Abstract MP64: Estimated Impact Of Public Health System Reforms To Increase Hypertension Treatment Coverage In India

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Matti Marklund ◽  
Rajeev Cherukupalli ◽  
Priya Pathak ◽  
Dinesh Neupane ◽  
Ashish Krishna ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Health Workers ◽  
Scale Up ◽  
System Reform ◽  
Task Sharing ◽  
Treatment Coverage ◽  
The Public ◽  
The Status

Background: Approaches to scale up hypertension (HTN) treatment are needed in India, where only ~10% of individuals with HTN have controlled blood pressure. Objective: Estimate the current HTN treatment capacity of the public health system in India and model the effects of selected health system reform options. Methods: Using constrained optimization models, we estimated the HTN treatment capacity and salary costs of HTN-treating staff within the public health system; and simulated the potential effects of 1) increased workforce, 2) greater task sharing, and/or 3) reduced visit frequency (quarterly) vs the common practice of monthly visits for prescription refills. Results: An estimated 8% of all adults with HTN could be treated in the status quo (current number of health workers, no further task sharing, and monthly visits) (Figure). Treating 70% of adults with HTN with monthly visits without greater task sharing could require an additional 1.6 million staff, with ~200 billion ₹ (≈US$2.7 billion)) in additional annual salaries. Greater task sharing was estimated to allow the current workforce to treat ~25% of individuals with HTN with monthly visits. Quarterly visits (i.e., longer prescription periods) together with greater task sharing could allow the current workforce to treat ~70% of patients with HTN in India. Conclusion: Expanding HTN treatment coverage through workforce expansion alone will require substantial human and financial resources. The combination of greater task sharing and quarterly visits could increase the coverage of HTN treatment to ~70% of adults with HTN in India, without any expansion of the current workforce of the public health system.

Health strike is unlikely to shape Kenya national vote

2017 ◽  
Keyword(s):  
Public Health ◽  
Public Sector ◽  
Health System ◽  
Public Health System ◽  
Health Workers ◽  
Content Type ◽  
The Public ◽  
General Elections ◽  
Slow Progress ◽  
National Settlement

Significance Public sector doctors have been on strike since early December citing multiple grievances including pay, conditions at facilities and lack of investment in the public health system. The bitter dispute is the latest in a series of public-sector strikes and comes amid campaigning for August’s general elections. Impacts Agreeing to the strikers' full demands would add pressure for higher salaries in private facilities and the public sector. A national settlement could slow progress towards full devolution of health responsibilities to the counties. Elite segments of society do not rely on the public health system and may be less sympathetic to health workers’ grievances.

scholarly journals The importance of strengthening public health systems based on primary health care in designing a successful vaccination strategy: an example of qualitative research in three regions of Senegal.

2019 ◽  
Author(s):  
Jacopo Bianchi ◽  
Chiara Milani ◽  
Angela Bechini ◽  
Sara Boccalini ◽  
Maria José Caldes Pinilla ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Public Health System ◽  
Health Workers ◽  
Conventional Medicine ◽  
Specific Information ◽  
The Public ◽  
Primary Health

Abstract Background Because of its low cost and its capability in reducing child mortality and morbidity, vaccination is considered a successful preventive deed in Low and Middle-Income Countries. In Senegal, vaccines are provided free of charge by the public health system, but the provision of the service is not evenly distributed between and within the Regions. Our study aimed at identifying barriers and enabling factors towards vaccination in three Regions of Senegal. Methods We performed 41 face-to-face semi-structured interviews with health services’ workers and three focus groups with local women in nine different structures in three different Regions of Senegal. We combined health workers’ (HW) and mothers’ points of view with direct observation in order to fulfill our purpose. Results We identified three groups of barriers – structural, personal and psychological – and many subthemes for each of them. Structural and personal barriers such as inadequacy of health structures, shortage of HW, lack of money, distance between villages and health facilities and lack of public transport, hamper mothers from utilising the vaccination service, even when they want to. The lack of effective communication between health personnel and mothers, the lack of collaboration between traditional and conventional medicine and the lack of trust in the public health system as a whole, are major problems to the vaccination uptake too. Conclusions The interlink of several elements in conditioning vaccination coverage suggests the need of implementing global and national strategies to overcome them. The key factor is the presence of a solid health system, publicly funded, based on primary health care. On the other hand, context-specific determinants cannot be detected based on global and non-specific information. The role of community health workers (CHWs) is crucial in overcoming wrong beliefs, lack of knowledge and distrust. They must be regarded as a bridge between HW and population. CHWs should be formally included in the organization of the social-health system, adequately formed and enhanced.

scholarly journals Observations by and Conversations with Health Workers and Hospital Personnel Involved in Transferring Māori Patients and Whānau to Waikato Hospital in Aotearoa New Zealand

2020 ◽  
Vol 17 (23) ◽  
pp. 8833
Author(s):  
Bridgette Masters-Awatere ◽  
Donna Cormack ◽  
Rebekah Graham ◽  
Rachel Brown
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Health Workers ◽  
Hospital Staff ◽  
Home Base ◽  
Key Informants ◽  
The Public ◽  
Aotearoa New Zealand ◽  
Meaningful Engagement

The predominant focus of Aotearoa New Zealand’s public health system on biomedical models of health has left little room for meaningful engagement with holistic indigenous approaches. Culturally appropriate provision and support are recognized for their relevance and importance during hospital transferals. Hospital staff involved in transfers to one of New Zealand’s trauma centers share their observations of whānau Māori engagement during an admission away from their home base. Sixteen key informants share their experiences, which are presented as strategies and challenges to whānau engagement. Three main themes highlight challenges within the health system that make it difficult for hospital staff to engage whānau in the desired ways and as often as both parties would like. Key informants described services and practices that are not designed with patients and their whānau in mind; instead they are designed by clinicians around the needs of administrative systems. As employees within the public health system, key informants felt powerless to challenge dominant settings. Nevertheless, employees managed to circumnavigate processes. Our findings highlight the need for continued decolonization and anti-racism work within public health settings.

scholarly journals The high cost patients on waiting list for the Liver Transplantation. main burdens and consequences for the Public Health System

2015 ◽  
Vol 18 (3) ◽  
pp. A224
Author(s):  
J.A. Turri ◽  
L.B. Haddad ◽  
W. Andrauss ◽  
L.A. D’Albuquerque ◽  
M.A. Diniz
Keyword(s):  
Public Health ◽  
Liver Transplantation ◽  
Health System ◽  
Public Health System ◽  
Waiting List ◽  
The Public

Development of a probabilistic model for quantitative risk assessment of COVID-19 in Brazil

2021 ◽  
pp. 2150069
Author(s):  
Paulo Gabriel Santos Campos de Siqueira ◽  
Alexandre Calumbi Antunes de Oliveira ◽  
Heitor Oliveira Duarte ◽  
Márcio das Chagas Moura
Keyword(s):  
Public Health ◽  
Risk Assessment ◽  
Health System ◽  
Probabilistic Model ◽  
Public Health System ◽  
The Other ◽  
Quantitative Risk Assessment ◽  
The Public ◽  
Business As Usual ◽  
Excessive Number

We have developed a probabilistic model to quantify the risks of COVID-19 explosion in Brazil, the epicenter of COVID-19 in Latin America. By explosion, we mean an excessive number of new infections that would overload the public health system. We made predictions from July 12th to Oct 10th, 2020 for various containment strategies, including business as usual, stay at home (SAH) for young and elderly, flight restrictions among regions, gradual resumption of business and the compulsory wearing of masks. They indicate that: if a SAH strategy were sustained, there would be a negligible risk of explosion and the public health system would not be overloaded. For the other containment strategies, the scenario that combines the gradual resumption of business with the mandatory wearing of masks would be the most effective, reducing risk to considerable category. Should this strategy is applied together with the investment in more Intensive Care Unit beds, risk could be reduced to negligible levels. A sensitivity analysis sustained that risks would be negligible if SAH measures were adopted thoroughly.

scholarly journals Neutralization of B.1.1.28 P2 variant with sera of natural SARS-CoV-2 infection and recipients of BBV152 vaccine

2021 ◽  
Author(s):  
Gajanan Sapkal ◽  
Pragya Yadav ◽  
Raches Ella ◽  
Priya Abraham ◽  
Deepak Patil ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Natural Infection ◽  
Vaccination Program ◽  
Vaccine Regimen ◽  
The Public ◽  
Neutralizing Potential ◽  
Dose Vaccine

The emergence of new SARS-CoV-2 variants has been a serious threat to the public health system and vaccination program. The variant of concerns have been the under investigation for their neutralizing potential against the currently available COVID-19 vaccines. Here, we have determined the neutralization efficacy of B.1.1.28.2 variant with the convalescent sera of individuals with natural infection and BBV152 vaccination. The two-dose vaccine regimen significantly boosted the IgG titer and neutralizing efficacy against both B.1.1.28.2 and D614G variants compared to that seen with natural infection. The study demonstrated 1.92 and 1.09 fold reductions in the neutralizing titer against B.1.1.28.2 variant in comparison with prototype D614G variant with sera of vaccine recipients and natural infection respectively.

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