Implementation of maternal and perinatal death surveillance and response system among health facilities in Morogoro Region: a descriptive cross-sectional study

Abstract Background When used effectively, the Maternal and Perinatal Death Surveillance and Response (MPDSR) system can bring into reality a revolutionary victory in the fight against maternal and perinatal mortality from avoidable causes. This study aimed at determining the status of implementation of the system among health facilities in the Morogoro Region. Method This study was conducted among 38 health facilities from three districts of the Morogoro region, Tanzania, from April 27, 2020, to May 29, 2020. Quantitative data were collected through document review for MPDSR implementation status. The outcome was determined by using a unique scoring sheet with a total of 30 points. Facilities that scored less than 11 points were considered to be in the pre-implementation phase, those scored 11 to 17 were considered in the implementation phase, and those scored 18 to 30 were considered to be in the institutionalization phase. Results The majority 20(53 %) of health facilities were in the pre-implementation phase, only 15(40 %) of assessed health facilities were in the implementation phase, and few 3(8 %) of health facilities were in institutionalization phase. There was a strong evidence that MPDSR implementation was more advanced in urban compared to rural health facilities (Fisher’s test = 6.158, p = 0.049), hospitals compared to health centers (Fisher’s test =14.609, p <0.001) and private and faith-based organization than public facilities (Fisher’s test, 15.897 = p = 0.002). Conclusions The study revealed that health facilities in Morogoro Region have not adequately implemented the MPDSR system. The majority of health facilities in rural settings and owned by the government showed poor MPDSR implementation and hence called for immediate action to rectify the situation. Strengthen MPDSR implementation, health facilities should be encouraged to adhere to the available MPDSR guidelines in the process of death reviews. Transparent systems should also be established to ensure thorough tracking and follow-up of recommendations evolving from MPDSR reviews. Health facilities should also consider integrating MPDSR to other quality improvement teams to maximize its efficiency.

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Implementation of maternal and perinatal deaths surveillance and response system among health facilities in Rural Tanzania: Analytical cross-sectional study

10.21203/rs.3.rs-181872/v1 ◽

2021 ◽

Author(s):

Christina Kashililika ◽

Fabiola Vincent Moshi

Keyword(s):

Health Facility ◽

Cross Sectional Study ◽

Health Facilities ◽

Cross Sectional ◽

Perinatal Deaths ◽

Rural Tanzania ◽

Surveillance And Response ◽

The Status ◽

Bivariate Logistic Regression ◽

Implementation Status

Abstract BackgroundMaternal and Perinatal Deaths Review and Surveillance (MPDSR) system when used effectively has the power to bring into reality, a revolutionary victory in the fight against maternal and perinatal mortality from avoidable causes. This study aimed at determining the status of implementation of the system among health facilities in rural settings of Tanzania.MethodThis study was conducted among 38 health facilities from three districts of Morogoro region, Tanzania from April 27, 2020 to May 29, 2020. Quantitative data was collected through document review for MPDSR implementation status. The outcome was determined by using special scoring sheet with a total 30 points. Facilities that scored 10 points or above were considered to have satisfactory status of MPDSR implementation while the facilities that scored below 10 points were considered to have unsatisfactory status of MPDSR implementation. Bivariate logistic regression analyses were used to determine the predictors of implementation status among health facilities.ResultsMajority of health facilities 20(52.6%) had satisfactory MPDSR implementation status. The predictors of MPDSR implementation in a facility were level of health facility [Hospital (AOR = 11.945 at 95% CI = 1.133 – 125.942, P = 0.039)] and ownership of the facility [Public (AOR = 0.133 at 95% CI = 0.019 – 0.920, P = 0.041)].ConclusionMPDSR implementation status among health facility is on average not satisfactory. More efforts are needed to raise the status of MPDSR implementation in the country so that the maximum benefit of MPDSR is obtained.

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Implementation status of antimicrobial stewardship programs in hospitals: A quantitative analysis study in Ho Chi Minh city, Vietnam

MedPharmRes ◽

10.32895/ump.mpr.4.2.5 ◽

2020 ◽

Vol 4 (2) ◽

pp. 34-39

Author(s):

Thi-Hai-Yen Nguyen ◽

Truong Van Dat ◽

Phuong-Thao Huynh ◽

Chi-Thuong Tang ◽

Vinh-Chau Van Nguyen ◽

...

Keyword(s):

Antimicrobial Stewardship ◽

Health Workers ◽

Cross Sectional Study ◽

Ho Chi Minh City ◽

Multi Drug Resistance ◽

Cross Sectional ◽

Clostridioides Difficile ◽

The Status ◽

Specific Assessment ◽

Implementation Status

Vietnam has one of the highest multi drug resistance in Asia. Although, despite many efforts to implement the Antimicrobial Stewardship Programs (the ASP) since 2016, studies that on the implementation policy are very lacking of this program are limited. For that reason, we conducted this cross-sectional study to analyze the viewpoint of health workers (HWs) on the implementation of the ASP at some hospitals in Ho Chi Minh City (HCMC). An assessment of 234 HWs showed that the implementation of the ASP in HCMC hospitals was above average (62.7/100.0). A barrier to the implementation consisted of the deficiency in finances, guidelines for diagnosis, and specific interventions for some common infections, such as distributing current antibiogram and monitoring rate of Clostridioides difficile infections. These were the widely recognized problems in initially implementing the ASP. Although most HWs are aware of the importance of implementing the ASP (79.1%), the specific assessment has not been recorded clearly due to the numerous neutral responses. Despite the support of the leadership, the implementation still faces many difficulties and limitations, especially in 3rd and 4th class hospitals. Besides, there was a lack of wide dissemination of information on the ASP at each unit. To generalize the status of the ASP implementation, researchers should conduct qualitative and quantitative studies with a larger scale.

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Implementation status of morbidity and mortality conferences in Austrian hospitals-A cross-sectional national survey study

PLoS ONE ◽

10.1371/journal.pone.0248692 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0248692

Author(s):

Alexandru-Cristian Tuca ◽

Johanna Münch ◽

David L. B. Schwappach ◽

Andrea Borenich ◽

Chiara Banfi ◽

...

Keyword(s):

Hierarchical Structures ◽

Cross Sectional Study ◽

Morbidity And Mortality ◽

Survey Study ◽

Limiting Factor ◽

Cross Sectional ◽

The Status ◽

Blame Culture ◽

Morbidity And Mortality Conferences ◽

Implementation Status

Introduction Morbidity and mortality conferences (M&MCs) are an instrument for learning from past complications, unexpected follow-ups and deaths in hospitals and are important for improving patient safety. However, there are currently no quantitative data on the implementation of M&MCs in Austria. The aim of the study was to determine the status quo of the M&MCs in Austria. Materials and methods A national cross-sectional study was conducted by means of a survey of 982 chief physicians of surgical disciplines, internal medicine, anesthesiology, intensive care, gynecology/obstetrics and pediatrics. The questionnaire focused on overall goals, structure and procedures of hospital M&MCs. Results Of the 982 contacted chief physicians, 314 (32.0%) completed the survey. Almost two thirds of the respondents, i.e. 203 (64.7%), had already implemented M&MCs. Of the 111 chief physicians who had not yet introduced M&MCs, 62 (55.9%) were interested in introducing such conferences in the future. Of the 203 respondents that had implemented M&MCs, 100 stated that their M&MC could be improved. They reported issues with "shame and blame" culture, hierarchical structures, too little knowledge about the capability of M&MC and, in particular, time constraints. Overall, the participating chief physicians showed that they are striving to improve their existing M&MCs. Discussion/Conclusion While we found a relatively high number of already implemented M&MCs we also identified a large heterogeneity in the format of the M&MCs. A highly structured M&MC including guidelines, checklists or templates does not only considerably improve its outcome but can also alleviate the main limiting factor which is the lack of time.

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Assessment of Preparedness of Government of Nepal in COVID Designated Hospitals and Clinics for Pandemic Response

Journal of Nepal Health Research Council ◽

10.33314/jnhrc.v19i1.3237 ◽

2021 ◽

Vol 19 (1) ◽

pp. 48-54

Author(s):

Pradip Gyanwali ◽

Navindra Raj Bista ◽

Mira Khadka ◽

Anju Vaidya ◽

Namra Kumar Mahato ◽

...

Keyword(s):

Cross Sectional Study ◽

Infection Prevention And Control ◽

Cross Sectional ◽

Face To Face ◽

Care Workers ◽

Response Status ◽

The Status ◽

Service Training ◽

The Government ◽

And Control

Background: Preparedness, readiness, and response status of any country is integral in identifying, managing, and preventing COVID-19 pandemic. The objective of this study is to assess the status of the Government of Nepal designated COVID hospitals and COVID clinics to respond against COVID-19. Methods: A cross sectional study was conducted with the focal persons of COVID hospitals and COVID clinics using a semi-structured questionnaire from April 26, 2020 to May 27, 2020 via face to face interview with onsite observation and telephonic interview in few unreachable health facilities. Results: Government of Nepal designated COVID hospitals and COVID clinics demonstrated efforts in establishing preparedness plans and committees such as COVID management core team (96.7% and 86%), provision of coordination with the government authority (both 100% ), preparedness response plan (93.3% and 84%), and infection prevention and control committee (63.3% and 65.6%) to respond to COVID-19 respectively. The participants reported differences in training provided to their health care workers with maximum COVID hospitals (80%) providing training on use of personal protective equipment and least (43.3%) on handling dead bodies. Only half of the COVID clinics (49.5%) had provision of triage systems.Conclusions: COVID hospitals and COVID clinics in Nepal demonstrated different status of COVID pandemic preparedness and readiness. In case of surge, Nepalese hospitals would struggle due to lack of trained workforce and infrastructure. Interdisciplinary, multi-sectoral collaboration with various focused strategies, including in-service training to staff, is paramount to increase preparedness and readiness. Keywords: COVID-19; Nepal; preparedness; readiness

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Do older people with cardiovascular-metabolic multimorbidity prefer to sign contracts for family doctor services? Evidence from a cross-sectional study in rural Shandong, China

BMC Geriatrics ◽

10.1186/s12877-021-02543-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Shijun Yang ◽

Jie Li ◽

Peipei Fu ◽

Yan Chen ◽

Yi Wang ◽

...

Keyword(s):

Older Adults ◽

Older People ◽

Family Doctor ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Logistic Analysis ◽

The Status ◽

The Government ◽

Rural Older Adults

Abstract Background Family doctor policy is an important part of deepening healthcare reform in China. The study aimed to explore the association between cardiovascular-metabolic multimorbidity and the status of signing a contract for family doctor services among the older people in rural Shandong, China. Methods A cross-sectional study was conducted in 3 cities of Shandong province, China. A total of 1395 rural residents over 60 years of age were included in this study using a multistage stratified random sampling method. Covariates included demographic and socioeconomic characteristics, health-related characteristics, health service utilization, and awareness of family doctor contract services. The univariate and multivariate regression logistic analysis was used to analyze the data. Results There were 28.2% of the rural older people contracted for the family doctor contract services. The contract rate of seniors with cardiovascular-metabolic multimorbidity was statistically higher than those without cardiovascular-metabolic multimorbidity (OR = 1.67, 95%CI, 1.21-2.32) after controlling for confounding factors. In addition, occupation, physical activities, self-rated health status, distance from the village clinic, the awareness of family doctor contract services were found to be associated with the signing behavior among the rural older adults. Conclusion This study demonstrated that the rural older people with cardiovascular-metabolic multimorbidity had a higher family doctor contract rate than those without cardiovascular-metabolic multimorbidity, and there was a gap between the current signing rate and the policy goal. To increase the rate of signing for family doctor contract services, the government should take joint efforts to expand the publicity and coverage, and give priority to meeting the healthcare demands of rural older adults with cardiovascular-metabolic multimorbidity.

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Storage management and wastage of reproductive health medicines and associated challenges in west Wollega zone of Ethiopia: a mixed cross-sectional descriptive study

BMC Health Services Research ◽

10.1186/s12913-021-06291-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Oliyad Kebede ◽

Gizachew Tilahun ◽

Desalegn Feyissa

Keyword(s):

Reproductive Health ◽

Supply And Demand ◽

Health Department ◽

Storage Conditions ◽

Cross Sectional Study ◽

Health Facilities ◽

Health Centers ◽

Cross Sectional ◽

Store Management ◽

The Government

Abstract Background Keeping proper storage conditions at health facilities is vital to reduce pharmaceutical wastage caused by environmental factors. The expiration of medicines at the health facilities could lead to wastage of potentially life-saving drugs and unnecessary expenditure on the disposal of those expired medicines. Therefore, the aim of this study was to assess pharmaceutical stores and wastage of reproductive health medicines due to expiration in the west Wollega zone of Ethiopia. Method We conducted a facility-based cross-sectional study from 15th to 31st July 2019 using quantitative and qualitative data from West Wollega Zone of Ethiopia. Results Among 23 health facilities assessed, 17 (73.91%) (4(100%) hospitals and 13(68.42%) health centers) fulfilled desirable storage conditions. Hospitals’ stores had equipment and furniture, fulfilled desirable storage conditions, whereas, a significant number of the health centers’ stores did not comply with desirable storage conditions. Challenges of store management identified were poor store infrastructure and shortage of manpower. The total value of reproductive health medicines wasted due to expire in surveyed facilities was 357,920.52 ETB (12,323.81 US dollars) and the Percentage of Stock Wasted due to Expiration was 8.04%. Levonorgestrel 0.75 mg tablet is the highest in the percentage of stock wasted due to expiry. Factors contributing to wastage due to expiration were supply and demand imbalance. Conclusion Reproductive health medicines wasted due to expiration is high compared to the government of Ethiopia’s plan for the year 2018/19. This might imply that the monitoring of this plan is poor. Even though hospitals store management is good, there is a weakness in store management in health centers. This could be due to poor attention given to health centers. Therefore, west Wollega zonal health department should appropriately monitor the wastage of Reproductive health medicines and enforce health centers to follow appropriate storage guidelines. Hospitals and health centers should not accept medicines beyond their need to reduce expiry.

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Association between participation in the government subsidy programme for domestic travel and symptoms indicative of COVID-19 infection in Japan: cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2021-049069 ◽

2021 ◽

Vol 11 (4) ◽

pp. e049069

Author(s):

Atsushi Miyawaki ◽

Takahiro Tabuchi ◽

Yasutake Tomata ◽

Yusuke Tsugawa

Keyword(s):

Sore Throat ◽

Fixed Effects ◽

Cross Sectional Study ◽

High Fever ◽

Internet Survey ◽

Government Subsidy ◽

Sampling Weights ◽

Cross Sectional ◽

Taste Disorder ◽

The Government

ObjectiveTo investigate the association between participation in government subsidies for domestic travel (subsidise up to 50% of all travel expenses) introduced nationally in Japan on 22 July 2020 and the incidence of symptoms indicative of COVID-19 infections.DesignCross-sectional analysis of nationally representative survey data.SettingInternet survey conducted between 25 August and 30 September 2020 in Japan. Sampling weights were used to calculate national estimates.Participants25 482 survey respondents (50.3% (12 809) women; mean (SD) age, 48.8 (17.4) years).Main outcome measuresIncidence rate of five symptoms indicative of the COVID-19 infection (high fever, sore throat, cough, headache, and smell and taste disorder) within the past month of the survey, after adjustment for characteristics of individuals and prefecture fixed effects (effectively comparing individuals living in the same prefecture).ResultsAt the time of the survey, 3289 (12.9%) participated in the subsidy programme. After adjusting for potential confounders, we found that participants in the subsidy programme exhibited higher incidence of high fever (adjusted rate, 4.7% for participants vs 3.7% for non-participants; adjusted OR (aOR) 1.83; 95% CI 1.34 to 2.48; p<0.001), sore throat (19.8% vs 11.3%; aOR 2.09; 95% CI 1.37 to 3.19; p=0.002), cough (19.0% vs 11.3%; aOR 1.96; 95% CI 1.26 to 3.01; p=0.008), headache (29.2% vs 25.5%; aOR 1.24; 95% CI 1.08 to 1.44; p=0.006) and smell and taste disorder (2.6% vs 1.8%; aOR 1.98; 95% CI 1.15 to 3.40; p=0.01) compared with non-participants. These findings remained qualitatively unaffected by additional adjustment for the use of 17 preventative measures (eg, social distancing, wearing masks and handwashing) and fear against the COVID-19 infection.ConclusionsThe participation of the government subsidy programme for domestic travel was associated with a higher probability of exhibiting symptoms indicative of the COVID-19 infection.

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Determinants of alcohol consumption and marijuana use among young adults in the Republic of Palau

Environmental Health and Preventive Medicine ◽

10.1186/s12199-020-00928-8 ◽

2021 ◽

Vol 26 (1) ◽

Author(s):

Mizuki Sata ◽

Renzhe Cui ◽

Chifa Chiang ◽

Singeru Travis Singeo ◽

Berry Moon Watson ◽

...

Keyword(s):

Young Adults ◽

Alcohol Consumption ◽

Age Groups ◽

Marijuana Use ◽

Cross Sectional Study ◽

Cross Sectional ◽

Education Levels ◽

The Status ◽

The Republic ◽

Republic Of Palau

Abstract Background This study aimed to describe the status of alcohol consumption and drug use among young adults as well as their determinants. Methods We conducted a cross-sectional study of 356 young adults (aged 18 to 24 years) living in Palau in 2013. The prevalence of self-reported alcohol and marijuana usage were compared within and between sexes, age groups, ethnicities, and education levels. Results The proportion of current drinking was higher in people aged 21–24 than in those aged 18–20 (73.2% vs. 60.9%, p = 0.09 in men and 48.3% vs. 30.0%, p = 0.02 in women), while that of marijuana use did not differ between the age groups. The proportions of current drinking and marijuana use were higher in Palauan than in other ethnicities (current drinking: 70.6% vs. 40.6%, p = 0.005 in men and 38.8% vs. 16.6%, p = 0.04 in women; lifetime marijuana use: 80.0% vs. 52.9%, p = 0.02 in men and 56.1% vs. 30.6%, p = 0.09 in women). The proportion of frequent (3 times or more) marijuana users was higher for the lower educated than for the higher educated (62.5% vs. 32.1%, p < 0.001 in men and 33.9% vs. 24.4%, p = 0.12 in women). Conclusions Sex, age, ethnicity, and education were significant determinants of alcohol and marijuana use.

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Government management capacities and the containment of COVID-19: a repeated cross-sectional study across Chinese cities

BMJ Open ◽

10.1136/bmjopen-2020-041516 ◽

2021 ◽

Vol 11 (4) ◽

pp. e041516

Author(s):

Wenchao Li ◽

Jing Li ◽

Junjian Yi

Keyword(s):

Outcome Measures ◽

Cross Sectional Study ◽

Control Measures ◽

Secondary Outcome ◽

Cross Sectional ◽

Travel Restrictions ◽

Government Management ◽

The Government ◽

Laws And Policies ◽

Novel Coronavirus

ObjectivesBetter understanding of the dynamics of the COVID-19 (2019 novel coronavirus disease) pandemic to curb its spread is now a global imperative. While travel restrictions and control measures have been shown to limit the spread of the disease, the effectiveness of the enforcement of those measures should depend on the strength of the government. Whether, and how, the government plays a role in fighting the disease, however, has not been investigated. Here, we show that government management capacities are critical to the containment of the disease.SettingWe conducted a statistical analysis based on cross-city comparisons within China. China has undergone almost the entire cycle of the anticoronavirus campaign, which allows us to trace the full dynamics of the outbreak, with homogeneity in standards for statistics recording.Primary and secondary outcome measuresOutcome measures include city-specific COVID-19 case incidence and recoveries in China.ResultsThe containment of COVID-19 depends on the effectiveness of the enforcement of control measures, which in turn depends on the local government’s management capacities. Specifically, government efficiency, capacity for law enforcement, and the transparency of laws and policies significantly reduce COVID-19 prevalence and increase the likelihood of recoveries. The organisation size of the government, which is not closely related to its capacity for management, has a limited role.

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Student and educator perspectives on virtual institutional introductory pharmacy practice experience (IPPE)

BMC Medical Education ◽

10.1186/s12909-021-02698-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Omar A. Almohammed ◽

Lama H. Alotaibi ◽

Shatha A. Ibn Malik

Keyword(s):

Pharmacy Practice ◽

Cross Sectional Study ◽

Training Experience ◽

Cross Sectional ◽

Virtual Training ◽

Care Experience ◽

Face To Face ◽

Practice Experience ◽

Face To Face Learning ◽

The Government

Abstract Background The COVID-19 pandemic has required governments around the world to suspend face-to-face learning for school and university students. Colleges of pharmacy are faced with the challenge of training students in hospitals that are under considerable pressure at this time. The government of Saudi Arabia has moved all classes and training online to limit the spread of the virus. This study describes the experience of the Introductory and Advanced Pharmacy Practice Experience (IPPE and APPE) students and preceptors engaged in the virtual IPPE training. Methods A cross-sectional study was conducted to describe and appraise the implemented virtual IPPE training from the experiences of IPPE and APPE students, and their preceptor. The IPPE students described their experiences in close-ended questionnaires, while APPE students in open-ended questionnaires, and the preceptor described the experiences in narrative. The study focused on highlighting the advantages, opportunities, challenges, and shortcomings of the virtual training. Results Two preceptors and seven APPE students participated in the preparation and administration of the virtual training. The IPPE students’ experiences, based on 87 respondents, were mostly positive. Although IPPE students enjoyed the time flexibility that allowed the learning of new skills and reflection on previous experiences, 15% experienced difficulty finding quiet places with a reliable internet connection or had difficulty working on team-based activities. Moreover, some were anxious about the lack of adequate patient-care experience. On the other hand, the APPE students found the experience enriching as they gained experience and understanding of academic workflow, gained skills, and overcame the challenges they faced during this virtual training experience. Conclusions Future training programs should be organized to overcome the challenges and to maximize the benefits of training experiences. Schools of pharmacy may benefit from the training materials constructed, prepared, and administered by APPE students to improve IPPE students’ learning experiences and outcomes.

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