Labour migration of doctors and nurses and the impact on the quality of health care in Eastern European countries: The case of Poland

2019 ◽  
Vol 30 (2) ◽  
pp. 307-320 ◽  
Author(s):  
Piotr Żuk ◽  
Paweł Żuk ◽  
Justyna Lisiewicz-Jakubaszko
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Western Europe ◽  
Central Statistical ◽  
Health Care Database ◽  
Economic Migration ◽  
Central Statistical Office ◽  
Eastern European Countries ◽  
The Impact ◽  
Doctors And Nurses

The purpose of this commentary article is to explain the causes and effects of the economic migration of health care workers from Poland to Western countries, and to analyse the impact of the migration of doctors and nurses on the functioning of the public health system. We use data from the National Central Statistical Office, our own preliminary research, social surveys and the Watch Health Care database. Domestic data are analysed and compared with trends in Western Europe as described in Eurostat and Organisation for Economic Co-operation and Development reports. The decreasing number of active physicians remaining in the health care system results in long waits for specialist appointments. The demand for doctors from Central and Eastern Europe will continue to grow. Consequently, there will be a further outflow of medical staff from Poland and other countries in the region and the current problems with access to health care will continue. JEL Codes: I00, I11, J61

The Development of Agritourism in the Podkarpackie Voivodeship in the Light of International and National Conditions

2017 ◽  
Vol 13 ◽  
pp. 244-261
Author(s):  
Mariola Tracz ◽  
Małgorzata Bajgier-Kowalska ◽  
Radosław Uliszak
Keyword(s):  
Development Strategy ◽  
Current State ◽  
Central Statistical ◽  
Central Statistical Office ◽  
Tourism Resources ◽  
The One ◽  
The Impact ◽  
District Offices ◽  
Socio Economic Factors

Podkarpackie Voivodeship is one of the regions of Poland in which the number of agritourism entities is very high. Therefore tourism plays a significant role in its development strategy. The aim of the paper is to identify the current state of agritourism and the changes that have occurred in the region in the years 2000–2016. Specific objectives are to determine the distribution of agritourism farms and their offer, together with a comprehensive analysis of the environmental and socio-economic factors, as well as the impact of the Slovak-Ukrainian border. The report was developed on the statistical materials from the Polish Central Statistical Office, Podkarpackie Agricultural Advisory Centre in Boguchwała and data collected from municipalities and district offices that is published on their websites, as well as through interviews with 100 owners of agritourism farms in the Podkarpackie Voivodeship. The research has shown, on the one hand, the decline in the number of farms in the region and, on the other hand, the increase in the diversity of the tourist offer of these entities. Distribution of agritourism farms is closely linked to the attractiveness of natural environment and quality of secondary tourism resources. Traditional agritourism has not yet fully used its countryside, as well as cross-border advantages of its location.

scholarly journals The Impact of Internalized Stigma on LGBT Parenting and the Importance of Health Care Structures: A Qualitative Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5373
Author(s):  
Carolina Alday-Mondaca ◽  
Siu Lay-Lisboa
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Health Care Services ◽  
Universal Access ◽  
Civil Society Organizations ◽  
Support Network ◽  
Internalized Stigma ◽  
Lgbt People ◽  
Mental Health Programs ◽  
The Impact

Research on LGBTIQ+ families has focused on the effects of being in a diverse family on the development of children. We seek to show the experience of parenthood from the perspective of LGBTIQ+ people, considering its particularities and the role that health care services play as a potential support network. We used the biographical method through open-ended interviews, participants were LGBT people, and key informants from Chile, Colombia, and Mexico were selected based on a sociostructural sampling. We found that internalized stigma impacts LGBTIQ+ parenting in five ways: the impossibility of thinking of oneself as a parent, fear of violating children’s rights, fear of passing on the stigma, fear of introducing their LGBTIQ+ partner, and the greater discrimination that trans and intersex people suffer. We identified gaps in health care perceptions: the need to guarantee universal access to health care, the need to include a gender perspective and inclusive treatment by health personnel, mental health programs with a community approach, access to assisted fertilization programs, and the generation of collaborative alliances between health services, civil society organizations, and the LGBTIQ+ community. We conclude that the health system is a crucial space from which to enable guarantees for the exercise of rights and overcome internalized stigma.

Advocacy for a Digital Oral Health That Leaves No One Behind

2021 ◽  
pp. 238008442110266
Author(s):  
N. Giraudeau ◽  
B. Varenne
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Access To Health Care ◽  
Universal Access ◽  
Digital Health ◽  
World Health ◽  
Noncommunicable Diseases ◽  
Central Component ◽  
Health Coverage ◽  
The Impact

During the first wave of the coronavirus disease 2019 (COVID-19) pandemic, the lockdown enforced led to considerable disruption to the activities of dental services, even leading to closures. To mitigate the impact of the lockdowns, systems were quickly put in place in most countries to respond to dental emergencies, giving priority to distance screening, advice to patients by remote means, and treatment of urgent cases while ensuring continuous care. Digital health was widely adopted as a central component of this new approach, leading to new practices and tools, which in turn demonstrated its potential, limitations, and possible excesses. Political leaders must become aware of the universal availability of digital technology and make use of it as an additional, safe means of providing services to the public. In view of the multiple uses of digital technologies in health—health literacy, teaching, prevention, early detection, therapeutics, and public health policies—deployment of a comprehensive program of digital oral health will require the adoption of a multifaceted approach. Digital tools should be designed to reduce, not increase, inequalities in access to health care. It offers an opportunity to improve healthy behavior, lower risk factors common to oral diseases and others noncommunicable diseases, and contribute to reducing oral health inequalities. It can accelerate the implementation of universal health coverage and help achieve the 2030 Sustainable Development Agenda, leaving no one behind. Digital oral health should be one of the pillars of oral health care after COVID-19. Universal access to digital oral health should be promoted globally. The World Health Organization’s mOralHealth program aims to do that. Knowledge Transfer Statement: This position paper could be used by oral health stakeholders to convince their government to implement digital oral health program.

scholarly journals 482. Impact of COVID-19 Pandemic on Psychosocial and Clinical Factors among people with and without HIV living in Miami

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S308-S308
Author(s):  
Patricia RaccamarichClaudia S Uribe ◽  
Ana S Salazar Zetina ◽  
Emily K Montgomerie ◽  
Douglas Salguero ◽  
Alejandro M Mantero ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Access To Health Care ◽  
People Living With Hiv ◽  
Coping With Stress ◽  
Care Access ◽  
Significant Difference ◽  
Physical Consequences ◽  
The Impact ◽  
Hiv Negative

Abstract Background As the COronaVIrus Disease 2019 (COVID-19) continues to unfold, drastic changes in daily life pose significant challenges on mental and clinical health. While public health interventions such as national lockdowns and social distancing are enforced to reduce the spread of COVID-19, the psychosocial and physical consequences have yet to be determined that may disproportionately affect people living with HIV (PLWH). Methods To evaluate the impact of COVID-related stress on mental and clinical health, we conducted a 20-minute questionnaire eliciting sociodemographic information, clinical and psychological factors from people living in Miami, Fl. All individuals >18 years with or without a history of COVID-19 were included. Participating PLWH were recruited from an existing HIV registry and HIV uninfected participants from community flyers and word of mouth. Results A total of 135 participants were recruited from 05/2020-06/2020. The mean age was 50 years old, 73/135 (54%) were female, and 102/135 (75%) were PLWH. Among participating PLWH, 60/102 (58.8%) self-identified as African American, and 9/102 (8.8%) were positive for COVID-19 by a commercially approved test. Among HIV-negative participants, 15/33 (45.5%) self-identified as White and 11/33 (33%) were positive for COVID-19. Both PLWH and HIV-negative participants described significant disruptions in health care access (47%), difficulty paying basic needs (41%), and feelings of anxiety and depression (48%); there was no statistically significant difference by HIV status. However, HIV negative participants were less likely to experience job loss and income disruption compared to PLWH during the pandemic (70% for HIV-negative vs 48% for PLWH; OR 0.40, p=0.03). Conclusion The impact of COVID-19 on emotional and clinical health is significant in both PLWH and HIV-negative groups. These findings highlight the need for providing mental and physical health care during the pandemic, especially for coping with stress and anxiety during these difficult times and ensuring adequate access to health care. Disclosures All Authors: No reported disclosures

scholarly journals The impact of introducing ambulance and delivery fees in a rural hospital in Tanzania.

2020 ◽  
Author(s):  
Corinna Vossius ◽  
Estomih Md ◽  
Robert Moshiro ◽  
Paschal M ◽  
Jan Terje Kvaløy ◽  
...  
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Low Birthweight ◽  
Care Facility ◽  
Health Care Facility ◽  
Skilled Birth Attendance ◽  
Health Care Facilities ◽  
Birth Attendance ◽  
Vaginal Deliveries ◽  
The Impact

Abstract Background: Access to health care facilities is a key requirement to enhance safety for mothers and newborns during labour and delivery. Haydom Lutheran Hospital (HLH) is a regional hospital in rural Tanzania with a catchment area of about two million inhabitants. Up to June 2013 ambulance transport and delivery at HLH were free of charge, while a user fee for both services was introduced from January 2014. We aimed to explore the impact of introducing user fees on the population of women giving birth at HLH in order to document potentially unwanted consequences in the period after introduction of fees . Methods: Retrospective analysis of data from a prospective observational study. Data was compared between the period before introduction of fees from February 2010 through June 2013 and the period after from January 2014 through January 2017. Logistic regression modelling was used to construct risk-adjusted variable-life adjusted display (VLAD) and cumulative sum (CUSUM) plots to monitor changes. Results: A total of 28,601 births were observed. The monthly number of births was reduced by 17.3% during the post-introduction period. Spontaneous vaginal deliveries were registered less frequently, while labour complication and caesarean sections were more frequent. There was a reduction of newborns with birth weight less than 2500 grams. The observed changes were stable over time. For most variables, a significant change could be detected after a few weeks. Conclusion: After the introduction of ambulance and delivery fees an increase in labour complications and caesarean sections of about 80 per 1000 births and a decrease in non-cephalic presentations and newborns with low birthweight of about 17 per 1000 births each was observed. This might indicate that women delay the decision to seek skilled birth attendance or do not seek help at all, possibly due to financial reasons. Lower rates of births in a safe health care facility like HLH is of great concern, as access to skilled birth attendance is a key requirement in order to further reduce perinatal mortality. Therefore, free delivery care should be a high priority.

scholarly journals Evaluation of a novel approach to community health care delivery in Ifanadiana District, Madagascar

2020 ◽  
Author(s):  
Bénédicte Razafinjato ◽  
Luc Rakotonirina ◽  
Jafeta Benony Andriantahina ◽  
Laura F. Cordier ◽  
Randrianambinina Andriamihaja ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Community Health ◽  
Access To Health Care ◽  
Care Delivery ◽  
Local Level ◽  
Scale Up ◽  
P Value ◽  
The Impact

AbstractDespite the widespread global adoption of community health (CH) systems, there are evidence gaps in how to best deliver community-based care aligned with global best practice in remote settings where access to health care is limited and community health workers (CHWs) may be the only available providers. PIVOT partnered with the Ministry of Public Health to pilot a new two-pronged approach for care delivery in rural Madagascar: one CHW provided care at a stationary CH site while 2-5 additional CHWs provided care via proactive household visits. The pilot included professionalization of the CHW workforce (i.e. recruitment, training, financial incentive) and twice monthly supervision of CHWs. We evaluated the impact of the CH pilot on utilization and quality of integrated community case management (iCCM) in the first six months of implementation (October 2019-March 2020).We compared utilization and proxy measures of quality of care (defined as adherence to the iCCM protocol for diagnosis, classification of disease severity, treatment) in the intervention commune and five comparison communes, using a quasi-experimental study design and relying on routinely collected programmatic data. Average per capita monthly under-five visits were 0.28 in the intervention commune and 0.22 in the comparison communes. In the intervention commune, 40.0% of visits were completed at the household via proactive care. CHWs completed all steps of the iCCM protocol in 77.8% of observed visits in the intervention commune (vs 49.5% in the comparison communes, p-value=<0.001). A two-pronged approach to CH delivery and professionalization of the CHW workforce increased utilization and demonstrated satisfactory quality of care. National stakeholders and program managers should evaluate program re-design at a local level prior to national or district-wide scale-up.

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