scholarly journals Interpreting the Lancet surgical indicators in Somaliland: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e042968
Author(s):  
Shukri Dahir ◽  
Cesia F Cotache-Condor ◽  
Tessa Concepcion ◽  
Mubarak Mohamed ◽  
Dan Poenaru ◽  
...  
Keyword(s):  
Low Income ◽  
Assessment Tool ◽  
Surgical Care ◽  
Cross Sectional Study ◽  
Current Status ◽  
Health Coverage ◽  
Surgical Volume ◽  
Cross Sectional ◽  
Middle Income ◽  
Surgical Workforce

BackgroundThe unmet burden of surgical care is high in low-income and middle-income countries. The Lancet Commission on Global Surgery (LCoGS) proposed six indicators to guide the development of national plans for improving and monitoring access to essential surgical care. This study aimed to characterise the Somaliland surgical health system according to the LCoGS indicators and provide recommendations for next-step interventions.MethodsIn this cross-sectional nationwide study, the WHO’s Surgical Assessment Tool–Hospital Walkthrough and geographical mapping were used for data collection at 15 surgically capable hospitals. LCoGS indicators for preparedness was defined as access to timely surgery and specialist surgical workforce density (surgeons, anaesthesiologists and obstetricians/SAO), delivery was defined as surgical volume, and impact was defined as protection against impoverishment and catastrophic expenditure. Indicators were compared with the LCoGS goals and were stratified by region.ResultsThe healthcare system in Somaliland does not meet any of the six LCoGS targets for preparedness, delivery or impact. We estimate that only 19% of the population has timely access to essential surgery, less than the LCoGS goal of 80% coverage. The number of specialist SAO providers is 0.8 per 100 000, compared with an LCoGS goal of 20 SAO per 100 000. Surgical volume is 368 procedures per 100 000 people, while the LCoGS goal is 5000 procedures per 100 000. Protection against impoverishing expenditures was only 18% and against catastrophic expenditures 1%, both far below the LCoGS goal of 100% protection.ConclusionWe found several gaps in the surgical system in Somaliland using the LCoGS indicators and target goals. These metrics provide a broad view of current status and gaps in surgical care, and can be used as benchmarks of progress towards universal health coverage for the provision of safe, affordable, and timely surgical, obstetric and anaesthesia care in Somaliland.

Doctor Retention in Ireland - What it may mean for the Global Health Workforce Reform Agenda Comment on "Doctor Retention: A Cross-sectional Study of How Ireland Has Been Losing the Battle"

2020 ◽  
Author(s):  
Bernard Hope Taderera
Keyword(s):  
Global Health ◽  
Health Workforce ◽  
Cross Sectional Study ◽  
Early Career ◽  
Healthcare Personnel ◽  
Health Coverage ◽  
Cross Sectional ◽  
Middle Income ◽  
Reform Agenda ◽  
Medical Graduates

The study of healthcare personnel migration in Ireland reports that most medical graduates plan to leave the country’s health system. It may be possible to address this challenge by understanding and addressing the reasons why young doctors plan to leave. Future studies should contribute to the retention of early career doctors in highincome countries such as Ireland. This will help reduce the migration of doctors from low- and middle-income countries in order to address the global health workforce crisis and its impact on the attainment of universal health coverage in all health systems.

Inpatients’ experience and the associated factors: A cross-sectional study at Lung hospital, Son La, in 2020

2021 ◽  
Vol 05 (04) ◽  
pp. 110-116
Author(s):  
Huu Thang Nguyen ◽  
◽  
Thi Nguyet Minh Doan ◽  
Thanh Huong Tran ◽  
Hai Thanh Pham
Keyword(s):  
Low Income ◽  
Associated Factors ◽  
Income Group ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Related Factors ◽  
Cross Sectional ◽  
Middle Income ◽  
Medical Facilities ◽  
Middle Income Group

Objectives: Medical facilities with an autonomous tendency always try to serve positive and pleasant experiences to improve the brand name, increase patient satisfaction and loyalty. A descriptive cross-sectional study was conducted on 245 inpatients at Lung Hospital in Son La province in 2020. To describe the current situation of the inpatient's experience at Lung Hospital in Son La province by 2020 and its related factors. Methods: This was a cross-sectional study conducted on 245 inpatients at Son La Lung Hospital Results: The study showed that the total score of inpatients’ experience ranged from 22 points to 57 points and the mean of it was 39.7 (6.13) points. Subject's experience scores were divided into 2 groups, the satisfied group accounted for 32.7% and the percentage of the unsatisfied group was 67.3%. As compared to men, a higher total score of women was (OR: 1.134; 95% CI: 0.284-0.997). The urban area group’s score was 1,190 times higher than that of those who live in rural and mountainous areas (95% CI: 1,010 - 1,400). The middle-income group had more positive experience than the low-income group (OR: 1.180; 95% CI: 1.010 - 1.370). Conclusions: Our research showed that gender, living area and economic condition affected the total score of inpatients’ experience at the Lung hospital. Keywords: Patient experiences, inpatient treatment, hospital, associated factors

scholarly journals The ISN 0by25 Global Snapshot Study

2016 ◽  
Vol 68 (Suppl. 2) ◽  
pp. 29-31 ◽  
Author(s):  
John Feehally
Keyword(s):  
Low Income ◽  
Kidney Injury ◽  
Complete Recovery ◽  
Cross Sectional Study ◽  
Low Income Countries ◽  
Clinical Indication ◽  
Partial Recovery ◽  
Cross Sectional ◽  
Middle Income ◽  
New Information

The International Society of Nephrology's (ISN) 0by25 initiative aims to prevent avoidable deaths from acute kidney injury (AKI) by 2025, most of which occur in low and lower middle-income countries (LLMICs). To increase evidence about the epidemiology of AKI, especially in LLMICs, ISN conducted a ‘Global Snapshot', a multinational, cross-sectional study in which 322 physicians from 72 countries in 6 continents identified 3,664 adults and 354 children with AKI who were under their care of which 45% were from LLMICs, nevertheless low-income countries were under-represented. In LLMICs, patients with AKI were younger, and community acquired AKI was more common. Hypotension (40%) and dehydration (39%) were the most common causes of AKI. Dehydration was a more common cause in LLMIC, as were sepsis, pregnancy-related AKI and animal envenomation. Acute dialysis was performed in 23% of patients. Eight percent had a clinical indication for this but were not dialyzed. In LLMICs, lack of resources (16%) and inability to afford therapy (30%) accounted for almost half of these cases. Overall mortality at 7 days was 11% and was higher in LLMICs. Complete recovery from AKI occurred in 30% of patients and partial recovery 37%, and was more often complete in LLMICs. The 0by25 Global Snapshot provides new information about the worldwide epidemiology of AKI, helping to identify elements that would be amenable in intervention to reduce preventable deaths.

scholarly journals Prevalence of substance use in Bangladesh

2020 ◽  
Vol 32 (1) ◽  
pp. 1-8
Author(s):  
Md Faruq Alam ◽  
Mekhala Sarkar ◽  
Mohammad Tariqul Alam ◽  
Helal Uddin Ahmed ◽  
Avra Das Bhowmik ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Low Income ◽  
Sampling Technique ◽  
Income Group ◽  
Cross Sectional Study ◽  
Cluster Sampling ◽  
Statistical Parameters ◽  
Cross Sectional ◽  
Middle Income

The prevalence of substance use is on rising trend in the country. This two-stage nationwide multicentric community based cross sectional study was conducted by National Institute of Mental Health (NIMH), Dhaka during the period of September 2017 to July 2018 to determine the prevalence of substance use as well as to identify the proportion of users used different substances and to find out socio-demographic correlates of substance use in Bangladesh. The sample were collected by cluster sampling technique. In the first stage data were collected from 19692 respondents aged between 7 years and above in 140 clusters through face-to-face interview using semi-structured questionnaires to collect information by trained data collector. Diagnoses of substance use were made in the second stage of interview by research psychiatrists following DSM-5 diagnostic criteria of mental disorders. Descriptive and inferential statistics of the collected data was done using standard statistical parameters. SPSS programme (Version 23) was used to summarize and to analyze the data. The results showed that, the prevalence of substance use was found as 3.3% among the population 18 years and above. Prevalence of substance use was 4.8% in male and 0.6% in female. Most frequently used substances include cannabis in (42.7%), alcohol in 27.5%, amphetamine (yaba) in 15.2%, opioid in 5.3% and sleeping pills in 3.4% users. Among professions of substance users 6.7% were labors, 5.7% unemployed, 4.3% business men, 3.8% farmers and 3.5% service holders. Extremes of social classes were found as increased users of substances such as people with low income 3.2% and people with high income 3.8% using as against 2.6% in middle income group. The data of this community survey will be used for planning of mental health services in Bangladesh. Bang J Psychiatry June 2018; 32(1): 1-8

scholarly journals The COVID-19 vaccination experience in Bangladesh: Findings from a cross-sectional study

2021 ◽  
Vol 35 ◽  
pp. 205873842110656
Author(s):  
Md. Rabiul Islam ◽  
Moynul Hasan ◽  
Waheeda Nasreen ◽  
Md. Ismail Tushar ◽  
Mohiuddin Ahmed Bhuiyan
Keyword(s):  
Adverse Events ◽  
Low Income ◽  
Heart Diseases ◽  
Developed Countries ◽  
Cross Sectional Study ◽  
Low Income Countries ◽  
Sectional Study ◽  
Cross Sectional ◽  
Middle Income ◽  
Mass Immunization

Objectives Vaccination rollout against COVID-19 has started in developed countries in early December 2020. Mass immunization for poor or low-income countries is quite challenging before 2023. Being a lower–middle-income country, Bangladesh has begun a nationwide COVID-19 vaccination drive in early February 2021. Here, we aimed to assess the opinions, experiences, and adverse events of the COVID-19 vaccination in Bangladesh. Methods We conducted this online cross-sectional study from 10 February 2021, to 10 March 2021, in Bangladesh. A self-reported semi-structured survey questionnaire was used using Google forms. We recorded demographics, disease history, medication records, opinions and experiences of vaccination, and associated adverse events symptoms. Results We observed leading comorbid diseases were hypertension (25.9%), diabetes (21.1%), heart diseases (9.3%), and asthma (8.7%). The most frequently reported adverse events were injection site pain (34.3%), fever (32.6%), headache (20.2%), fatigue (16.6%), and cold feeling (15.4%). The chances of having adverse events were significantly higher in males than females ( p = 0.039). However, 36.4% of respondents reported no adverse events. Adverse events usually appeared after 12 h and went way within 48 h of vaccination. Besides, 85.5% were happy with the overall vaccination management, while 88.0% of the respondents recommended the COVID-19 vaccine for others for early immunization. Conclusion According to the present findings, reported adverse events after the doses of Covishield in Bangladesh were non-serious and temporary. In Bangladesh, the early vaccination against COVID-19 was possible due to its prudent vaccine deal, previous mass vaccination experience, and vaccine diplomacy.

scholarly journals Evaluating capacity at three government referral hospital emergency units in the Kingdom of Eswatini using the WHO Hospital Emergency Unit Assessment Tool

2020 ◽  
Author(s):  
Jennifer Pigoga ◽  
Anjni Patel Joiner ◽  
Phindile Chowa ◽  
Jennifer Luong ◽  
Masitsela Mhlanga ◽  
...  
Keyword(s):  
Emergency Care ◽  
Assessment Tool ◽  
Care Delivery ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Emergency Unit ◽  
Hospital Emergency ◽  
Cross Sectional ◽  
Middle Income ◽  
Entry Points

Abstract Background The Kingdom of Eswatini, a lower-middle income nation of 1.45 million in southern Africa, has recently identified emergency care as a key strategy to respond to the national disease burden. We aimed to evaluate the current capacity of hospital emergency care areas using the WHO Hospital Emergency Unit Assessment Tool (HEAT) at government referral hospitals in Eswatini. Methods We conducted a cross-sectional study of three government referral hospital emergency care areas using HEAT in May 2018. This standardised tool assists healthcare facilities to assess the emergency care delivery capacity in facilities and support in identifying gaps and targeting interventions to strengthen care delivery within emergency care areas. Senior-level emergency care area employees, including senior medical officers and nurse matrons, were interviewed using the HEAT. Results All sites provided some level of emergency care 24 hours a day, seven days a week, though most had multiple entry points for emergency care. Only one facility had a dedicated area for receiving emergencies and a dedicated resuscitation area; two had triage areas. Facilities had limited capacity to perform signal functions (life-saving procedures that require both skills and resources). Commonly reported barriers included training deficits and lack of access to supplies, medications, and equipment. Sites also lacked formal clinical management and process protocols (such as triage and clinical protocols). Conclusions The HEAT highlighted strengths and weaknesses of emergency care delivery within hospitals in Eswatini and identified specific causes of these system and service gaps. In order to improve emergency care outcomes, multiple interventions are needed, including training opportunities, improvement in supply chains, and implementation of clinical and process protocols for emergency care areas. We hope that these findings will allow hospital administrators and planners to develop effective change management plans.

scholarly journals Understanding the Effect of COVID-19 Pandemic on Emergency Surgical Care Delivery in India: A Multicenter Cross-Sectional Study

2020 ◽  
Author(s):  
Anita Gadgil ◽  
Geetu Bhandoria ◽  
Monty Khajanchi ◽  
Bhakti Sarang ◽  
Deepa Kizhakke Veetil ◽  
...  
Keyword(s):  
Health Care Services ◽  
Emergency Services ◽  
Care Delivery ◽  
Surgical Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Middle Income ◽  
Care Services ◽  
Research Consortium

Abstract Background The ongoing COVID-19 pandemic and subsequent lockdown have adversely affected global health care services to varying extent. Emergency Services were also affected along with elective surgeries, which were deferred to accommodate the added burden of COVID 19 affected patients, on the healthcare systems. We aimed to assess the change in delivery of essential and emergency surgeries due to the pandemic.Methodology A research consortium led by WHO Collaboration Centre (WHOCC) for Research in Surgical Care Delivery in Low- and Middle-Income countries (LMIC), India, conducted this retrospective cross-sectional study with 12 recruited centers. All surgeries performed during the months of April 2020 were compared with those performed in April 2019. These surgeries were stratified into emergency and elective, and further categorized based on NHS surgery prioritization documents. Results A total of 4396 surgeries were performed at these centers in April 2019 and 1216 surgeries were performed in same month during 2020, yielding a fall of 72.3% (1216 /4396).We found a 54% reduction in emergency surgeries and a 91% reduction in the elective surgeries. Number of cesarean sections reduced by 29.7% and fracture surgeries declined by 85.3% Laparotomies and surgeries for local soft tissue infections with necrotic tissue reduced by 71.7% and 69.5% respectively.Conclusion Our study quantifies the effects of COVID 19 pandemic on surgical care delivery in India and documents that the overall surgical volume reduced by three fourths in the pandemic period. Emergency surgeries reduced to half when compared with pre-pandemic period. Cesarean section surgeries were affected the least by pandemic, whereas the fracture surgeries and laparotomies were affected the most.

scholarly journals State of deworming coverage and equity in low-income and middle-income countries using household health surveys: a spatiotemporal cross-sectional study

2019 ◽  
Vol 7 (11) ◽  
pp. e1511-e1520 ◽  
Author(s):  
Nathan C Lo ◽  
Sam Heft-Neal ◽  
Jean T Coulibaly ◽  
Leslie Leonard ◽  
Eran Bendavid ◽  
...  
Keyword(s):  
Low Income ◽  
Health Surveys ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries

Association of Malnutrition and Socioeconomic Status in Dental Caries – A Cross Sectional Study

2014 ◽  
Vol 8 (1) ◽  
pp. 12-15 ◽  
Author(s):  
VC Punitha ◽  
P Sivaprakasam
Keyword(s):  
Socioeconomic Status ◽  
Dental Caries ◽  
Nutritional Status ◽  
Low Income ◽  
Income Group ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Middle Income ◽  
Significant Difference ◽  
Middle Income Group

ABSTRACT The objective Of this study was to assess the association of nutritional status and socio economic status in dental caries among rural children. Methods Children of age 6 – 10 yrs (n = 120) from government schools in two villages of Kanchipuram district were the study subjects. The children's nutritional status was assessed by means of anthropometric measurements. Body Mass Index using weight and height of children was evaluated using the reference standard of the WHO 2007. The socioeconomic status was assessed based on education, occupation and material possession. The children's oral cavity was screened for decayed and filled teeth (dft index) Results Nutritional assessment showed that 66.7% were malnourished. Female children (71.7%) were more malnourished than males (62.2%) with no significant difference between them. Children belonging to the low income group were more malnourished (74.7%) than children of middle income group (53.3%) (p = 0.01). The prevalence of caries in this population was 60% with mean dft index score of 1.7. Caries occurrence was more in the low income group (61.3%) than middle income group (57.8%) with no significant difference between the two groups (p=0.70). Comparing the caries occurrence between the malnourished children and the normal weight children it was seen that the caries occurrence was less in the malnourished children (p=0.23) Conclusion This cross sectional study concludes that malnutrition is not associated with dental caries and socioeconomic status influences nutritional status of a child in this rural population.

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