesh.SettingCommunities surrounding two large paediatric hospitals in Dhaka, Bangladesh.ParticipantsHouseholds with children under 5 years old who either recently relocated<12 months or who were residentially stable living>24 months in their current residence (total n=10 020) were selected for this study.Primary outcome measuresFull vaccination coverage among children aged 9-59 months and visits to a qualified medical provider for severe ARI among children under 5 years old.ResultsUsing vaccination cards with maternal recall, full vaccination was 80% among recently relocated children (n=3795) and 85% among residentially stable children (n=4713; χ2=37.2, p<0.001). Among children with ARI in the prior year, 69% of recently relocated children (n=695) had visited a qualified medical provider compared with 82% of residentially stable children (n=763; χ2=31.9, p<0.001). After adjusting for demographic and socioeconomic characteristics, recently relocated children were less likely to be fully vaccinated (prevalence ratio [PR] 0.97; 95% CI 0.95 to 0.99; p=0.016) and to have visited a qualified medical provider for ARI (PR 0.88; 95% CI 0.84 to 0.93; p<0.001).ConclusionsChildren in recently relocated households in Dhaka, Bangladesh, have decreased use of vaccination and qualified health services for severe ARI.

scholarly journals Low and unequal use of outpatient health services in public primary health care facilities in southern Ethiopia: a facility-based cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hiwot Abera Areru ◽  
Mesay Hailu Dangisso ◽  
Bernt Lindtjørn
Keyword(s):  
Health Service ◽  
Health Services ◽  
Health Facilities ◽  
Health Service Utilisation ◽  
Southern Ethiopia ◽  
Service Utilisation ◽  
Cross Sectional ◽  
Health Authorities ◽  
Utilisation Rate ◽  
Children Under 5

Abstract Background Outpatient department visits per individual for each year are one of the core indicators of healthcare delivery to assess accessibility or quality of services. In addition, this study aimed to assess health service utilisation and disease patterns in southern Ethiopia, by including the health authorities’ suggestions to improve the services. No study has assessed this in Ethiopia previously. Methods An institution-based cross-sectional design study was done in 65 primary health care units in Dale and Wonsho districts, in Sidama region, for all patients visiting health facilities from 1 July 2017 to 30 June 2018. We estimated the utilisation rate as visits per person per year, the odds ratio for health use and proportions of diseases’ diagnoses. The results of our study were presented to local health authorities, and their suggestions for improvements were incorporated into the analysis. Result A total of 81,129 patients visited the health facilities. The annual outpatient health service utilisation was 0.18 (95% CI: 0.18–0.19) new visits per person per year. The health service utilisation rate per year for the rural population was lower than the urban utilisation by 91% (OR = 0.09; 95% CI: 0.08–0.09). Children in the age group of 5–14 years had lower odds of health service utilisation by 78% (OR = 0.22; 95% CI: 0.21–0.23), compared to children under 5 years of age. Females were four times (OR = 4.17; 95% CI: 4.09–4.25) more likely to utilise health services than males. Febrile illness constituted 17.9% (14,847 of 83,148) of the diagnoses in all age groups. Almost half of the febrile cases, 46.5% (3827 of 8233), were among children under 5 years of age. There were very few cases of non-communicable diseases diagnosed in the health facilities. The health authorities suggested improving diagnostic capacities at health centres, enhancing health professionals’ skill and attitudes, and improving affordability and physical accessibility of the services. Conclusion The health service utilisation rate was low in Sidama. The use of health services was lower among rural residents, men, children and elderly, and health post users. Improving the quality, affordability and accessibility of the health services, by involving responsible stakeholders could increase service usage.

scholarly journals Quality evaluation of community pharmacy blood pressure (BP) screening services: an English cross-sectional survey with geospatial analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e032342 ◽  
Author(s):  
Ravina Barrett ◽  
James Hodgkinson
Keyword(s):  
Blood Pressure ◽  
Community Pharmacy ◽  
Value Added ◽  
Primary Objective ◽  
Service Utilisation ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Undiagnosed Hypertension ◽  
Service Redesign ◽  
The Impact

ObjectivesThe primary objective was to assess the accuracy (calibration and validation status) of digital blood pressure (BP) monitors used within community pharmacy in England and the secondary objectives were to assess the overall quality of the BP service by assessing service prevalence, service utilisation and other in-service considerations.DesignA cross-sectional survey.SettingPrimary-care retail-pharmacies.Participants500 pharmacies that contribute to government dispensing-data were invited by post to complete the survey. Private contractors were excluded.InterventionsWe conducted a questionnaire survey with a follow-up (September 2018 to December 2018).Results109 responses were received. 61% (n=66) of responding pharmacies provided a free BP check to their patients. 40 (61%) pharmacies used recommended validated clinical metres, 6 (9%) had failed validation and 20 (30%) provided too little information to enable us to determine their monitor’s status.ConclusionsResponding pharmacies were able to provide useful BP monitoring services to their patients, though quality enhancements need to be implemented. Majority of pharmacies use validated BP monitors, however, there was a lack of range of cuff sizes, variation in replacement and calibration of monitors and apparent absence of such practice in a minority of pharmacies alongside variation in training standards. We noted higher frequency of BP screening in the most deprived postcodes.We recommend in-service redesign and delivery improvements, and suggest professional bodies and researchers work together to create clearer frameworks for front-line practitioners, creating appropriate incentives to facilitate this service redesign.Funders and policy setters should consider the value added to the National Health Service and other healthcare agencies of such screening by pharmacy providers both nationally and internationally. It has the potential to reduce complications of undiagnosed hypertension and the medicines burden that it creates. Future work should examine the impact of pharmacist-led BP screening on patients.

scholarly journals Impact of COVID-19 and mitigation plans on essential health services: institutional experience of a hospital in Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Firaol Dandena ◽  
Berhanetsehay Teklewold ◽  
Dagmawi Anteneh
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Services ◽  
Cross Sectional Study ◽  
Vital Role ◽  
Treatment Center ◽  
Cross Sectional ◽  
Poor Countries ◽  
Care Services ◽  
The Impact

Abstract Background Health systems around the world are being challenged by an on-going COVID-19 pandemic. The COVID-19 pandemic and associated response can have a significant downstream effect on access to routine health care services, and indirectly cause morbidity and mortality from causes other than the disease itself, especially in resource-poor countries such as Ethiopia. This study aimed to explore the impact of the pandemic on these services and measures taken to combat the effect. Methods The study was conducted at St. Paul’s hospital millennium medical college (SPHMMC) from December 15, 2020 to January 15, 2021 using a comparative cross-sectional study design. We collected data on the number of clients getting different essential health care services from May to October 2019 (Pre COVID) and the same period in 2020 (during a COVID-19 pandemic) from the patient registry book. The analysis was done with SPSS version 24 software. Result Overall, the essential services of SPHMMC were affected by the COVID-19 pandemic. The most affected service is inpatient admission, which showed a 73.3% (2044 to 682) reduction from the pre-COVID period and the least affected is maternal service, which only decreased by 13% (3671 to 3177). During the 6 months after the COVID-19 pandemic, there was a progressive increment in the number of clients getting essential health services. Conclusion and recommendation The establishment of a triple setup for fighting against COVID-19, which encompasses non-COVID services, an isolation center and a COVID-19 treatment center, played a vital role in preserving essential health services.

scholarly journals Delays and Disruptions in Cancer Health Care Due to COVID-19 Pandemic: Systematic Review

2021 ◽  
pp. 311-323
Author(s):  
Rachel Riera ◽  
Ângela Maria Bagattini ◽  
Rafael Leite Pacheco ◽  
Daniela Vianna Pachito ◽  
Felipe Roitberg ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Services ◽  
Methodological Quality ◽  
Data Extraction ◽  
Cross Sectional Study ◽  
Routine Activity ◽  
Cross Sectional ◽  
Cancer Services ◽  
The Impact

PURPOSE There has been noteworthy concern about the impact of COVID-19 pandemic on health services including the management of cancer. In addition to being considered at higher risk for worse outcomes from COVID-19, people with cancer may also experience disruptions or delays in health services. This systematic review aimed to identify the delays and disruptions to cancer services globally. METHODS This is a systematic review with a comprehensive search including specific and general databases. We considered any observational longitudinal and cross-sectional study design. The selection, data extraction, and methodological assessment were performed by two independent reviewers. The methodological quality of the studies was assessed by specific tools. The delays and disruptions identified were categorized, and their frequency was presented. RESULTS Among the 62 studies identified, none exhibited high methodological quality. The most frequent determinants for disruptions were provider- or system-related, mainly because of the reduction in service availability. The studies identified 38 different categories of delays and disruptions with impact on treatment, diagnosis, or general health service. Delays or disruptions most investigated included reduction in routine activity of cancer services and number of cancer surgeries; delay in radiotherapy; and delay, reschedule, or cancellation of outpatient visits. Interruptions and disruptions largely affected facilities (up to 77.5%), supply chain (up to 79%), and personnel availability (up to 60%). CONCLUSION The remarkable frequency of delays and disruptions in health care mostly related to the reduction of the COVID-19 burden unintentionally posed a major risk on cancer care worldwide. Strategies can be proposed not only to mitigate the main delays and disruptions but also to standardize their measurement and reporting. As a high number of publications continuously are being published, it is critical to harmonize the upcoming reports and constantly update this review.

scholarly journals COVID-19 concerns, health services utilisation and social support among Western Australians with diabetes during the pandemic

2021 ◽  
pp. 1035719X2110408
Author(s):  
Jenny L Olson ◽  
Enrique Mergelsberg ◽  
Jessica Jensen ◽  
Deborah Schofield ◽  
Natasha Watson
Keyword(s):  
Health Services ◽  
Online Survey ◽  
Self Care ◽  
Routine Care ◽  
Service Utilisation ◽  
Health Crisis ◽  
Optimal Service ◽  
Increased Risk ◽  
Pragmatic Assessment ◽  
The Impact

People with diabetes face increased risk of serious COVID-19 complications, making self-care for optimal metabolic management crucial. However, the pandemic has reduced access to routine care among people with diabetes. The pandemic can also elicit distress, which can impact diabetes self-management and health. To understand the impact of COVID-19 on Western Australians with diabetes, we conducted an evaluation involving an online survey of consumers of diabetes health services and an analysis of routine program data (i.e. service utilisation/program attendance). Survey respondents were concerned about contracting COVID-19, many intended to change the way they utilised health services and many indicated they would continue to socially isolate. Utilisation of digital/telephone services peaked between April and June 2020. Despite the concerns indicated, a participation resurgence was observed upon resumption of face-to-face programs. Continued access to diabetes programs via multiple modes of delivery is critical to support optimal self-care and mitigate COVID-19 risks, distress and social isolation. This timely and pragmatic assessment of consumer beliefs synthesised with routinely collected evaluation data represents an agile approach to evaluation through an emerging public health crisis. The findings helped to ensure optimal service delivery to meet the needs of this priority population throughout the pandemic.

scholarly journals Impact of COVID-19 and Mitigation Plans on Essential Health Services: Institutional Experience of St. Paul’s Hospital Millennium Medical College

2021 ◽  
Author(s):  
Firaol Dandena ◽  
Berhanetsehay Teklewold ◽  
Dagmawi Anteneh
Keyword(s):  
Health Services ◽  
Health Care Services ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Vital Role ◽  
Cross Sectional ◽  
Poor Countries ◽  
Medical College ◽  
Treatment Centre ◽  
The Impact

Abstract BackgroundHealth systems around the world are being challenged by on-going COVID-19 pandemic .The COVID-19 pandemic and associated response can have a significant downstream effect on access to routine health care services, and indirectly cause morbidity and mortality from causes other than the disease itself ,especially in resource-poor countries such Ethiopia. This study aimed to explore the impact of the pandemic on these service and measures taken to combat the effect.MethodsThe study was conducted at St. Paul’s hospital millennium medical college (SPHMMC). The study was conducted from December 15, 2020 to January 15, 2021 using comparative cross- sectional study design. We collected data on the number of clients getting different essential healthcare services from May to October 2019 (Pre COVID) and same period in 2020 (during COVID-19 pandemic) from patient registry book. The analysis was done with SPSS version 24 software.ResultOverall, the essential services of SPHMMC were affected by COVID-19 pandemic. The most affected service is inpatient admission that showed 73 % (2044 to 682) reduction from pre- COVID period and the least affected is maternal service, which only decrease by 13% (3671 to 3177). During the 6 months after COVID-19 pandemic, there is a progressive increment in number of clients getting essential health services.ConclusionThe establishment of a triple setup for fighting against COVID-19, which encompass; non COVID service, isolation centre and COVID-19 treatment centre played a vital role in preserving essential health services.

scholarly journals The Functional Impacts of the Covid-19 Pandemic: A Rapid Review

2020 ◽  
Author(s):  
Danielle Hitch ◽  
Emma Cramer ◽  
Emily Adcock ◽  
Taylah Sayers ◽  
Helen Nelson ◽  
...  
Keyword(s):  
Health Service ◽  
Health Services ◽  
Healthcare Workers ◽  
Quantitative Methods ◽  
Systems Approach ◽  
Rapid Review ◽  
Cross Sectional ◽  
Functional Impact ◽  
To Come ◽  
The Impact

Abstract Background: The Covid-19 pandemic is having a severe and unprecedented impact on human functioning, due to its influence on bodily functions and structures, the activities we participate in and the environments in which we live. The aim of this rapid review is to inform health services planning and decision making, by identifying and synthesizing the potential functional impact of the Covid-19 pandemic on human health and wellbeing.Methods: This rapid review was completed within four weeks during April – May 2020. The review focused on primary sources describing and evaluating the functional impact of the SARS, MERS and Covid-19 coronavirus pandemics, published since January 2000 in peer reviewed journal articles. All included sources were evaluated for quality, and the International Classification of Function provided a theoretical structure for synthesizing the available evidence.Results: A total of 65 sources met the inclusion criteria for this review. The majority (n=42, 61.6%) were related to the SARS pandemic, and originated from Asia for North America. Almost half of the reviewed sources (n=32, 49.2%) investigated the impact of coronavirus pandemics on the community, with smaller evidence bases related to people with coronaviruses and their families (n=19, 29.2%) and healthcare workers (n=17, 26.1%). Of the research sources available, the majority utilized descriptive quantitative methods via cross sectional data collection.The functional impact of the Covid-19 pandemic is likely to spread far beyond infected patients, to influence the wellbeing of healthcare workers and the entire community in both positive and negative ways. The findings of this review indicate that health services must engage with the inter-sectionality of pandemic experiences, collaborate with other sectors as part of society-wide responses and prioritize function as a key outcome.Conclusions:Based on the experience of past coronavirus pandemics, and the experience to date of the current Covid-19 outbreak, every health service in all health systems must be prepared to prevent and manage the functional impacts of the Covid-19 pandemic, possibly for decades to come. This review highlights the multitude of avenues available for health service prioritization and planning, and emphasized that a multi-dimensional, multi-service (and ideally multi-systems) approach is needed.

scholarly journals Impact of COVID-19 and Partial Lockdown on Access to Care, Self-Management and Psychological Well-being among People with Diabetes: A Cross-sectional Study

2020 ◽  
Author(s):  
Ester Yeoh ◽  
Sooon Guan Tan ◽  
Yingshan Lee ◽  
Ying Yee Low ◽  
Su Chi Lim ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
Health Services ◽  
Clinical Care ◽  
Self Care ◽  
Well Being ◽  
Cross Sectional ◽  
Disinhibited Eating ◽  
Health Services Access ◽  
The Impact

Background The impact of lockdown measures can be widespread, affecting both clinical and psychosocial aspects of health. This study aims to assess changes in health services access, diabetes self-care, behavioral and psychological impact of COVID-19 and partial lockdown in Singapore. Methods We conducted a cross-sectional online survey amongst people with diabetes with the Diabetes Health Profile-18 (DHP-18). Hierarchical regression analyses were performed for each DHP-18 subscale (Psychological Distress, Disinhibited Eating and Barriers to Activity) as dependent variables in separate models. Results Among 301 respondents, 45.2% were women, majority were ethnic Chinese (67.1%), aged 40 to 49 years (24.2%), have Type 2 diabetes (68.4%) and on oral medications (42.2%). During the lockdown, nearly all respondents were able to obtain their medications, supplies (94%) and contact their doctors (97%) when needed. Respondents reported less physical activity (38%), checking of blood pressure (29%) and blood glucose (22%). Previous diagnosis of mental health conditions (β=11.44, p= 0.017), diabetes-related comorbidities (β= 3.98, p= 0.001) and Indian ethnicity (β= 7.73, p= 0.018) were significantly associated with higher psychological distress. Comorbidities were associated with higher disinhibited eating (β= 2.71, p= 0.007) while mental health condition was associated with greater barriers to activities (β= 9.63, p= 0.033). Conclusion Health services access were minimally affected but COVID-19 and lockdown had mixed impact on self-care and management behaviors. Greater clinical care and attention should be provided to people with diabetes with greater number of comorbidities and previous mental health disorders during the pandemic and lockdown.

scholarly journals A Cross-Sectional Epizootiological Study and Risk Assessment of Foot-Related Lesions and Lameness in Intensive Dairy Sheep Farms

Animals ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1614
Author(s):  
Marios Moschovas ◽  
Aphrodite I. Kalogianni ◽  
Panagiotis Simitzis ◽  
Georgios Pavlatos ◽  
Stavros Petrouleas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Dairy Sheep ◽  
Related Factors ◽  
White Line ◽  
Cross Sectional ◽  
Total N ◽  
Foot Health ◽  
Foot Diseases ◽  
Foot Lesions ◽  
The Impact

Foot-related lameness, foot-diseases and lesions are emerging issues in dairy sheep; however, relevant epizootiological studies are scarce, and risk factors have not been elucidated. The objectives of this cross-sectional study were (i) to address this dearth of knowledge by investigating the epizootiology of lameness-related foot-lesions and diseases, and (ii) to assess the impact of potential risk factors on foot health, in intensive dairy sheep farms. Thirty farms were assigned in two representative clusters using a multivariate statistical analysis. Three farms per cluster and 100 multiparous milking ewes per farm (total n = 600) were selected and enrolled in the study. Foot-related lameness, ovine interdigital dermatitis (OID), infectious footrot (IFR), white line disease, hoof wall cracks, as well as health and welfare traits were recorded. Overall prevalence of foot-related lameness was 9.0% and was primarily associated with IFR; however, additional infectious and non-infectious foot diseases and lesions also contributed. Among infectious foot diseases, OID was the most prevalent (21.3%) followed by IFR (8.0%); WLD and hoof wall cracks were the most prevalent non-infectious foot-lesions (37.7% and 15.3%, respectively). IFR and OID prevalence increased with age (p < 0.05) and BCS (p < 0.01), respectively, suggesting that host-related factors and husbandry practices are important determinants of its occurrence.

scholarly journals Patterns of use of secondary mental health services before and during COVID-19 lockdown: observational study

BJPsych Open ◽  
2020 ◽  
Vol 6 (6) ◽  
Author(s):  
Samuel Tromans ◽  
Verity Chester ◽  
Hannah Harrison ◽  
Precina Pankhania ◽  
Hanna Booth ◽  
...  
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Mental Health Services ◽  
Health Services ◽  
Older People ◽  
Child And Adolescent ◽  
Time Frame ◽  
Service Utilisation ◽  
Patterns Of Use ◽  
The Impact

Background The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on both the physical and mental well-being of the global population. Relatively few studies have measured the impact of lockdown on utilisation of secondary mental health services in England. Aims To describe secondary mental health service utilisation pre-lockdown and during lockdown within Leicestershire, UK, and the numbers of serious incidents during this time frame. Method Data pertaining to mental health referral and hospital admissions to adult mental health, child and adolescent mental health, intellectual disability and mental health services for older people were collated retrospectively from electronic records for both 8 weeks pre-lockdown and the first 8 weeks of lockdown in England. Serious incidents during this time frame were also analysed. Results Significantly (P < 0.05) reduced referrals to a diverse range of mental health services were observed during lockdown, including child and adolescent, adult, older people and intellectual disability services. Although admissions remained relatively stable before and during lockdown for several services, admissions to both acute adult and mental health services for older people were significantly (P < 0.05) reduced during lockdown. Numbers of serious incidents in the pre-lockdown and lockdown periods were similar, with 23 incidents pre-lockdown, compared with 20 incidents in lockdown. Conclusions To the best of our knowledge, this is the first UK-based study reporting patterns of use of mental health services immediately prior to and during COVID-19 lockdown. Overall numbers of referrals and admissions reduced following commencement of COVID-19 lockdown. Potential reasons for these observations are discussed.

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