Assessing the impact of an intervention to implement the referral care component of Integrated Management of Childhood Illnesses (IMCI) in district hospitals

2013 ◽  
Author(s):  
Mike English
Keyword(s):  
Integrated Management ◽  
Childhood Illnesses ◽  
District Hospitals ◽  
The Impact

scholarly journals Managing pneumonia through facility-based integrated management of childhood management (IMCI) services: an analysis of the service availability and readiness among public health facilities in Bangladesh

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ahmed Ehsanur Rahamn ◽  
Shema Mhajabin ◽  
David Dockrell ◽  
Harish Nair ◽  
Shams El Arifeen ◽  
...  
Keyword(s):  
Public Health ◽  
Distribution System ◽  
Integrated Management ◽  
Child Death ◽  
Health Facilities ◽  
Family Welfare ◽  
Service Availability ◽  
District Health ◽  
Public Health Facilities ◽  
District Hospitals

Abstract Background With an estimated 24,000 deaths per year, pneumonia is the single largest cause of death among young children in Bangladesh, accounting for 18% of all under-5 deaths. The Government of Bangladesh adopted the WHO recommended Integrated Management of Childhood Illness (IMCI)-strategy in 1998 for outpatient management of pneumonia, which was scaled-up nationally by 2014. This paper reports the service availability and readiness related to IMCI-based pneumonia management in Bangladesh. We conducted a secondary analysis of the Bangladesh Health Facility Survey-2017, which was conducted with a nationally representative sample including all administrative divisions and types of health facilities. We limited our analysis to District Hospitals (DHs), Maternal and Child Welfare Centres (MCWCs), Upazila (sub-district) Health Complexes (UHCs), and Union Health and Family Welfare Centres (UH&FWCs), which are mandated to provide IMCI services. Readiness was reported based on 10 items identified by national experts as ‘essential’ for pneumonia management. Results More than 90% of DHs and UHCs, and three-fourths of UH&FWCs and MCWCs provide IMCI-based pneumonia management services. Less than two-third of the staff had ever received IMCI-based pneumonia training. Only one-third of the facilities had a functional ARI timer or a watch able to record seconds on the day of the visit. Pulse oximetry was available in 27% of the district hospitals, 18% of the UHCs and none of the UH&FWCs. Although more than 80% of the facilities had amoxicillin syrup or dispersible tablets, only 16% had injectable gentamicin. IMCI service registers were not available in nearly one-third of the facilities and monthly reporting forms were not available in around 10% of the facilities. Only 18% of facilities had a high-readiness (score 8–10), whereas 20% had a low-readiness (score 0–4). The readiness was significantly poorer among rural and lower level facilities (p < 0.001). Seventy-two percent of the UHCs had availability of one of any of the four oxygen sources (oxygen concentrators, filled oxygen cylinder with flowmeter, filled oxygen cylinder without flowmeter, and oxygen distribution system) followed by DHs (66%) and MCWCs (59%). Conclusion There are substantial gaps in the readiness related to IMCI-based pneumonia management in public health facilities in Bangladesh. Since pneumonia remains a major cause of child death nationally, Bangladesh should make a substantial effort in programme planning, implementation and monitoring to address these critical gaps to ensure better provision of essential care for children suffering from pneumonia.

scholarly journals Effects of terrorist attacks on access to maternal healthcare services: a national longitudinal study in Burkina Faso

2020 ◽  
Vol 5 (9) ◽  
pp. e002879
Author(s):  
Thomas Druetz ◽  
Lalique Browne ◽  
Frank Bicaba ◽  
Matthew Ian Mitchell ◽  
Abel Bicaba
Keyword(s):  
Antenatal Care ◽  
Burkina Faso ◽  
Negative Binomial ◽  
Terrorist Attack ◽  
Healthcare Services ◽  
Terrorist Attacks ◽  
Cesarean Sections ◽  
Maternal Healthcare ◽  
District Hospitals ◽  
The Impact

IntroductionMost of the literature on terrorist attacks’ health impacts has focused on direct victims rather than on distal consequences in the overall population. There is limited knowledge on how terrorist attacks can be detrimental to access to healthcare services. The objective of this study is to assess the impact of terrorist attacks on the utilisation of maternal healthcare services by examining the case of Burkina Faso.MethodsThis longitudinal quasi-experimental study uses multiple interrupted time series analysis. Utilisation of healthcare services data was extracted from the National Health Information System in Burkina Faso. Data span the period of January 2013–December 2018 and include all public primary healthcare centres and district hospitals. Terrorist attack data were extracted from the Armed Conflict Location and Event Data project. Negative binomial regression models were fitted with fixed effects to isolate the immediate and long-term effects of terrorist attacks on three outcomes (antenatal care visits, of facility deliveries and of cesarean sections).ResultsDuring the next month of an attack, the incidence of assisted deliveries in healthcare facilities is significantly reduced by 3.8% (95% CI 1.3 to 6.3). Multiple attacks have immediate effects more pronounced than single attacks. Longitudinal analysis show that the incremental number of terrorist attacks is associated with a decrease of the three outcomes. For every additional attack in a commune, the incidence of cesarean sections is reduced by 7.7% (95% CI 4.7 to 10.7) while, for assisted deliveries, it is reduced by 2.5% (95% CI 1.9 to 3.1) and, for antenatal care visits, by 1.8% (95% CI 1.2 to 2.5).ConclusionTerrorist attacks constitute a new barrier to access of maternal healthcare in Burkina Faso. The exponential increase in terrorist activities in West Africa is expected to have negative effects on maternal health in the entire region.

Service Quality Components and Inpatients Satisfaction at District Hospitals in Haryana: An Empirical Analysis

2021 ◽  
pp. 097206342110504
Author(s):  
Dalbir Singh ◽  
Rajesh Kumar Aggarwal
Keyword(s):  
Service Quality ◽  
Food Services ◽  
Treatment Services ◽  
Laboratory Services ◽  
Perceived Satisfaction ◽  
Nursing Services ◽  
District Hospitals ◽  
Quality Of Health Services ◽  
The Impact

Success of any health facility can be directly correlated with the perceived satisfaction of outpatients and inpatients availing treatment at these facilities. Therefore, patient satisfaction is a commonly used measure to assess the quality of services at various health facilities. The present article attempts to analyse the impact of service quality on inpatient satisfaction across all the district hospitals (DHs) of Haryana. Among other things, the article extracted eight factors, namely treatment services (TSs), food services (FSs), laboratory services (LSs), wards services (WSs), admission services (ASs), infrastructural services (ISs), medicine services (MSs) and nursing services (NSs) through exploratory factor analysis. Further, TSs were found to be the most important to predict the satisfaction of inpatients of DHs of Haryana followed by FSs, LSs, ISs, WSs, NSs, ASs and MSs. The article suggests the areas that require interventions to bring about overall course-correction and improve the overall quality of health services in the State and also contributes towards the existing literature on understanding service quality dynamics and measuring patients’ satisfaction for health care.

scholarly journals The Impact of Integrated Management for Salt Tolerant Forage Production on Small Farmers Poverty Egypt Case Study (Sahl El-Tina)

2016 ◽  
Vol 4 (10) ◽  
pp. 825
Author(s):  
Sherine Fathy Mansour ◽  
Dalia Elsaid Abozaid
Keyword(s):  
Poverty Reduction ◽  
Integrated Management ◽  
Poverty Line ◽  
Policy Instrument ◽  
Small Farmers ◽  
Forage Production ◽  
Capita Expenditure ◽  
Farming Household ◽  
Per Capita ◽  
The Impact

This study examines the impact of New Integrated Management Package (IMP) adoption on income and poverty among fodder farming household in Sahl El-Tina. The IMP such as Rate, time, and methods of nitrogen fertilization and other fertilization, Leaching requirements for some crops, Intercropping system, Use of suitable crop genotype/variety, Use of modern irrigation systems or modified systems to save water, date, rate and method of planting. The study aims mainly to improve the lives of small farmers through the level of dissemination and application of cultivation techniques forage crops tolerant to salinity through develop and disseminate technologies packages of forage production. And reducing their probability of falling below the poverty line. Therefore suggest that intensification of the investment on IMP dissemination is a reasonable policy instrument to raise incomes and reduce poverty among fodder farming household. It used instrumental variables (IV)-based estimator to estimate the Local Average Treatment Effect (LATE) of adoption of IMP on income and poverty reduction, using cross-sectional data of 200 farmers from Shal El-Tina. The findings reveal a robust positive and significant impact of IMP adoption on farm household income and welfare measured by per capita expenditure and poverty reduction. Specifically, the empirical results suggest that adoption of IMP raises household per capita expenditure and income by an average of 529.27$ and 1371$ in Shal El-Tina per cropping season respectively, thereby reducing their probability of falling below the poverty line. Therefore suggest that intensification of the investment on IMP dissemination is a reasonable policy instrument to raise incomes and reduce poverty among fodder farming household, although complementary measures are also needed. The incidence of poverty was higher among non-IMP adopters (55.2%) than IMP adopters (49.5%). In addition, both the depth and severity of poverty were also higher (20.85% and 15.42%) among non-adopters than the adopters (18.48% and 9.88%). All three poverty measures indicate that poverty was more prevalent and severe among non-adopters compared to adopters.

scholarly journals Cardiogenic shock in Taiwan from 2003 to 2017 (CSiT-15 study)

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Shih-Chieh Chien ◽  
Chien-Yi Hsu ◽  
Hung-Yi Liu ◽  
Chao-Feng Lin ◽  
Chung-Lieh Hung ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Temporal Trends ◽  
Interrupted Time Series ◽  
Fold Increase ◽  
Application Rate ◽  
Ventricular Assist Devices ◽  
Research Database ◽  
Advanced Therapies ◽  
District Hospitals ◽  
The Impact

Abstract Background This study investigated temporal trends in the treatment and mortality of patients with cardiogenic shock (CS) in Taiwan in relation to acute myocardial infarction (AMI) accreditation implemented in 2009 and the unavailability of percutaneous ventricular assist devices. Methods Data of patients diagnosed as having CS between January 2003 and December 2017 were collected from Taiwan’s National Health Insurance Research Database. Each case was followed from the date of emergency department arrival or hospital admission for the first incident associated with a CS diagnosis up to a 1-year interval. Measurements included demographics, comorbidities, treatment, mortality, and medical costs. Using an interrupted time-series (ITS) design with multi-level mixed-effects logistic regression model, we assessed the impact of AMI accreditation implementation on the mortality of patients with AMI and CS overall and stratified by the hospital levels. Results In total, 64 049 patients with CS (mean age:70 years; 62% men) were identified. The incidence rate per 105 person-years increased from 17 in 2003 to 25 in 2010 and plateaued thereafter. Average inpatient costs increased from 159 125 points in 2003 to 240 993 points in 2017, indicating a 1.5-fold increase. The intra-aortic balloon pump application rate was approximately 22–25% after 2010 (p = 0.093). Overall, in-hospital, 30-day, and 1-year mortality declined from 60.3%, 63.0%, and 69.3% in 2003 to 47.9%, 50.8% and 59.8% in 2017, respectively. The decline in mortality was more apparent in patients with AMI-CS than in patients with non-AMI-CS. The ITS estimation revealed a 2% lower in-hospital mortality in patients with AMI-CS treated in district hospitals after the AMI accreditation had been implemented for 2 years. Conclusions In Taiwan, the burden of CS has consistently increased due to high patient complexity, advanced therapies, and stable incidence. Mortality declined over time, particularly in patients with AMI-CS, which may be attributable to advancements in AMI therapies and this quality-improving policy.

scholarly journals The Impact of Proper PPE Protocol in A Highly Community Spread of Infectious COVID-19 in Semporna

2021 ◽  
Vol 5 ◽  
pp. 21
Author(s):  
Muhammad Farid Bin Zainal Abidin ◽  
Nur Farhana Binti Zainan ◽  
Mafeitzeral Bin Mamat ◽  
Sivasankar Pubalan ◽  
Mohd Syahfadzreen Bin Yunus
Keyword(s):  
Emergency Department ◽  
Healthcare Workers ◽  
Task Force ◽  
Control Unit ◽  
Third Wave ◽  
District Hospitals ◽  
Crisis Services ◽  
Multiple Issues ◽  
The Impact ◽  
Multiple Units

Introduction: The district of Semporna, Sabah was majorly hit by the third wave surge of COVID-19 in September 2020. At the peak of the crisis, services in Semporna Hospital were paralyzed with 40 healthcare workers (HCW) found to be COVID-19 positive; contributing to 14% of the total manpower.Objectives: Due to the immediate crisis, the main priority was to control the spread of COVID- 19 amongst the Semporna Hospital HCWs. This was important to curb direct infection from handling suspected patients seeking treatment in Semporna Hospital. Based on the hospital capabilities and resources, a comprehensive modified protocol was needed to control the situation.Methods: Semporna Hospital pandemic emergency task force was established with the presence of multi department and specialties. Multiple issues were raised and attended to, especially; issue of preparedness, low PPE stock and Emergency Department infrastructure.Results: The number of Semporna Hospital HCWs infected with COVID-19 was minimal after the initial disaster. Emergency Department infrastructure was improvised, workflow processes modified, HCW protection education prioritized and complete PPE sets were stocked up. All these efforts were under the strict supervision of the infectious control unit. The presence of multiple units of Powered Air-Purifying Respirator (PAPR) completed our adherence to the Ministry of Health (MOH) guidelines in managing the highly infectious level 4 patients for aerosolized generating procedures (AGP).Conclusion: This achievement can be used as a preparedness reference for other non-specialist district hospitals in Malaysia.International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S21

scholarly journals THE IMPACT OF HOSPITAL BASED INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS TRAINING ON PEDIATRIC NURSE COMPETENCY

2018 ◽  
Vol 4 (1) ◽  
pp. 16-23
Author(s):  
Fitri Haryanti ◽  
Mohammad Hakimi ◽  
Yati Sunarto ◽  
Yayi S Prabandari
Keyword(s):  
Mixed Model ◽  
Linear Mixed Model ◽  
Integrated Management ◽  
Well Being ◽  
Childhood Illness ◽  
Internal Conflict ◽  
Child Health Services ◽  
Management Support ◽  
The Impact

Background: Although the WHO strategy integrated management of childhood illness (IMCI) for primary care has been implemented in over 100 countries, there is less global experience with hospital-based IMCI training. Until recently, no training had been done in Indonesia, and globally there has been limited experience of the role of IMCI in rebuilding health systems after complex emergencies.Objective: We aimed to examine the effect of hospital-based IMCI training on pedicatric nurse competency and explore the perception of Indonesian doctors, nurse managers and paediatricians about IMCI training and its development in West Aceh, a region that was severely affected by the South-Asian tsunami in December 2004.Methods: This study used stepped wedge design. Training was conducted for 39 nurses staff, 13 midwifes, 6 Head nurses, 5 manager of nurses, 5 doctors, 1 paediatricians, and 3 support facilities  (nutritionist, pharmacist, laboratory) in Cut Nyak Dien (CND) Hospital in Meulaboh, West Aceh, Indonesia. The IMCI training was developed based on the WHO Pocketbook of Hospital Care for Children. A nurses competency questionnaire was used based on the guideline of assessment of the quality of child health services at the first level reference hospitals in districts / municipalities issued by the Ministry of Health in 2007. A linear mixed model was used for data analysis.Results: The hospital based IMCI training improved the competences of nurses paediatric in assessing emergency signs of the sick children, management of cough and difficulty breathing, diarrhoea, fever, nutritional problems, supportive care, monitoring, discharge planning and follow up.  The assessment highlighted several problems in adaptation process of material training, training process and implementation in an environment soon after a major disaster.Conclusion: Hospital based IMCI training can be implemented in a setting after major disasters or internal conflict as part of a rebuilding process.  The program requires strong management support and the emergency phase to be subsided.  Other pre-requisites include the existence of standard operating procedures, adequate physical facilities and support for staff morale and well-being.  Improving the quality of paediatric care requires more than just training and clinical guidelines; internal motivation and health worker support are essential.

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