scholarly journals Ensuring sustainability of polio immunization in health system transition: lessons from the polio eradication initiative in Indonesia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Luthfi Azizatunnisa’ ◽  
Utsamani Cintyamena ◽  
Yodi Mahendradhata ◽  
Riris Andono Ahmad
Keyword(s):  
Health System ◽  
National Level ◽  
Immunization Coverage ◽  
Polio Eradication ◽  
Lessons Learned ◽  
Frontline Workers ◽  
Government Organizations ◽  
Raising Awareness ◽  
Polio Immunization ◽  
The Government

Abstract Background Sustaining an effective evidence-based health intervention will maximize its impact on public health. Political and governmental reforms impacted on immunization program sustainability both positively and negatively. This study aims to explore the sustainability of polio immunization in a decentralized health system taking lessons learned from a polio eradication initiative in Indonesia. Methods We collected qualitative data through in-depth interviews with 27 key informants from various backgrounds at district, provincial, and national levels, consisting of frontline workers, managers, and Non-government Organizations (NGOs). We conducted thematic analysis and triangulated using document reviews. We also conducted member checking and peer debriefing to ensure trustworthiness. Results Competing priority was identified as the significant challenge to sustain government commitment for polio immunization and AFP surveillance during the transition toward a decentralized health system. Variation of local government capacities has also affected immunization delivery and commitment at the sub-national level government. The government reform has led to a more democratic society, facilitating vaccine rejection and hesitancy. The multi-sector partnership played a significant role in maintaining polio immunization coverage. Strong and continuous advocacy and campaign were essential to raising awareness of the community and policymakers to keep polio in the agenda and to maintain the high polio immunization coverage. Conclusion Competing priority was the major factor affecting high polio immunization coverage during the decentralization transition. Strong advocacy is needed at every level, from district to national level, to keep polio immunization prioritized.

scholarly journals Ensuring Sustainability of Polio Immunization in Health System Transition: Lessons from the Polio Eradication Initiative in Indonesia

2020 ◽  
Author(s):  
Luthfi Azizatunnisa’ ◽  
Utsamani Cintyamena ◽  
Yodi Mahendradhata ◽  
Riris Andono Ahmad
Keyword(s):  
Health System ◽  
National Level ◽  
Immunization Coverage ◽  
Polio Eradication ◽  
Lessons Learned ◽  
Vaccine Hesitancy ◽  
High Coverage ◽  
Frontline Workers ◽  
Polio Immunization ◽  
The Government

Abstract Background: Sustaining an effective evidence-based health intervention will maximize its impact in public health. Political and governmental reforms impact immunization program sustainability both positively and negatively. This study aims to explore sustainability of polio immunization in a decentralized health system taking lessons learned from a polio eradication initiative in Indonesia.Methods: We collected qualitative data through in-depth interviews with 27 key informants in from various backgrounds at district, provincial, and national levels, consisting of frontline workers, managers and NGOs at national and sub-national level. We conducted thematic analysis and triangulated using document reviews. We also conducted member checking and peer debriefing to ensure trustworthiness. Results: Competing priority was identified as the major challenge to sustain government commitment for polio immunization and AFP surveillance during the transition toward a decentralized health system. Variation of local government capacities has also affected immunization delivery and commitment at sub-national level government. The government reform has led to a more democratic society, which is also conducive for rejection and vaccine hesitancy. Multi sector partnership has been identified to play a big role in maintaining polio immunization coverage. Strong and continuous advocacy and campaign are essential to raise awareness for the community and policy makers to maintain the high polio immunization coverage. Conclusion: Competing priority was the major factor that affected high coverage of polio immunization during the decentralization transition. Strong advocacy is needed at every level, from district to national level, to keep polio immunization prioritized.

scholarly journals Health system gaps in cardiovascular disease prevention and management in Nepal

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Archana Shrestha ◽  
Rashmi Maharjan ◽  
Biraj Man Karmacharya ◽  
Swornim Bajracharya ◽  
Niharika Jha ◽  
...  
Keyword(s):  
Human Resources ◽  
Health System ◽  
Health Systems ◽  
National Health ◽  
Task Force ◽  
Health Spending ◽  
Building Blocks ◽  
Critical System ◽  
Government Organizations ◽  
The Government

Abstract Background Cardiovascular diseases (CVDs) are the leading cause of deaths and disability in Nepal. Health systems can improve CVD health outcomes even in resource-limited settings by directing efforts to meet critical system gaps. This study aimed to identify Nepal’s health systems gaps to prevent and manage CVDs. Methods We formed a task force composed of the government and non-government representatives and assessed health system performance across six building blocks: governance, service delivery, human resources, medical products, information system, and financing in terms of equity, access, coverage, efficiency, quality, safety and sustainability. We reviewed 125 national health policies, plans, strategies, guidelines, reports and websites and conducted 52 key informant interviews. We grouped notes from desk review and transcripts’ codes into equity, access, coverage, efficiency, quality, safety and sustainability of the health system. Results National health insurance covers less than 10% of the population; and more than 50% of the health spending is out of pocket. The efficiency of CVDs prevention and management programs in Nepal is affected by the shortage of human resources, weak monitoring and supervision, and inadequate engagement of stakeholders. There are policies and strategies in place to ensure quality of care, however their implementation and supervision is weak. The total budget on health has been increasing over the past five years. However, the funding on CVDs is negligible. Conclusion Governments at the federal, provincial and local levels should prioritize CVDs care and partner with non-government organizations to improve preventive and curative CVDs services.

scholarly journals Acceptability of contact management and care of simple cases of COVID-19 at home: a mixed-method study in Senegal

2021 ◽  
Author(s):  
Mouhamadou Faly Ba ◽  
Valéry Ridde ◽  
Amadou Ibra Diallo ◽  
Jean Augustin Diégane Tine ◽  
Babacar Kane ◽  
...  
Keyword(s):  
Health System ◽  
Mixed Method ◽  
National Level ◽  
Mixed Method Study ◽  
Quantitative Survey ◽  
Modes Of Transmission ◽  
Home Based ◽  
The Government ◽  
Home Based Care ◽  
At Home

ABSTRACTIntroductionIn mid-2020, due to the health system challenges from increased COVID-19 cases, the Ministry of Health and Social Action in Senegal opted for contact management and care of simple cases at home. The study’s objective was to determine the acceptability of contact management, home care of simple cases of COVID-19, and its associated factors.MethodThis was a sequential mixed-method study. We collected data from June 11, 2020, to July 10, 2020, for the quantitative survey (N=813) and from August 24 to September 16, 2020, for the qualitative survey (N=30). We carried out a sampling strategy using marginal quotas at the national level. We collected data using a structured questionnaire in a telephone interview for the quantitative survey and using an interview guide formulated from the quantitative survey’s initial results for the qualitative data. We assessed acceptability using binomial logistic regression combined with content analysis.ResultsThe care of simple cases of COVID-19 at home was well accepted (78.5%). This result was justified for some (saturation of the health system) but not for others (risk of contamination). The use of home contact management was less accepted (51.4%), with risk limitation as the main reason given. The acceptability of home-based care for simple cases was positively associated with knowledge of the modes of transmission of the virus (ORaj: 1.55 [95%CI: 1.04,2.28]), regular research into COVID-19 (ORaj: 2.12 [95%CI: 1.45,3.12]), belief in the existence of treatment (ORaj: 1.82 [95%CI: 1.19,2.83]), and confidence in institutional information (ORaj: 2.10 [95%CI: 1.43,3.10]). The acceptability of home-based contact management was positively associated with knowledge of the modes of transmission of the virus (ORaj: 1.77 [95%CI: 1.27,2.48]), regular research for information on COVID-19 (ORaj: 2.39 [95%CI: 1.76,3.26]), and confidence in the government in the fight against the epidemic (ORaj: 1.51 [95%CI: 1.10,2.08]).ConclusionRegular information on the disease, knowledge of its mode of transmission and trust in institutions are factors in accepting COVID-19 management at the community level. Authorities should take these factors into account for better communication to improve the acceptability of home-based care.

scholarly journals Earthquake and Dhaka City - An Approach to Manage the Impact

2013 ◽  
Vol 9 (1-2) ◽  
pp. 65-75 ◽  
Author(s):  
MM Rahman ◽  
SK Paul ◽  
K Biswas
Keyword(s):  
Local Community ◽  
National Level ◽  
Economic Loss ◽  
Dhaka City ◽  
Earthquake Hazards ◽  
Earthquake Disaster ◽  
Government Organizations ◽  
The Government ◽  
Policy And Planning ◽  
The Impact

Dhaka city, the soul of Bangladesh is highly vulnerable to the earthquake disaster due to high density of population, unplanned infrastructure and close proximity with India and Myanmar’s active seismic area, poor economic condition, poor emergency preparation and recovery capability. A major earthquake might kill about 88,000 people and demolish 72,000 buildings and damage 86,000 others and economic loss due to damage of structures will be from US $ 650 million to US $ 1,075 million in the capital Dhaka [9]. The government organizations and strategies and community based organizations is important for the management of devastating impact of earthquake in Dhaka city. By introducing proper policy and planning for disaster management, community awareness build up and training, proper implementation of national building code, well coordination among government organizations and infrastructures and nongovernment organizations, enrichment of well equipped rescue team can limit the impact in a manageable boundary. The policy issues regarding disaster like earthquake could be handled mostly at the national level but planning and implementation issues are to be handled at the local community level. The earthquake hazards can never be resisted but the severe damages of earthquake disaster in Dhaka city can be reduced by increasing capacity as it reduces the risk and vulnerability. DOI: http://dx.doi.org/10.3329/jsf.v9i1-2.14649 J. Sci. Foundation, 9(1&2): 65-75, June-December 2011

Tata kelola internal dan eksternal untuk mengatasi permasalahan pangan di Indonesia

2018 ◽  
Vol 13 (1) ◽  
Author(s):  
Reza Hendriyantore
Keyword(s):  
Good Governance ◽  
National Level ◽  
Open Government ◽  
Agricultural Cooperatives ◽  
Methodological Framework ◽  
Agricultural Cooperative ◽  
The Reformation ◽  
The Government ◽  
Good Access ◽  
Descriptive Method

The effort to put good governance in development in Indonesia is basically not new. Since the Reformation, the transformation of closed government into an open government (inclusive) has begun to be pursued. Highlighting the conflicts in the land sector that tend to strengthen lately, there are some issues that have intensified conflicts in the field, such as the lack of guaranteed land rights in various legal and policy products. In this paper, a descriptive method is considered important in identifying the applicable issue and methodological framework for addressing governance issues in Indonesia. To reduce such agrarian conflicts between farmers and the government, and as an effort to increase farmers' income, all farmers are incorporated into agricultural cooperatives. Agricultural cooperatives are structured down to the National Level. Thus, farmers participate in good access to the marketing of agricultural produce.Keywords:good governance, agrarian conflict, agricultural cooperative

Malaysian Homestays: The Need for Standardized Regulation

2020 ◽  
Vol 17 (2) ◽  
pp. 63
Author(s):  
ROHASLINDA BINTI RAMELE ◽  
YAMAZAKI JUICHI ◽  
MD NAJIB IBRAHIM ◽  
LILIS SHEREENA SAFIEE
Keyword(s):  
Rural Community ◽  
Rural Tourism ◽  
Asian Countries ◽  
Government Organizations ◽  
Rural Income ◽  
Arts And Culture ◽  
The Government ◽  
Host Families ◽  
Southeast Asian Countries ◽  
Management Operation

This study aims to clarify regulations used among each type of registered and unregistered Malaysian homestays and to reveal issues arose regarding the implemented regulations. Selected homestays that are established by the government organizations and individuals were investigated to carry out the comparison on each homestay. Host families and persons in charge of the Ministry of Tourism, Arts and Culture (MOTAC), the Ministry of Agriculture (MOA), and the Ministry of Rural and Regional Development (MRRD) were also interviewed. Findings showed that there is only one guideline used for all types of homestays in Malaysia, which is the Malaysia Homestay Registration Guideline, established by MOTAC. MOTAC has also been selected as a leader of homestays in the Southeast Asian countries by the ASEAN Secretariat; therefore, the ASEAN Homestay Standard is also being referred. However, the implementation of this guideline and standard among other homestays unregistered with MOTAC (homestays established by MOA, MRRD, and individuals) is not compulsory, although encouraged, where they may receive equal benefits in term of facilities and promotion. Some issues arose due to the tax regulated by the local authorities, failure on homestays to be registered with MOTAC, and abandoned homestays. This study recommended that the Malaysia Homestay Registration Guideline to be standardized and regulated to all types of homestays, including individuals and unregistered homestays in Malaysia. This is important in order to reduce issues arose involving the homestay industry, providing safety and comfort to the tourists and, to help to develop rural income among host families and the rural community themselves.Keywords: Rural tourism, homestay, regulation, management, operation

Manajemen Sekolah Adiwiyata (Green School)

2020 ◽  
pp. 37-43
Author(s):  
Asep Priatna
Keyword(s):  
Junior High School ◽  
National Level ◽  
Educational Institutions ◽  
School Program ◽  
West Java ◽  
World Community ◽  
Strategic Issue ◽  
Green School ◽  
The Government ◽  
Environmentally Sound

The issue of environmental pollution has come to the attention of the world community and has become a strategic issue in sustainable development, so it needs to have the support of all parties, including the government, the private sector and educational institutions. Integrated Junior High School Lampang, Subang Regency West Java Indonesia has been implementing the green school program since 2008 and in 2019 it was entrusted by the West Java Education Office to be proposed as a national level green school program. Some achievements as a green school implementing school are private schools that have obtained "A" (exellent) accreditation with a beautiful environment and are able to fulfil 4 (four) components, namely (1) environmentally sound policies, (2) implementation of environment-based curriculum, (3) participatory-based environmental activities and (4) management of environmentally friendly supporting facilities Keywords : Management, green school Isu pencemaran lingkungan hidup telah menjadi perhatian masyarakat dunia dan menjadi isu strategis dalam pembangunan berkelanjutan, sehingga perlu mendapat dukungan semua pihak baik pemerintah, sector swasta maupun lembaga pendidikan. SMPS Terpadu Lampang Kabupaten Subang telah melaksanakan program adiwiyata sejak tahun 2008 dan pada tahun 2019 diberi kepercayaan oleh Dinas Pandidikan Jawa Barat diusulkan sebagai Sekolah Adiwiyata (green school program)  tingkat nasional. Beberapa capaian sebagai sekolah pelaksana green shcool  adalah sekolah swasta yang telah memperoleh akreditasi “A” (Unggul) dengan lingkungan asri dan mampu memenuhi 4 (empat) komponen yaitu (1) kebijakan berwawasan lingkungan, (2) pelaksanaan kurikulum berbasis lingkungan, (3) kegiatan lingkungan berbasis partisipatif dan (4) pengelolaan sarana pendukung ramah lingkungan Kata Kunci : Manajemen, Sekolah Adiwiyata

Role of Income Generation Programme in Women Empowerment

2016 ◽  
Vol 2 (2) ◽  
Author(s):  
Shalakha Rao ◽  
Shivani Kushwaha
Keyword(s):  
Skill Training ◽  
Safe Motherhood ◽  
Women Empowerment ◽  
Income Generation ◽  
Related Field ◽  
Government Organizations ◽  
Support Programme ◽  
The Status ◽  
The Government ◽  
The Impact

The connection between poverty and women's lack of power over resources and decision-making has now caught the attention of policymakers in government and mainstream development all over the world. Women empowerment issues perceived nationally or locally are being addressed by both state and non-state agencies. Beside the government intervention, NGOs are implementing various types of Women Empowerment Programmes including IG Programmes. Women Empowerment Programmes in India include livelihood support Programme, rehabilitation and job placement for rescued women, safe motherhood Programme and so forth. In spite of involvement of various NGOs in women empowerment through Income Generation and Skill Development Programmes, the status of women is still not satisfactory in India as various official as well as unofficial reports claim and the outcomes against the stated objectives of the NGOs' Women Empowerment Programmes are often questioned. Therefore, the present study is focused in assessing the impact of IG Programmes run by non-government organizations in empowering women. The researcher hypothesizes that IG Programme with its components viz., skill training, resource inputs of loan and equipment help to increase income to the women through independent business or work in the related field; the increased income lessens their dependence on family heads and enables to spend for personal expenses; gives them certain freedoms as individuals; enables them to contribute to family affairs financially, which creates an environment in the family in favor or the women to accept her views and participation in family matters like education, marriage, purchase etc.

scholarly journals Private Forests in Nepal: Status and Policy Analysis

2017 ◽  
Vol 15 (1) ◽  
pp. 120-130 ◽  
Author(s):  
Swoyambhu M. Amatya ◽  
Prakash Lamsal
Keyword(s):  
Present Status ◽  
National Level ◽  
Timber Harvesting ◽  
Lessons Learned ◽  
Private Land ◽  
Private Forest ◽  
Community Forest ◽  
Private Forest Owners ◽  
Forest Owners ◽  
Private Forests

 This paper reviews and analyses the present status of private forests and tenure administration in light of existing legal, policy, and regulatory frameworks in Nepal. Additionally, the present status of private forests, as well as the scenarios of timber harvesting, transportation, marketing, and their administration are thoroughly revised. Provisions regarding forests and trees on private land and their basis are examined and implications are articulated for potential policy improvements for enhanced tenure security. It is shown that robust national-level policies and legal frameworks exist, and that there is an increasing trend of timber flows to markets from private forests over the past five years. However, there is still skepticism, mistrust and fear amongst private forest owners, saw millers, and forest administration that prevents the full use of the bundle of rights that legal and policy provisions have promised. An unusually slow pace of private forest registration, lengthy and multi stage processes for obtaining harvesting and transportation permits, and official bans on important commercial species, among others, are found to be the factors that most hinder the private forest owners’ and tree growers’ interests, and their rights and obligations with respect to the management and use of their private forest resources. It is concluded that a simplified permitting process along with programmatic support would promote and help to grow private forestry and that Nepal’s experience and lessons learned from community forest implementation would be a great asset to move towards this end. Connecting community forest user groups for organised and cooperative action, and mobilising their institutional strength and accumulated funds for pro-farmer technical and regulatory support would allow farmers to intensify tree plantations and forest management. Further steps are required to convince policymakers and secure necessary budgetary support to this end..

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